Endoscopy therapy and/or medications will be used to treat variceal bleeding when you are first diagnosed.
Endoscopic therapy consists of either sclerotherapy or banding. Sclerotherapy is a procedure in which the varices are injected with a solution that causes thrombosis and scarring. Banding is a procedure in which rubber bands are used to block the blood supply to the varices.
Medications such as beta blockers(propranolol), or nitrates (isosorbide mononitrate), may be prescribed alone or in combination with endoscopic therapy to reduce pressure in your varices and further reduce the risk of rebleeding. Endoscopic therapy and medications control bleeding in about 75% of patients.
If the first level of treatment fails, you will require decompression (reducing the pressure) of your varices.
Two options for decompression are the Transjugular
Intrahepatic Portalsystemic Shunt(TIPS) procedure and the Distal Splenorenal Shunt (DSRS) procedure.