Preventing a first episode of esophageal variceal hemorrhage

Cleve Clin J Med. 2008 Mar;75(3):235-44. doi: 10.3949/ccjm.75.3.235.


In patients with esophageal varices, hemorrhage is common and often lethal, so we need to take a proactive approach to preventing a first episode of bleeding. All patients with cirrhosis should undergo endoscopy to look for varices. Depending on the size and appearance of the varices and the patient's Child-Pugh grade, prophylactic treatment may be indicated.

Publication types

  • Review

MeSH terms

  • Angiotensin Receptor Antagonists
  • Decision Trees
  • Decompression, Surgical
  • Esophageal and Gastric Varices / complications*
  • Esophageal and Gastric Varices / drug therapy
  • Esophageal and Gastric Varices / etiology
  • Esophageal and Gastric Varices / surgery
  • Esophageal and Gastric Varices / therapy*
  • Esophagoscopy
  • Gastrointestinal Hemorrhage / drug therapy
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / prevention & control*
  • Hepatic Veins / physiopathology
  • Humans
  • Ligation
  • Liver Cirrhosis / complications*
  • Portal Pressure
  • Risk Factors
  • Sclerotherapy / mortality
  • Severity of Illness Index


  • Angiotensin Receptor Antagonists