Cirrhosis: Beta-Blockers for Portal Hypertension and Varices

Overview

Beta-blocker medicines are used to prevent an episode of variceal bleeding by lowering the pressure in the enlarged veins (varices). Variceal bleeding occurs when the pressure increases in the portal vein system and the veins in the esophagus, stomach, and rectum enlarge to help blood flow through the liver.

By slowing the heart rate and widening the blood vessels, beta-blocker medicines such as propranolol and nadolol appear to lower the pressure in varices that bypass the liver. In people who have esophageal varices, beta-blockers have been shown to reduce the risk of having a first episode of bleeding. They also reduce risk in people who have had a variceal bleed. They are usually prescribed for people who have moderate-to-large varices.