What is the screening recommendation for patients with newly diagnosed cirrhosis regarding esophageal varices?

The recommendation for screening patients with newly diagnosed cirrhosis regarding esophageal varices is to conduct endoscopy. This is because esophageal varices are a common complication of portal hypertension, which often develops in patients with cirrhosis. Endoscopic screening is the gold standard for directly visualizing the esophagus and assessing the presence, size, and risk of varices that can potentially lead to hemorrhage.

In patients with cirrhosis, the risk of developing varices significantly increases as the disease progresses, and identifying these varices can allow for timely interventions, such as endoscopic variceal ligation, which can help prevent serious complications like variceal bleeding. The American Association for the Study of Liver Diseases recommends that patients with compensated cirrhosis should undergo their first endoscopy within 1 to 2 years of diagnosis to evaluate for varices, while those with decompensated cirrhosis should be screened more urgently.

Other screening methods such as ultrasound, CT scans, or blood tests do not directly assess esophageal varices and, while they may provide useful information about liver architecture or portal vein status, they are not suitable substitutes for endoscopy in this context.