Reduction in Early Recurrence of Variceal Bleeding by Propranolol

U. A. Marbet Division of Gastroenterology and Intensive Care Medicine, University of Basle, Basle, Switzerland; Dept. of Internal Medicine, University of Basle, Basle, Switzerland

A. Straumann Division of Gastroenterology and Intensive Care Medicine, University of Basle, Basle, Switzerland; Dept. of Internal Medicine, University of Basle, Basle, Switzerland

K. E. Gyr Division of Gastroenterology and Intensive Care Medicine, University of Basle, Basle, Switzerland; Dept. of Internal Medicine, University of Basle, Basle, Switzerland

C. Beglinger Division of Gastroenterology and Intensive Care Medicine, University of Basle, Basle, Switzerland; Dept. of Internal Medicine, University of Basle, Basle, Switzerland

N. Schaub Division of Gastroenterology and Intensive Care Medicine, University of Basle, Basle, Switzerland; Dept. of Internal Medicine, University of Basle, Basle, Switzerland

J. Vögtlin Division of Gastroenterology and Intensive Care Medicine, University of Basle, Basle, Switzerland; Dept. of Internal Medicine, University of Basle, Basle, Switzerland

J. Loosli Division of Gastroenterology and Intensive Care Medicine, University of Basle, Basle, Switzerland; Dept. of Internal Medicine, University of Basle, Basle, Switzerland

W. Kiowski Division of Gastroenterology and Intensive Care Medicine, University of Basle, Basle, Switzerland; Dept. of Internal Medicine, University of Basle, Basle, Switzerland

R. Ritz Division of Gastroenterology and Intensive Care Medicine, University of Basle, Basle, Switzerland; Dept. of Internal Medicine, University of Basle, Basle, Switzerland

G. A. Stalder Division of Gastroenterology and Intensive Care Medicine, University of Basle, Basle, Switzerland; Dept. of Internal Medicine, University of Basle, Basle, Switzerland

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Abstract

Marbet UA, Straumann A, Gyr KE, Beglinger C, Schaub N, Vögtlin J, Loosli J, Kiowski W, Ritz R, Stalder GA. Reduction in early recurrence of variceal bleeding by propranolol.

Survival after variceal bleeding depends greatly on the outcome of the immediate posthaemorrhagic period. This may in turn depend on the recurrence of bleeding. We therefore prospectively evaluated the influence of propranolol on the recurrence of variceal haemorrhage during the early period after the acute bleeding episode. Twenty consecutive patients with acute variceal haemorrhage and liver disease were randomly assigned to treatment either with propranolol or placebo orally for 14 days. Propranolol significantly decreased the rate of recurrence of variceal haemorrhage during this early period (p = 0.0028; 95% confidence interval in the placebo group, 90 ± 20%; in the beta blocker group, 20 ± 26%). Whereas a recurrence of variceal bleeding occurred in 9 of 10 patients in the placebo group, only 2 of 10 rebled during treatment with propranolol. These results suggest that propranolol may prevent rebleeding in the crucial early period after actue haemorrhage from oesophageal varices.

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Reduction in Early Recurrence of Variceal Bleeding by Propranolol

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Reduction in Early Recurrence of Variceal Bleeding by Propranolol

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