title: Towards noninvasive detection of oesophageal varices.
abstract: Current guidelines recommend that all cirrhotic patients should undergo screening endoscopy at diagnosis to identify patients with varices at high risk of bleeding who will benefit from primary prophylaxis. This approach places a heavy burden upon endoscopy units and the repeated testing over time may have a detrimental effect on patient compliance. Noninvasive identification of patients at highest risk for oesophageal varices would limit investigation to those most likely to benefit. Upper GI endoscopy is deemed to be the gold standard against which all other tests are compared, but is not without its limitations. Multiple studies have been performed assessing clinical signs and variables relating to liver function, variables relating to liver fibrosis, and also to portal hypertension and hypersplenism. Whilst some tests are clearly preferable to patients, none appear to be as accurate as upper GI endoscopy in the diagnosis of oesophageal varices. The search for noninvasive tests continues.
authors.affiliation: Liver Unit, Royal Derby Hospital, Uttoxeter Road, Derby DE22 3NE, UK.
authors.forename: Kara
authors.initials: K
authors.lastname: Rye
authors.forename: Robert
authors.initials: R
authors.lastname: Scott
authors.forename: Gerri
authors.initials: G
authors.lastname: Mortimore
authors.forename: Adam
authors.initials: A
authors.lastname: Lawson
authors.forename: Andrew
authors.initials: A
authors.lastname: Austin
authors.forename: Jan
authors.initials: J
authors.lastname: Freeman