Health Library

 

Cirrhosis: Beta-Blockers for Portal Hypertension and Varices

Topic Overview

In people who have cirrhosis, portal hypertension causes many problems. One serious complication is bleeding of enlarged veins, or varices, in the digestive tract (variceal bleeding).

When the buildup of scar tissue caused by cirrhosis reduces the flow of blood through the liver, pressure may build up in the portal vein system, which filters blood from the intestines through the liver. In turn, veins in the esophagus, stomach, and rectum may enlarge to accommodate the pressure from the blocked blood flow. The walls of these expanded veins become thin and may rupture and bleed.

One way to prevent an episode of variceal bleeding is to lower the blood pressure in the enlarged veins. By slowing the heart rate and widening the blood vessels, beta-blocker medicines such as propranolol and nadolol appear to lower the blood pressure in varices that bypass the liver. In people who have esophageal varices, beta-blockers have been shown to reduce the risk of having a first episode of bleeding.1 They are usually prescribed for people who have moderate-to-large varices.

Beta-blockers may cause side effects that lead people to stop taking them. Common side effects can include fatigue and dizziness. Less common side effects can include asthma getting worse, nightmares, or confusion. Rapid heart rate and high blood pressure can occur if the medicine is withdrawn suddenly. Studies have shown that for people who have high-risk varices and cannot take beta-blockers because of side effects, other treatment options such as variceal banding may be a better choice.1

References

Citations

  1. Garcia-Tsao G, et al. (2007). Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. American Journal of Gastroenterology, 102(9): 2086–2102.

Credits

By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer W. Thomas London, MD - Hepatology
Current as of March 12, 2014

Current as of: March 12, 2014

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

© 1995-2014 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

First Nurse

First Nurse

Call First Nurse 24 Hours a Day for free health care advice, resources and referrals!

Ames: 515-239-6877
In Iowa: 800-524-6877 

Search health information online in our Mulimedia Health Library.

Symptom Checker

Use our interactive symptom checker to evaluate your symptoms and determine appropriate action or treatment.

Symptom Checker

Patient Privacy | Net Learning for Employees | MGMC PACS for Physicians
Emergency Preparedness

1111 Duff Avenue Ames, IA 50010 - 515-239-2011 - yourhealth.mgmc@mgmc.com

©2014 Mary Greeley Medical Center - All rights reserved.