Portal hypertensive gastropathy with a focus on management

Patrick Snyder, Rabia Ali, Michael Poles, Seth A. Gross

Research output: Contribution to journalReview article

4 Scopus citations

Abstract

Portal hypertensive gastropathy (PHG) is a painless condition of gastric mucosal ectasia and impaired mucosal defense, commonly seen in patients with elevated portal pressures. While it is typically asymptomatic and incidentally discovered on upper endoscopy, acute and chronic bleeding may occur. There are no definitive recommendations for treatment of asymptomatic PHG. Non-selective β-blockers represent the mainstay of therapy for chronic bleeding, while somatostatin and vasopressin and their derivatives may be used in conjunction with supportive measures for acute bleeding. Salvage therapy with transjugular intrahepatic portosystemic shunt or rarely surgical shunt is appropriate when medical management fails. The role of endoscopic therapy for PHG is controversial. Liver transplantation should be considered as a final resort in cases of refractory bleeding due to PHG.

Original languageEnglish (US)
Pages (from-to)1207-1216
Number of pages10
JournalExpert Review of Gastroenterology and Hepatology
Volume9
Issue number9
DOIs
StatePublished - Sep 2 2015
Externally publishedYes

Keywords

  • Anemia
  • Cirrhosis
  • Congestive gastropathy
  • Hemorrhage
  • Portal hypertension
  • Portal hypertensive gastropathy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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