Prevention of oesophageal variceal bleeds
Endoscopic ligation and sclerotherapy of varices are widely used to prevent gastrointestinal bleeding in patients with cirrhosis.
Although these techniques may obliterate the varices they do not affect the underlying pathology. Furthermore 50% of patients with a variceal bleed will bleed again before the varices are obliterated.
Beta-blockers are used to reduce portal pressure, but randomised trials have not shown conclusive efficacy.
A randomised trial of long-term octreotide in conjuction with endoscopic sclerotherapy has demonstrated significant reduction in rebleed rates.
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