Pathogenesis of portal hypertensive gastropathy: translating basic research into clinical practice
| Autor: | Rafael F. Perini, Paula R S Camara, Jose G. Ferraz |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Liver Cirrhosis
medicine.medical_specialty Cirrhosis Portal venous pressure medicine.medical_treatment Stomach Diseases Portal hypertensive gastropathy Liver transplantation Severity of Illness Index Gastroenterology Risk Factors Internal medicine Hypertension Portal medicine Animals Humans Aspirin Hepatology biology business.industry Stomach digestive oral and skin physiology Helicobacter pylori biology.organism_classification medicine.disease Portal Pressure medicine.anatomical_structure Portal hypertension Diffusion of Innovation business medicine.drug |
| Zdroj: | Nature Reviews Gastroenterology & Hepatology. 6:150-158 |
| ISSN: | 1759-5053 1759-5045 |
| DOI: | 10.1038/ncpgasthep1356 |
| Popis: | Portal hypertensive gastropathy (PHG) is often seen in patients with portal hypertension, and can lead to transfusion-dependent anemia as well as acute, life-threatening bleeding episodes. This Review focuses on the mechanisms that underlie the pathogenesis of PHG that provide reasonable grounds for the treatment of this condition, and ultimately enable translation of basic research into clinical practice. Increased portal pressure associated with cirrhosis and liver dysfunction is critical for the development of clinically significant PHG, and leads to impaired gastric mucosal defense mechanisms that render the stomach susceptible to mucosal injury. The use of pharmacological agents such as beta-blockers reduces the frequency of bleeding episodes in PHG. As a last resort, surgical decompression of the portal system, transjugular intrahepatic stent placement and liver transplantation can resolve this condition. Elimination of known risk factors for gastric injury such as alcohol, aspirin and traditional NSAIDs is critical. The role of Helicobacter pylori colonization of the gastric mucosa in PHG is not clear. Careful and critical interpretation of human and experimental data can be helpful to establish a rationale for the medical management of this important condition. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|