Table 1: Primary prophylaxis and surveillance.

Surveillance/prophylaxis modalities Indications Dose Goal Endoscopic surveillance Low-risk* small varices (not on nonselective BB**) Every 2 years and annually with liver decompensation Surveillance for progression into higher-risk lesions needing medical or endoscopic prophylaxis Nadolol High-risk*** small varices and medium-large varices Optional: low-risk small varices Start: 40 mg qd Titrate to heart rate: 55 beats/minute or maximally tolerated dose Propranolol High-risk small varices and medium-large varices Optional: low-risk small varices Start: 10 mg bid Titrate to heart rate: 55 beats/minute or maximally tolerated dose EVBL Medium to large varices Every 2–4 weeks Until 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.