Pharmacological therapy of vascular malformations of the gastrointestinal tract

Vascular malformation (AVM) in the gastrointestinal tract is an uncommon, but not rare, C cause of bleeding and iron deficiency ane-mia, especially in all aging population. While endosocopic coagulative therapy is the method of choice for controlling bleeding, a substantial number of cases require additional therapy. Adjunctive or even primary phamacotherapy may be indicated in recurrent bleeding. However, there is little evidence-based proof of efficacy for any agent. The bulk, of support is derived frorn anecdotal reports or case series. The present review compares the outcome of AVM after no intervcrition, coagulative therapy or focus oil pharmacological agents. Most of the literature encompasses two common AVMs angiodysplasia and hereditary hemorrhagicic telangietrasia. Similarly, the bulk of information evaluates two therapies, hormones (estrogen and progesterone) and the somatostatin analogue octreotide. Of these, the former is the only therapy evaluated in randomized trials, and the results are conflicting without clear guidelines. The latter therapy has been reported only is case reports and case series without prospective trials. In addition, other anecdotally used medications are discussed.