{
  "abstract": "The British Society of Gastroenterology (BSG) recognises that the current UK guideline on the management of variceal bleeding in cirrhotic patients (2015) 1 requires updating. Recent updates to similar international guidance including the American Association for the Study of Liver Disease (AASLD),2 European Society of Gastrointestinal Endoscopy (ESGE)3 and Baveno VII,4 as well as updated NICE cirrhosis guidelines5 are acknowledged by the Clinical Guidelines Development (CGD) group. However, the CGD are also mindful of the large-scale, multicentre UK studies recently completed or currently in progress addressing both primary and secondary prophylaxis of variceal bleeding, with results expected to significantly influence UK best practice. Therefore, the CGD has opted to produce a position statement on the latest international guidance, while these data are pending. This decision is supported by the BSG Clinical Services (CS) committee. Furthermore, prioritising the identification of clinically significant portal hypertension (CSPH), rather than the management of varices alone, was felt to be an important shift in practice. On review, the CGD agreed that the AASLD guidance was most consistent with UK clinical practice. Therefore, the BSG endorses the interim use of the AASLD guidance in the UK, with some important caveats. The individual AASLD guidance statements are reproduced below, with necessary caveats added where applicable. These caveats primarily pertain to the recommendations for diagnosis of CSPH including the role of non-invasive tests (NITs), defining indications for non-selective beta-blockers (NSBB) and use of pre-emptive transjugular intrahepatic portosystemic shunt (pTIPSS) following acute oesophageal variceal bleeding (OVB).",
  "authors": [
    {
      "affiliations": [
        "Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK"
      ],
      "name": "Philip D J Dunne"
    },
    {
      "affiliations": [
        "Liver Unit, Queen Elizabeth Hospital, Birmingham, UK"
      ],
      "name": "Dhiraj Tripathi"
    },
    {
      "affiliations": [
        "Hepatology and Liver Transplantation, Royal Free Hampstead NHS Trust, London, UK"
      ],
      "name": "David Patch"
    },
    {
      "affiliations": [
        "Roger Williams Institute of Liver Studies, King’s College London, London, UK"
      ],
      "name": "Vishal C Patel"
    },
    {
      "affiliations": [
        "Hepatology, Imperial College Healthcare NHS Trust, London, UK"
      ],
      "name": "James B Maurice"
    },
    {
      "affiliations": [
        "Institute of Liver Studies, King’s College Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Mark McPhail"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Hepatology & Endoscopy, Hull Royal Infirmary, Hull, UK"
      ],
      "name": "Lynsey Corless"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Hepatology & Endoscopy, Hull Royal Infirmary, Hull, UK"
      ],
      "name": "Dianne Backhouse"
    },
    {
      "affiliations": [
        "University of Leeds, Leeds, UK"
      ],
      "name": "Ian A Rowe"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK"
      ],
      "name": "Ewan Forrest"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK"
      ],
      "name": "Adrian Stanley"
    },
    {
      "affiliations": [
        "Institute of Liver Studies, King’s College London, London, UK"
      ],
      "name": "Thomas H Tranah"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Gateshead Health NHS Foundation Trust, Gateshead, UK"
      ],
      "name": "Louise Greenwell"
    },
    {
      "affiliations": [
        "Gateshead Health NHS Foundation Trust, Gateshead, UK",
        "Newcastle University, Newcastle upon Tyne, UK"
      ],
      "name": "Dina Mansour"
    }
  ],
  "title": "British Society of Gastroenterology position statement on the American Association for the Study of Liver Disease practice guidance on risk stratification and management of portal hypertension and varices in cirrhosis",
  "uid": "49bdbde9-e7cb-5650-b550-b0dd81b92df1"
}