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Cirrhosis: Beta-Blockers for Portal Hypertension and Varices

Overview

Beta-blocker medicines are used to prevent an episode of variceal bleeding by lowering the blood pressure in the enlarged veins (varices). Variceal bleeding occurs when the blood pressure increases in the portal vein system and the veins in the esophagus, stomach, and rectum enlarge to accommodate blocked blood flow through the liver.

By slowing the heart rate and widening the blood vessels, beta-blocker medicines such as propranolol and nadolol appear to lower the blood pressure in varices that bypass the liver. In people who have esophageal varices, beta-blockers have been shown to reduce the risk of having a first episode of bleeding.footnote 1 They are usually prescribed for people who have moderate-to-large varices.

References

Citations

  1. Garcia-Tsao G, et al. (2007). Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. American Journal of Gastroenterology, 102(9): 2086–2102.

Credits

Current as of: February 10, 2021

Author: Healthwise Staff
Medical Review:
Adam Husney MD - Family Medicine
W. Thomas London MD - Hepatology