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International HHT Guidelines: GI Bleeding Management

Dr. Murali Chakinala, Co-Director, Washington University HHT Center of Excellence and Dr. Vivek Iyer, Director, Mayo Clinic HHT Center of Excellence as they discuss how to recognize the signs and symptoms of GI bleeding in HHT. Drs. Chakinala and Iyer will further dissect this subject area by taking the audience through the diagnosis process and current favorable treatments in managing this complication of HHT. Learn how to use the “My GI Bleeding Care Checklist” (also available in our Comprehensive Guide to Managing Your HHT booklet – copies available by request to Cure HHT, to ensure that you and your family members are receiving the best possible care for HHT.


Key points from webinar:

  • Endoscopy findings (# of telangiectasias) don’t necessarily correlate with severity of anemia and best treatment options
  • Most common symptom of GI bleeding is iron deficiency (with or without anemia)
  • SMAD4 mutation has its own screening guidelines with endoscopy starting as early as age 15
  • HHT GI Bleeding Management Guidelines include six recommendations for treatment options:
    • Endoscopic
    • Anti-fibrinolytic drug therapy (i.e., Tranexamic Acid)
    • Anti-angiogenic drug therapy (i.e., Bevacizumab [Avastin®], Pazopanib [Votrient®], Pomalidomide)
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