An evidence-based approach to the treatment of esophageal variceal bleeding

Esophageal varices are a life threatening cause of gastrointestinal bleeding. Management includes both primary prevention of variceal bleeding and treatment of actively bleeding varices. Evidence from randomized controlled trials indicates that beta blockers and nitrates may prevent the initial episode of bleeding varices. Ample data from randomized controlled trials indicate that band ligation is more effective than scleropathy for the treatment of bleeding esophageal varices. Somatostatin may decrease rebleeding rates with or without endoscopic therapy. No effective treatment has been developed for the treatment of patients who fail endoscopic therapy.