**Gastric Antral Vascular Ectasia and Portal Hypertensive Gastropathy Gastropathy**

**Gastric Antral Vascular Ectasia and Portal Hypertensive** 

DOI: 10.5772/intechopen.70610

Daryl Ramai, Sandar Linn and Madhavi Reddy

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.70610

Daryl Ramai, Sandar Linn and

#### **Abstract**

Madhavi Reddy

Gastric antral vascular ectasia (GAVE) and portal hypertensive gastropathy (PHG) are mucosal lesions that can cause chronic gastrointestinal bleeding in the patients with cirrhosis. While PHG occurs exclusively in patients with liver cirrhosis, GAVE can also present in patients with systemic and autoimmune conditions. The need to accurately characterize these two conditions is dependent on clinical, endoscopic, and histological parameters. The management of GAVE utilizes endoscopic ablation techniques, while medical therapy is directed toward stabilizing portal pressure in patients with PHG. Herein, we review the epidemiology, diagnosis, pathophysiology, and medical, endoscopic, and surgical management of GAVE and PHG.

**Keywords:** stomach diseases, gastric antral vascular ectasia (GAVE), portal hypertensive gastropathy (PHG), portal hypertension, cirrhosis, management

## **1. Introduction**

Gastric antral vascular ectasia (GAVE) and portal hypertensive gastropathy (PHG) are common gastric mucosal lesions that occur in patients with portal hypertension. These two conditions are responsible for acute on chronic gastrointestinal bleeding. While these two clinical entities share similar clinical presentations, their underlying pathophysiology, endoscopic features, and management options are different. The pathophysiology of GAVE is related to local changes in gastric mucosa, and management is aimed at endoscopic reduction of blood loss using thermal therapies. The pathophysiology of PHG is related to portal hypertension, and management is aimed at reducing portal hypertension using pharmacologic and in some

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

cases portosystemic shunts. Thus, it is important to differentiate GAVE and PHG as their management options are different.
