Table 1: Primary prophylaxis and surveillance.

Surveillance/prophylaxis modalitiesIndicationsDoseGoal

Endoscopic surveillanceLow-risk* small varices
(not on nonselective BB**)
Every 2 years and annually with liver decompensationSurveillance for progression into higher-risk lesions needing medical or endoscopic prophylaxis
NadololHigh-risk*** small varices and medium-large varices
Optional: low-risk small varices
Start: 40 mg qdTitrate to heart rate: 55 beats/minute or maximally tolerated dose
PropranololHigh-risk small varices and medium-large varices
Optional: low-risk small varices
Start: 10 mg bidTitrate to heart rate: 55 beats/minute or maximally tolerated dose
EVBLMedium to large varicesEvery 2–4 weeksUntil variceal obliteration

*Low-risk: Child A cirrhosis and no red wale marks, ** beta-blocker, ***high-risk: Child B or C cirrhosis and/or presence of red wale marks.