Conservative Treatment: Pharmacological Therapy

  • Hisashi HidakaEmail author


Current pharmacological therapy for the management of variceal hemorrhage consists of splanchnic vasoconstrictors (vasopressin and analogues, somatostatin and analogues, nonselective beta-blockers [NSBBs]), splanchnic vasodilators (nitrates and angiotensin receptor blockers), gastric acid-suppressive drugs, and prophylactic antibiotics. Several studies have shown that NSBBs are effective in decreasing portal venous pressure and the risk of variceal hemorrhage. However, approximately 15% of patients with risky varices have contraindications to the use of NSBBs. Furthermore, a meta-analysis showed that NSBBs did not significantly reduce the first variceal hemorrhage in patients with small varices. Further studies are warranted to determine the potential of drugs (besides NSBBs) as an alternative or adjunct to NSBBs.


Esophagogastric varices Portal hypertension Cirrhosis Nonselective beta-blockers Mortality 


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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Gastroenterology, Internal MedicineKitasato University School of MedicineSagamiharaJapan

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