The Role of Medical Therapy for Variceal Bleeding

Abdul Q Bhutta; Guadalupe Garcia-Tsao

doi:10.1016/j.giec.2015.03.001

The Role of Medical Therapy for Variceal Bleeding

Gastrointest Endosc Clin N Am. 2015 Jul;25(3):479-90. doi: 10.1016/j.giec.2015.03.001. Epub 2015 Apr 20.

Authors

Abdul Q Bhutta¹, Guadalupe Garcia-Tsao²

Affiliations

¹ Department of Internal Medicine, Yale University, 330 Cedar St, Boardman 110 P.O. Box 208056, New Haven, CT 06520-8056, USA; Section of Hospital Medicine, Yale-New Haven Hospital, 20 York Street, CB-2041, New Haven, CT 06520, USA.
² Section of Digestive Diseases, Yale University School of Medicine, 333 Cedar St, 1080 LMP, P.O. Box 208019, New Haven, CT 06520-8019, USA; Section of Digestive Diseases, VA-CT Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, USA. Electronic address: guadalupe.garcia-tsao@yale.edu.

PMID: 26142033
DOI: 10.1016/j.giec.2015.03.001

Abstract

Acute variceal hemorrhage (AVH) is a lethal complication of portal hypertension and should be suspected in every patient with liver cirrhosis who presents with upper gastrointestinal bleed. AVH-related mortality has decreased in the last few decades from 40% to 15%-20% due to advances in the general and specific management of variceal hemorrhage. This review summarizes current management of AVH and prevention of recurrent hemorrhage with a focus on pharmacologic therapy.

Keywords: Cirrhosis; Drug therapy; Nonselective β-blockers; Octreotide; Pharmacologic bases; Somatostatin; Terlipressin; Variceal hemorrhage.

Publication types

Research Support, N.I.H., Extramural
Review

MeSH terms

Disease Management*
Esophageal and Gastric Varices / complications*
Gastrointestinal Hemorrhage / drug therapy*
Gastrointestinal Hemorrhage / etiology
Humans
Vasoconstrictor Agents / therapeutic use*

Substances

Vasoconstrictor Agents

Abstract

Publication types

MeSH terms

Substances

Grants and funding