Editing Oesophageal/gastric varices (section)

=== Long-term management of     varices ===

** Medical management
*** Compensated cirrhosis:       carvedilol - prevents bleeding, possible survival benefit
*** Decompensated cirrhosis:       propanolol - less reduction in SBP
** Endoscopic surveillance
*** Scope every 1-3 years in       stable patients without known varices
*** Once varices have been       identified, repeat scope and band ligation every 2-4 weeks until varices       are down to grade I, then every three months for a year, then annually
*** Reduces risk of bleeding       and mortality
** Continue chronic endoscopic      therapy until patient develops an indication for further treatment (TIPS,      shunt, liver transplant):
*** Uncontrolled haemorrhage
*** Multiple major episodes of       re-bleeding
*** Hypertensive gastropathy