Chronic Liver Failure in Decompensated Liver Cirrhosis with Portal Hypertensive Gastropathy and Chronic Haemorrhage

This page covers the first-line management approach for patients presenting with chronic liver failure in the setting of decompensated cirrhosis, where portal hypertensive gastropathy (PHG) is driving chronic haemorrhage and resulting iron-deficiency anaemia.

Clinical Scenario

Decompensated liver cirrhosis complicated by portal hypertensive gastropathy (PHG) can cause persistent low-grade or intermittent gastrointestinal blood loss. Over time this leads to chronic haemorrhage and iron-deficiency anaemia, compounding the physiological burden of underlying chronic liver failure.

Treatment Approach (Partial Overview)

First-line management of chronic haemorrhage from PHG involves a non-selective beta-blocker as the cornerstone intervention, combined with iron supplementation to address the resulting deficiency.

Complete sequencing, indications for blood transfusion, and the full structured regimen are available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jhep.2018.03.024

First-line therapy for chronic haemorrhage from PHG is an NSBB.

NSBB and iron supplementation and/or blood transfusion, when indicated, are recommended as first-line therapy for chronic haemorrhage from PHG (I;1).

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