Clinical Gastroenterology Vol.27 No.2(3-1)

Theme Treatment for Portal Hypertension : Update
Title Pharmacological Therapy for Prevention of Variceal Bleeding
Publish Date 2012/02
Author Hisashi Hidaka Department of Gastroenterology, Internal Medicine, Kitasato University East Hospital
[ Summary ] We describe two new pharmacological therapies for esophageal varices, proton pump inhibitors (PPI) and angiotensin II type 1 receptor blocker (ARB). We demonstrated that long-term administration of PPIs reduced the risk of treatment failure, defined as variceal hemorrhage, and severe medical complications after endoscopic variceal ligation (EVL). Therefore, acid suppression therapy should also be considered as a treatment option after EVL. We demonstrated that olmesartan, an effective ARB, induced a significant reduction in portal pressure after one year of treatment in selected patients with cirrhosis. In Japan, endoscopic treatment is the first-option therapy for this condition and has been the most commonly performed procedure in recent years. Physicians should also consider pharmacological therapies for esophageal varices.
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