Premium
Variceal bleed: secondary prophylaxis‐ drugs versus endoscopy
Author(s) -
LO GINHO
Publication year - 2004
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2004.03673.x
Subject(s) - medicine , sclerotherapy , nadolol , medical therapy , endoscopy , bleed , surgery , ligation , cimetidine , esophageal varices , varix , varices , portal hypertension , propranolol , cirrhosis
Variceal rebleeding is frequently encountered in cirrhotic patients surviving an episode of acute esophageal variceal hemorrhage. Endoscopic therapy has evolved from injection sclerotherapy to banding ligation. Medical therapy evolves from propranolol to combination of nadolol and isosorbide‐5‐mononitrate. Either endoscopic therapy or medical therapy could be helpful for the majority of patients. The combination of endoscopic therapy and medical therapy is a logical approach to prevent variceal rebleeding. For failure cases, rescue therapy with transjugular intrahepatic porto‐systemic stent shunt or surgery ay be required.