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Preventing Variceal Bleeding: Strategies That Save Lives
Published: Sep 23, 2024
Preventing variceal bleeding is crucial for people with liver disease. With the right strategies, many life-threatening episodes can be avoided.
Medications: The First Line of Defense
Beta blockers are the cornerstone of prevention for many patients. These medications work by lowering blood pressure in the portal vein, reducing the risk of varices bursting. Carvedilol is often the first choice for patients with compensated cirrhosis, while other beta blockers may be used in more advanced cases.
Endoscopic Banding: Tying Off the Threat
For patients who can't take beta blockers, endoscopic variceal ligation (EVL) is an effective alternative. This procedure involves placing small rubber bands around the varices to cut off their blood supply. It's usually done in several sessions until the varices are eliminated.
Lifestyle Changes: Supporting Your Liver
Preventing variceal bleeding also involves managing underlying liver disease. This includes avoiding alcohol, maintaining a healthy diet, and treating conditions like hepatitis. For some patients, weight loss and controlling diabetes can also help reduce portal pressure.
Frequently Asked Questions
They can reduce the risk of first bleeding by about 40%.
Beta blockers may cause fatigue; EVL can cause temporary discomfort.
Usually long-term, but it depends on your liver condition.
The Bottom Line
Preventing variceal bleeding is a crucial part of managing liver disease and can significantly improve outcomes.
References
- Garcia-Tsao G, Bosch J. Management of varices and variceal hemorrhage in cirrhosis. N Engl J Med 2010; 362:823.
- Tripathi D, Stanley AJ, Hayes PC, et al. U.K. guidelines on the management of variceal haemorrhage in cirrhotic patients. Gut 2015; 64:1680.
- Villanueva C, Albillos A, GenescΓ J, et al. Ξ² blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet 2019; 393:1597.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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