Question

A 59-year-old man with alcohol-related cirrhosis (Child-Pugh B) is found on endoscopy to have medium-sized oesophageal varices that have not bled. According to cirrhosis management guidelines, what is the best strategy for primary prophylaxis against variceal haemorrhage?

Accepted Answer

Start a non-selective beta-blocker such as propranolol

Answer

Start a cardio-selective beta-blocker such as metoprolol

Answer

No prophylaxis is needed until the first variceal bleed

Answer

Begin long-term proton pump inhibitor therapy

Answer

Schedule elective transjugular intrahepatic portosystemic shunt (TIPS)

Practice question

A 59-year-old man with alcohol-related cirrhosis (Child-Pugh B) is found on endoscopy to have medium-sized oesophageal varices that have not bled. According to cirrhosis management guidelines, what is the best strategy for primary prophylaxis against variceal haemorrhage?