Appropriate Use of Beta Blockers in Cirrhosis

Abstract

Cirrhosis of the liver from various etiologies is a leading cause of morbidity and mortality in developing countries and industrialized nations alike. Beta blockers have been used for primary and secondary prophylaxis to prevent the initial episode of bleeding as well as rebleeding from gastroesophageal varices for several decades. However, the side effects of nonselective beta blockers preclude their use in all patients with cirrhosis. Recent evidence suggests that the use of beta blockers in patients with decompensated cirrhosis and refractory ascites may be contraindicated. The purpose of this review is to describe the appropriate use of beta blockers in cirrhosis taking into account emerging data.