The status of a patient with portal hypertensive gastropathy can be described using criteria defined by the New Italian Endoscopic Club for the Study and Treatment of Esophageal Varices (NIEC). These can help describe the change in the patient over time and any response to therapeutic interventions.


Clinical activity:

(1) progression

(2) regression

(3) fluctuating


Although not listed, stable disease is another disease state that needs to be included.



(1) acute

(2) chronic


Criteria for progression - one of the following:

(1) de novo appearance

(2) change in endoscopic lesions from mild to severe during followup


Criteria for regression - one of the following:

(1) disappearance

(2) change in endoscopic lesions from severe to mild during followup


Criteria for fluctuating course - alternating between mild and severe during subsequent visits. I would think that reappearance of lesions would qualify.


Criteria for stable disease - same state during subsequent visits


Criteria for acute bleeding - both of the following:

(1) hematemesis or melena

(2) actively bleeding gastric lesion


Criteria for chronic bleeding - all of the following:

(1) decrease in hemoglobin >= 2 g/dL over 6 months

(2) no active bleeding episodes

(3) no intake NSAIDs


I added a criteria for chronic bleeding in the implementation to exclude another source of bleeding.


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