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Indian Journal of Gastroenterology
Published in: Indian Journal of Gastroenterology 4/2018

01-07-2018 | Editorial

Improving outcomes with pharmacotherapy to treat acute esophageal variceal bleeding

Authors: C. E. Eapen, Subramani Kandasamy

Published in: Indian Journal of Gastroenterology | Issue 4/2018

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Excerpt

Borrowing from geo-political terminology, the portal circulation between the bowel and liver can be considered as a “land-locked” country. The portal venous circulation starts from venules draining the capillary bed in the intestines, spleen, and pancreas and ends in portal vein branches/venules draining into sinusoids in the liver. This anatomic system peculiarity renders access via the endovascular route to this land-locked country—i.e. the portal circulation—a challenge. One way to obtain entry to this difficult-to-access country is to bore a tunnel through a boundary wall—as done by creating a transjugular intrahepatic portosystemic shunt (TIPSS). …
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de Oliveira AC. Noninvasive assessment of portal hypertension and detection of esophageal varices in cirrhosis: state-of-the-art. Eur J Gastroenterol Hepatol. 2017;29:531–4.CrossRefPubMed
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Satapathy SK, Sanyal AJ. Nonendoscopic management strategies for acute esophagogastric variceal bleeding. Gastroenterol Clin N Am. 2014;43:819–33.CrossRef
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Møller S, Hansen EF, Becker U, Brinch K, Henriksen JH, Bendtsen F. Central and systemic haemodynamic effects of terlipressin in portal hypertensive patients. Liver. 2000;20:51–9.CrossRefPubMed
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Escorsell A, Bandi JC, Moitinho E, et al. Time profile of the haemodynamic effects of terlipressin in portal hypertension. J Hepatol. 1997;26:621–7.CrossRefPubMed
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Cavallin M, Piano S, Romano A, et al. Terlipressin given by continuous intravenous infusion versus intravenous boluses in the treatment of hepatorenal syndrome: a randomized controlled study. Hepatology. 2016;63:983–92.CrossRefPubMed
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Ding C, Wu X, Fan X, He C, Li J. Hemodynamic effects of continuous versus bolus infusion of terlipressin for portal hypertension: a randomized comparison. J Gastroenterol Hepatol. 2013;28:1242–6.CrossRefPubMed
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Jha SK, Mishra M, Jha A, Dayal VM. Comparison of continuous infusion versus intermittent infusion of terlipressin for the control of acute variceal bleeding in patients with portal hypertension: an open-label randomized controlled trials. Indian J Gastroenterol. 2018:37. doi.​org/​10.​1007/​s12664-018-0871-8
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Papaluca T, Gow P. Terlipressin: current and emerging indications in chronic liver disease. J Gastroenterol Hepatol. 2018;33:591–8.CrossRefPubMed
Metadata
Title
Improving outcomes with pharmacotherapy to treat acute esophageal variceal bleeding
Authors
C. E. Eapen
Subramani Kandasamy
Publication date
01-07-2018
Publisher
Springer India
Published in
Indian Journal of Gastroenterology / Issue 4/2018
Print ISSN: 0254-8860
Electronic ISSN: 0975-0711
DOI
https://doi.org/10.1007/s12664-018-0887-0

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Keynote webinar | Spotlight on medication adherence

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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