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GI Board Review- Esophageal Varices 1

 

  1. If drugs not tolerated for primary prophylaxis of (non-bleeding) esophageal varices, consider band ligation of varices

  • Primary prophylaxis of ESOPHAGEAL varices in medium to large varices only (not in grade 1 varices)

  • If no large varices, then check in 1 year and then q 3 years or with change in functional status


  1. EGD for variceal screening is negative in patient with inactive disease (such as person with alcoholic cirrhosis who has stopped drinking or NASH with weight loss)- recheck q 3 years

  • EGD variceal screening recheck q 2 years in compensated cirrhosis with ongoing liver injury

  • EGD for variceal screening not indicated in patients with platelets > 150k and transient elastography < 20


  1. If EGD shows no varices after variceal bleed, repeat in 3-6 months and then q 6-12 months.

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