Portal Hypertensive Bleeding in Cirrhosis

Publication Date: September 1, 2016

Last Updated: March 14, 2022

Guidance statements

Cirrhosis should be described, analyzed, and managed in two distinct clinical stages, compensated and decompensated, defined by the presence or absence of overt clinical complications of cirrhosis (ascites, variceal hemorrhage (VH), and hepatic encephalopathy [HE]).
Patients with compensated cirrhosis should be substaged into those with mild PH and those with CSPH, an entity that predicts the development of more-advanced stages.
Patients with clinically significant portal hypertension (CSPH) are substaged into those with and without gastroesophageal varices (GEV).
Treatment of portal hypertension (PH) differs depending on the stage and substages of cirrhosis, because prognosis and mechanisms of disease (and therefore therapeutic targets) are different.