Prevention of the First Gastrointestinal Bleeding

  • Didier Lebrec
  • Jean-Pierre Benhamou


Esophageal variceal bleeding may occur in patients with portal hypertension who have developed superior portosystemic circulation. Thus, the ideal way to prevent bleeding esophageal varices is to avoid the development of portal hypertension or esophageal varices themselves. Alcohol abstinence and hepatitis vaccines are the best measures of prevention of the development of portal hypertension; however, this syndrome may occur for other reasons. In addition to antiviral drugs, other substances may also limit the development of liver disease and thus prevent portal hypertension and its complications. For example, we recently showed that chronic oral administration of ursodeoxycholic acid or colchicine in rats with bile duct ligation reduces the development of secondary biliary cirrhosis when compared to rats receiving a placebo [1,2]. Accordingly, portal intrahepatic resistance was lower in treated rats than in the placebo group. In this experimental study, the degree of portal hypertension was significantly lower in the rats receiving ursodesoxycholic acid or colchicine than in the control rats. Similarly, preliminary results showed that the development of portosystemic shunts was less severe in mice with induced murine schistosomiasis receiving propranolol than in mice receiving a placebo [3]. Since these different pharmacologic treatments have not yet been evaluated in patients with chronic liver disease, clinical studies are obviously needed.


Portal Hypertension Gastrointestinal Bleeding Cirrhotic Patient Esophageal Varix Variceal Bleeding 
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Copyright information

© Springer Japan 1991

Authors and Affiliations

  • Didier Lebrec
  • Jean-Pierre Benhamou
    • 1
  1. 1.Unité de Recherches de Physiopathologie Hépatique, INSERM U24 et Service d’HépatologieHôpital BeaujonClichyFrance

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