Primary Prophylaxis of Variceal Bleeding in Liver Cirrhosis

Laura Piccolo Serafim, Douglas A. Simonetto

Research output: Chapter in Book/Report/Conference proceedingChapter


Variceal hemorrhage is a life-threatening complication of portal hypertension. Prevalence of gastroesophageal varices may reach 70% in patients with advanced liver disease; therefore prophylaxis of variceal bleeding is recommended for this population. Indications for primary prophylaxis include presence of large esophageal varices, presence of high-risk stigmata, and/or Child-Turcotte-Pugh class C in patients with small varices. Nonselective beta-blockers (NSBB) and endoscopic variceal band ligation are the cornerstone for prevention of first variceal bleeding. Although NSBB are preferred on patients with small esophageal varices and high-risk features, the decision should be individualized and contraindications and potential adverse effects of both therapies should be considered.

Original languageEnglish (US)
Title of host publicationVariceal Bleeding in Liver Cirrhosis
PublisherSpringer Singapore
Number of pages9
ISBN (Electronic)9789811572494
ISBN (Print)9789811572487
StatePublished - Jan 1 2020


  • Cirrhosis
  • Portal hypertension
  • Prophylaxis
  • Variceal bleeding

ASJC Scopus subject areas

  • General Medicine


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