Variceal Banding

Variceal banding (ligation) is a procedure for people who’ve had bleeding varices (enlarged veins that rupture and bleed into the esophagus). It may also be done to prevent varices from bleeding.

During variceal banding, a doctor uses a gastroscope with a special attachment on its end to place a band—an elastic ring that looks like a rubber band—around an enlarged vein. The band cuts off the blood flow through the vein. This vein will then clot off and be absorbed by the body. Variceal banding is often done several times to control or prevent bleeding. For example, banding might be repeated every 2 to 6 weeks for 3 to 4 sessions. Your doctor will then check the banded varices every 3 to 12 months after that.

What to Expect

You’ll be asked to turn on your left side. Oxygen prongs will be placed in your nose to give you extra oxygen. A mouth guard will also be inserted to keep your mouth open.

You’ll be given medication to keep you comfortable. After this, a gastroscope will be inserted into your mouth through to your esophagus (food tube), stomach, and the first part of your small intestine (duodenum). The scope does not interfere with your breathing.

Through the camera on the gastroscope, the doctor can look for varices. If varices are found the doctor might chose to treat them with banding. A banding device will be attached to the end of the gastroscope, and the doctor will place bands around the varices.  After a few days, the bands fall off by themselves and are passed during a normal bowel movement.

After the procedure, you’ll be taken to the recovery area. You’ll stay there for up to two hours—until it’s determined that you’re ready to go home. You won’t be able to drive until the day after your procedure, so you need a responsible adult to pick you up and take you home.

For the first four hours after a variceal banding procedure, you should consume only clear liquids. After four hours, you can eat soft foods for the rest of the day.

You’ll tolerate the procedure well, but you may have a sore throat or chest for one or two days afterwards.

Let your healthcare providers know if you’re experiencing pain that is not manageable or if you’re having difficulty swallowing.

Warning: Signs of bleeding varices include black bowel movements and vomit that’s bloody or looks like coffee grounds. If you develop these signs or lightheadedness, go to an emergency room immediately. If left untreated, bleeding varices can lead to death.

Note: This section was adapted from content on HealthLinkBC.

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