After esophageal and fundus varices, portal hypertensive gastropathy (
PHG) is the second most frequent cause of bleeding in cirrhotic patien
ts, It accounts for 1-8% of primary upper gastrointestinal hemorrhage
and 30-60% of secondary acute or chronic bleeding in the first 12 mont
hs, mainly after sclerosing therapy of varices, Endoscopy is diagnosti
c by showing either a typical ''mosaic pattern'' (mild form) or single
or confluent ''cherry red spots'' (severe form). Helicobacter pylori
or NSAID-induced gastropathy are to be distinguished. The therapeutic
principles are the same as in drug therapy of esophageal varices. Seco
ndary prophylaxis with propranolol, especially after sclerosing therap
y, is recommended, but not primary prophylaxis.