From the Guidelines
In the UK, the recommended surveillance interval for oesophageal varices is every 2-3 years for patients with no varices at baseline and every 1-2 years for those with small varices, as per the most recent guidelines 1. The surveillance interval for oesophageal varices in the UK depends on the findings at initial endoscopy.
- For patients with no varices at baseline, endoscopic surveillance should be repeated every 2-3 years.
- For those with small varices, surveillance endoscopy is recommended every 1-2 years. These recommendations are based on the natural progression rate of varices, which typically enlarge gradually over time, with small varices progressing to large varices at a rate of approximately 10-15% per year 1. Regular surveillance allows for timely intervention with either pharmacological therapy (non-selective beta-blockers like propranolol or carvedilol) or endoscopic band ligation before life-threatening bleeding occurs. The frequency of endoscopic surveillance could be modified according to the type and severity of underlying liver disease, as well as individual patient factors such as the severity of liver disease, presence of red signs on varices, and other risk factors for bleeding 1. It is essential to note that these recommendations may be modified based on individual patient factors, and the most recent guidelines should always be consulted for the most up-to-date information 1.
From the Research
Surveillance Interval for Oesophageal Varices in the UK
- The provided studies do not specifically mention the surveillance interval for oesophageal varices in the UK 2, 3, 4, 5, 6.
- However, study 5 suggests that for low or very low risk cirrhotic patients, those found to have no varices or small varices without stigmata, repeat endoscopy is recommended because screening for progression may be warranted in 2 or more years.
- Study 5 also recommends performing endoscopic screening for all newly diagnosed cirrhotic patients and all other cirrhotics who are medically stable, willing to be treated prophylactically, and would benefit from medical or endoscopic therapies.
- There is no specific guidance on the surveillance interval in the UK, but the studies suggest that the frequency of endoscopy should be based on the individual patient's risk factors and the presence of varices or stigmata 5.
- It is essential to note that the provided studies do not offer a clear answer to the question, and more research or clinical guidelines specific to the UK may be necessary to determine the recommended surveillance interval for oesophageal varices.