In this study, researchers from Italy prospectively evaluated 206 cirrhotics during a mean follow up of 37 months. Of these patients, 113 were without varices and 93 with small EV.
Patients with previous gastrointestinal bleeding or receiving any treatment for portal hypertension were excluded.
Endoscopy was performed every 12 months.
The research team found that the incidence of EV was 5% at 1 year and 28% at 3 years.
In addition, the rate of EV progression was 12% at 1 year and 31% at 3 years.
The team identified post-alcoholic origin of cirrhosis, Child-Pugh's class B or C, and the finding of red wale marks at first examination, as predictors for the variceal progression.
The 2-years risk of bleeding from EV was higher in patients with small varices upon enrolment than in those without varices, 12% versus 2%, respectively.
|Predictor for bleeding was the presence of red wale marks at first endoscopy.|
|Journal of Hepatology|
In addition, predictor for bleeding was the presence of red wale marks at first endoscopy.
Dr Manuela Merli's team concluded, "In patients with no or small EV, endoscopy surveillance should be planned taking into account cause and degree of liver dysfunction".
In a related editorial in the same publication, Dr Roberto de Franchis discusses the evaluation and follow-up of patients with cirrhosis and esophageal varices.
Dr de Franchis considers the results of several studies concerning the timing of follow-up endoscopies.
Concluding that, "It appears reasonable to maintain the recommended interval of 1 to 2 years, adopting a shorter interval for patients with alcoholic cirrhosis".