Management of Portal Hypertensive Gastropathy and Gastric Antral Vascular Ectasia

Portal hypertensive gastropathy (PHG) and gastric antral vascular ectasia (GAVE) are significant causes of gastrointestinal bleeding in patients with cirrhosis. Researchers reviewed current management strategies for both conditions.

Regarding the management of PHG, the primary goal is reduction in portal hypertension with either beta-blockers or transjugular intrahepatic portosystemic shunt (TIPS) or surgical shunt. The main take-home points were as follows:

• No evidence exists for primary prophylaxis.

• Because of evidence that endoscopic therapy of varices increases the risk for developing PHG, the addition of beta-blocker therapy to endoscopic management of varices should reduce PHG development.

• For chronic bleeding, randomized studies have sho…