Gastrointestinal varices primary prevention: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Gastrointestinal varices}} | {{Gastrointestinal varices}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}{{HK}} | ||
==Overview== | ==Overview== | ||
Primary prevention of variceal bleeding may be achieved via rigorous surveillance of varices after their development and via the use non-selective beta blockers and/or endoscopic band ligation (EBL). Liver disease is the most common cause of portal hypertension and effective measures for the [[primary prevention]] of [[liver diseases]] include [[hepatitis B]] [[vaccination]], avoidance from [[Unprotected sex|unprotected sexual intercourse]], precise [[screening]] of the [[Blood product|blood products]] before infusion, reducing [[alcohol consumption]], [[obesity]] prevention, and [[diabetes mellitus]] prevention. | |||
==Primary Prevention== | ==Primary Prevention== | ||
*Effective measures to prevent variceal bleeding include the following: | |||
'''Cirrhosis''' | |||
*Diagnostic endoscopy for the presence of varices | |||
'''No varices''' | |||
*Surveillance for development of varices (every 2-3 yr in compensated cirrhosis/yearly in cases of decompensation) | |||
'''Small varices-low bleeding risk''' | |||
*Surveillance for progression of varices (every 1-2 yr in compensated cirrhosis/yearly in cases of decompensation) | |||
'''Small varices-high bleeding risk''' | |||
*Non-selective beta blockers | |||
'''Medium-large varices''' | |||
*Non-selective beta blockers or endoscopic band ligation (EBL) | |||
* There are no established measures for the [[primary prevention]] of portal hypertension. | |||
* Effective measures for the [[primary prevention]] of [[liver diseases]], as the main causes of portal hypertension, include:<ref name="pmid21877109">{{cite journal |vauthors=Flores YN, Lang CM, Salmerón J, Bastani R |title=Risk factors for liver disease and associated knowledge and practices among Mexican adults in the US and Mexico |journal=J Community Health |volume=37 |issue=2 |pages=403–11 |year=2012 |pmid=21877109 |doi=10.1007/s10900-011-9457-4 |url=}}</ref> | |||
** Prevention of [[hepatitis B]] through [[vaccination]] | |||
** Avoid [[Unprotected sex|unprotected sexual intercourse]] | |||
** Prevention of [[hepatitis C]] through precise [[screening]] of the [[Blood product|blood products]] before [[infusion]] | |||
** Reduction of [[alcohol consumption]] | |||
** Prevention of [[overweight]] and [[obesity]] | |||
** Prevention of [[diabetes mellitus]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Gastroenterology]] | |||
Revision as of 04:36, 8 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
Primary prevention of variceal bleeding may be achieved via rigorous surveillance of varices after their development and via the use non-selective beta blockers and/or endoscopic band ligation (EBL). Liver disease is the most common cause of portal hypertension and effective measures for the primary prevention of liver diseases include hepatitis B vaccination, avoidance from unprotected sexual intercourse, precise screening of the blood products before infusion, reducing alcohol consumption, obesity prevention, and diabetes mellitus prevention.
Primary Prevention
- Effective measures to prevent variceal bleeding include the following:
Cirrhosis
- Diagnostic endoscopy for the presence of varices
No varices
- Surveillance for development of varices (every 2-3 yr in compensated cirrhosis/yearly in cases of decompensation)
Small varices-low bleeding risk
- Surveillance for progression of varices (every 1-2 yr in compensated cirrhosis/yearly in cases of decompensation)
Small varices-high bleeding risk
- Non-selective beta blockers
Medium-large varices
- Non-selective beta blockers or endoscopic band ligation (EBL)
- There are no established measures for the primary prevention of portal hypertension.
- Effective measures for the primary prevention of liver diseases, as the main causes of portal hypertension, include:[1]
- Prevention of hepatitis B through vaccination
- Avoid unprotected sexual intercourse
- Prevention of hepatitis C through precise screening of the blood products before infusion
- Reduction of alcohol consumption
- Prevention of overweight and obesity
- Prevention of diabetes mellitus
References
- ↑ Flores YN, Lang CM, Salmerón J, Bastani R (2012). "Risk factors for liver disease and associated knowledge and practices among Mexican adults in the US and Mexico". J Community Health. 37 (2): 403–11. doi:10.1007/s10900-011-9457-4. PMID 21877109.