Gastroscopic demonstration of extensive mucosal erythema is a clinical manifestation of portal hypertensive gastric disease. Gastric mucosal congestion and edema, erythematous exudative gastritis with bile reflux, is commonly seen in gastritis. Such atypical changes are seen in all kinds of gastritis. How to prevent and treat gastroscopic manifestation of extensive mucosal erythema? 1, drug treatment (1) propranolol (insulin) propranolol can be used to control bleeding, improve endoscopic gastric mucosal lesions and prevent rebleeding by constricting the small visceral arteries caused by the reduction of portal blood flow and portal pressure.PHG long-term application of propranolol treatment, if the interruption of the drug can often lead to rebleeding, should pay attention to. (2) Vasopressin (vasopressin) The synthetic vasopressin derivative terlipressin (triglycine lysine pressin) in recent years has significantly reduced visceral blood flow and lowered portal venous pressure, with few side effects, and although the gastric mucosal blood flow is significantly reduced, the oxygen saturation is slightly decreased. (3) Growth inhibitor (Stanozine) and its analogue octreotide (Sunnin) can reduce hepatic venous wedge pressure and gastric mucosal blood flow, and can be used in the treatment of PHG bleeding. The mechanism of action of growth inhibitor and octreotide is mainly indirect, and they work by antagonizing vasodilator substances such as hyperglycemia and improving the state of high power circulation in portal hypertension in cirrhosis. 2.Interventional treatment (1)Transjugular intrahepatic portosystemic shunt is suitable for ruptured esophageal variceal bleeding and refractory ascites that cannot be controlled by drugs and gastroscopy. Since TIPPS can both reduce the portal vein pressure permanently and have less impact on the patient’s organism, compared with traditional portal shunt, TIPS has wide indications and is also suitable for patients with ChildC grade. For patients with poor drug efficacy and recurrent bleeding, TIPS can be chosen. (2) Trans-splenic artery embolization Splenic artery embolization can reduce splenic vein blood flow, improve portal hemodynamics, reduce gastric mucosal hemoglobin content, mildly increase oxygen saturation, and significantly improve portal hypertensive gastropathy, which can be used for hemostasis and prophylaxis of PHG bleeding, especially for portal hypertensive patients with giant spleen with hypersplenism. It is especially suitable for patients with portal hypertension with hypersplenism. 3.Surgery The portal shunt can effectively reduce the portal vein pressure, which has a positive effect on the upper gastrointestinal bleeding caused by portal hypertensive gastropathy. For patients who do not respond to drug treatment, surgery can be considered. In the follow-up gastroscopy after portal shunt, the gastric mucosa returned to normal form in most patients. Portal bypass is safe and effective in the treatment of portal hypertensive gastropathy, providing rapid and durable hemostasis, and the main surgical complication is hepatic encephalopathy. The prognosis of portal hypertensive gastropathy is determined by the improvement or elimination of the primary disease, as the rebleeding after treatment is related to the loss of cirrhosis.