2.50
Hdl Handle:
http://hdl.handle.net/11287/593863
Title:
Beta-blockers in liver cirrhosis
Authors:
Giannelli, V.; Lattanzi, B.; Thalheimer, Ulrich; Merli, M.
Abstract:
Since the original description of the effectiveness of beta-blockers in lowering the portal pressure and therefore the risk of variceal bleeding, more than 500 articles in the English literature on the use of non selective beta-blockers (NSBB) in cirrhosis have been published. The use of NSBB in pre-primary prophylaxis of variceal bleeding is currently not indicated. In primary prophylaxis, patients with high risk small varices or large/medium varices should receive primary prophylaxis either with NSBB or with endoscopic band ligation if there are contraindications to NSBB. For secondary prophylaxis the current recommendation is to receive a combination of NSBB and endoscopic variceal ligation. In addition to lowering portal pressure, NSBB can also reduce bacterial translocation, potentially exerting multiple beneficial effects which go beyond the reduction of bleeding risk. Carvedilol is a NSBB with intrinsic anti-alpha(1)-adrenergic activity, possibly more effective than propranolol in lowering portal hypertension. A potential harmful effect of propranolol in patients with cirrhosis with refractory ascites deserves further confirmation. NSBB remain the cornerstone of therapy in cirrhotic patients with portal hypertension.
Citation:
Ann Gastroenterol. 2014;27(1):20-26.
Publisher:
Hellenic Society of Gastroenterology
Journal:
Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology
Issue Date:
1-Jan-2014
URI:
http://hdl.handle.net/11287/593863
PubMed ID:
24714633
Additional Links:
http://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24714633/
Note:
This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
Type:
Review
Language:
Eng
ISSN:
1108-7471
Appears in Collections:
2014 RD&E publications; Gastroenterology

Full metadata record

DC FieldValue Language
dc.contributor.authorGiannelli, V.en
dc.contributor.authorLattanzi, B.en
dc.contributor.authorThalheimer, Ulrichen
dc.contributor.authorMerli, M.en
dc.date.accessioned2016-01-19T12:35:55Zen
dc.date.available2016-01-19T12:35:55Zen
dc.date.issued2014-01-01en
dc.identifier.citationAnn Gastroenterol. 2014;27(1):20-26.en
dc.identifier.issn1108-7471en
dc.identifier.pmid24714633en
dc.identifier.urihttp://hdl.handle.net/11287/593863en
dc.description.abstractSince the original description of the effectiveness of beta-blockers in lowering the portal pressure and therefore the risk of variceal bleeding, more than 500 articles in the English literature on the use of non selective beta-blockers (NSBB) in cirrhosis have been published. The use of NSBB in pre-primary prophylaxis of variceal bleeding is currently not indicated. In primary prophylaxis, patients with high risk small varices or large/medium varices should receive primary prophylaxis either with NSBB or with endoscopic band ligation if there are contraindications to NSBB. For secondary prophylaxis the current recommendation is to receive a combination of NSBB and endoscopic variceal ligation. In addition to lowering portal pressure, NSBB can also reduce bacterial translocation, potentially exerting multiple beneficial effects which go beyond the reduction of bleeding risk. Carvedilol is a NSBB with intrinsic anti-alpha(1)-adrenergic activity, possibly more effective than propranolol in lowering portal hypertension. A potential harmful effect of propranolol in patients with cirrhosis with refractory ascites deserves further confirmation. NSBB remain the cornerstone of therapy in cirrhotic patients with portal hypertension.en
dc.language.isoEngen
dc.publisherHellenic Society of Gastroenterologyen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24714633/en
dc.titleBeta-blockers in liver cirrhosisen
dc.typeReviewen
dc.identifier.journalAnnals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterologyen
dc.description.noteThis article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.en

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