title: U.K. guidelines on the management of variceal haemorrhage in cirrhotic patients.
abstract: These updated guidelines on the management of variceal haemorrhage have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines which this document supersedes were written in 2000 and have undergone extensive revision by 13 members of the Guidelines Development Group (GDG). The GDG comprises elected members of the BSG liver section, representation from British Association for the Study of the Liver (BASL) and Liver QuEST, a nursing representative and a patient representative. The quality of evidence and grading of recommendations was appraised using the AGREE II tool.The nature of variceal haemorrhage in cirrhotic patients with its complex range of complications makes rigid guidelines inappropriate. These guidelines deal specifically with the management of varices in patients with cirrhosis under the following subheadings: (1) primary prophylaxis; (2) acute variceal haemorrhage; (3) secondary prophylaxis of variceal haemorrhage; and (4) gastric varices. They are not designed to deal with (1) the management of the underlying liver disease; (2) the management of variceal haemorrhage in children; or (3) variceal haemorrhage from other aetiological conditions.
authors.affiliation: Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Tripathi
authors.affiliation: GI Unit, Glasgow Royal Infirmary, Glasgow, UK.
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Stanley
authors.affiliation: Liver Unit, Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Hayes
authors.affiliation: The Royal Free Sheila Sherlock Liver Centre, Royal Free Hospital and University College London, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Patch
authors.affiliation: Gastrointestinal and Liver Services, York Teaching Hospitals NHS Foundation Trust, York, UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Millson
authors.affiliation: Department of Interventional Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Homoyon
authors.initials: H
authors.lastname: Mehrzad
authors.affiliation: Department of Gastroenterology, Derby Hospitals NHS Foundation Trust, Derby, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Austin
authors.affiliation: Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: James W
authors.initials: JW
authors.lastname: Ferguson
authors.affiliation: Department of Interventional Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Simon P
authors.initials: SP
authors.lastname: Olliff
authors.affiliation: Liver Unit, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Hudson
authors.affiliation: Department of Gastroenterology, Royal Devon and Exeter Hospital, Devon, UK.
authors.forename: John M
authors.initials: JM
authors.lastname: Christie
mesh_terms: D000465:Algorithms; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications
keywords: BLEEDING; CIRRHOSIS; GASTROINTESTINAL HAEMORRHAGE; OESOPHAGEAL VARICES; PORTAL HYPERTENSION