In mid-1997 the American College of Gastroenterology (ACG) published guidelines for the management of varices.
In this study, investigators from Portland, Oregon, assessed the change in regional practice patterns between early 1997 (pre-guidelines) and 2000 (post-guidelines).
The team sent gastroenterologists in Oregon and Southwestern Washington a self-reporting questionnaire regarding the management of varices in 1997 and 2000.
Overall, 76% of the surveys were completed in 1997 and 74% in 2000.
|More respondents followed the guidelines to prevent initial variceal hemorrhage in 2000.|
|American Journal of Gastroenterology|
The team found that 50 to 60% of the respondents saw between 3 and 5 cirrhotic patients per month.
They determined that more respondents followed the guidelines to screen and treat large varices to prevent initial variceal hemorrhage in 2000 than in 1997 (54% versus 18%).
Of the respondents who performed screening of EGDs, the majority treated large varices with beta-blocker therapy (93% in 1997 and 97% in 2000).
All respondents used early endoscopy to treat variceal bleeding.
More respondents began pharmacologic therapy prior to endoscopy if active variceal hemorrhage was suspected in 2000 than in 1997 (83% versus 56%).
Dr Atif Zaman and colleagues concluded, "After the publication of the ACG guidelines, significantly more gastroenterologists screened for varices to prevent initial variceal hemorrhage and significantly more used pharmacologic therapy prior to endoscopic treatment for variceal hemorrhage".