COMMENTARY

The Clinical Management of Gastroesophageal Varices

Rowen K. Zetterman, MD

Disclosures

January 20, 2012

In This Article

Secondary Prophylaxis Following Variceal Hemorrhage

The risk for rebleeding from esophageal varices after initial control is approximately 70% if no further treatment is provided.[37]Overall mortality from rebleeding is 30% and is more frequent with large varices, initial severe hemorrhage, and decompensated liver disease.[38] As noted, banding is more effective than sclerotherapy for long-term management of esophageal varices, especially when used in combination with beta-blocker therapy. For patients who have portal hypertensive gastropathy as a cause of initial gastrointestinal bleeding, long-term beta-blocker therapy should be provided.

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