In those with significant varices or cirrhosis nonselective β-blockers reduce the risk of future<unk> . With a target heart rate of 55 beats per minute they reduce the absolute risk of<unk>  by 10%. Endoscopic band ligation (EBL) is also effective at improving outcomes. Either B-blockers or EBL are recommended as initial preventative measures. In those who have had a previous variceal bleed both treatments are recommended. Some evidence supports the addition of isosorbide mononitrate. Testing for and treating those who are positive for H. pylori is recommended. Transjugular intrahepatic portosystemic shunting (TIPS) may be used to prevent<unk>  in people who re-bleed despite other measures. Among people admitted to the ICU who are at high risk, a PPI or H2RA if appears useful.
Gastrointestinal bleeding
Internal bleeding
Lower gastrointestinal bleeding
Upper gastrointestinal bleeding
Enteropathy
Rectal bleeding
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