Q: My 55 years old wife had blood stained vomiting. She was given five units of blood as her haemoglobin was 3.6 and was admitted in the ICU. On endoscopy oesophagealo varices and peptic ulcer varices were ligated again on fifth day after admitting to ICU. At present she is on tab Ciplar LA 80 mg. Her spleen is 156 mm. She has to go to pass stools at least 4 times a day. Her splenic area is painful, however there is no bleeding. Please advise.

A:Bleeding from oesophageal/gastric varices is due to increased blood pressure in the liver circulation. This happens when the liver shrinks and scars form, a condition called cirrhosis. There are several conditions that cause this. The treatment is to control the bleeding by injections, which is a very acute and serious condition. Once this is achieved drugs are used to reduce and control blood pressure in the liver circulation. I am sure your local specialist will offer you good advice.