UK Guidelines on the Management of Variceal Haemorrhage in Cirrhotic Patients


These updated guidelines on the management of variceal haemorrhage have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines which this document supersedes were written in 2000 and have undergone extensive revision by 13 members of the Guidelines Development Group (GDG). The GDG comprises elected members of the BSG liver section, representation from British Association for the Study of the Liver (BASL) and Liver QuEST, a nursing representative and a patient representative. The quality of evidence and grading of recommendations was appraised using the AGREE II tool. The nature of variceal haemorrhage in cirrhotic patients with its complex range of complications makes rigid guidelines inappropriate.

These guidelines deal specifically with the management of varices in patients with cirrhosis under the following subheadings:
(1) primary prophylaxis;
 (2) acute variceal haemorrhage;
(3) secondary prophylaxis of variceal haemorrhage; and
(4) gastric varices. 

They are not designed to deal with
(1) the management of the underlying liver disease;
(2) the management of variceal haemorrhage in children; or
(3) variceal haemorrhage from other aetiological conditions.

Keywords: randomized controlled trial; intrahepatic portosystemic shunt; retrograde transvenous obliteration; bleeding gastric varices; endoscopic band ligation; proton pump inhibitor; nonselective beta-blockers; small oesophageal varices; prophylactic portacaval anastomosis; spontaneous bacterial peritonitis

Available Languages


Source File

Publishing organization(s):

UK British Society of Gastroenterology, UK British Society of Gastroenterology, Gut/BMJ

Scientific area:


This item can be cited as: Gut 2015;0:1–25., PMID 25887380


  • Format
    • Standards and Guidelines
  • Language
    • English
  • UEG Week Pathway
    • Endoscopy
    • Hepatobiliary
    • Oesophagus
  • Year
    • 2015