Background/Aims: Esophageal variceal bleeding is one of the major causes of death in patients with portal hypertension, mostly due to liver cirrhosis. Surgical portal-systemic shunvs, sclero- therapy and/or pharmacological treatment are used in the primary and secondary prevention of hernorrhages in high-risk patients, but the effect of tbis therapy has not improved. A major innovation in the treatment of portal hypertension was the use of phannacologic agent.; to prevent bleeding and death from ruptured esophageal varices. Porta] pressure can be reduced by decreasing blood flow and/or vascular resistance within the portal venous system. Up to now, the medical treatment of portal hypertension has been based on the use of drugs that reduce the splanchnic blood tlow, such as vasopressin, somatostatin, and 0-adrenergic blockers. Especially, the oral administration of Isosorbide-5-rnononitrate, a preterentia] venous dilator with prolonged biological activity and no hepatic metabo]ism, caused a significant reduction in portal pressure in patients with cirrhosis. This was due in part to a decrease in hepatic vascular resistance. Hcwever, the indications for and against such therapies are not standardized and the problems caused by both hemodynamic evaluation of the response to treatment and selection of responders are still unresolved. Methods: Doppler ultrasonography(real time B-scan imaging and pulsed Doppler ultrasonographic study) represents a valuable and non-invasive method for the study nf portal hemodynamics in patients with liver cirrhosis. Twenty patients(16 males, aged 51+6) had hemo- dynamic measurements in the baseline condition Liefore and 1 day, l week, 3 weeks, aind 5 weeks after oral administration of propranolol and Isosorbide-S-Mononitrate, respectively by Doppler ultrasonography. Results: Diameter, maximal ve]ocity, cross sectional area, mean velcicity, blood flow vo]ume of porta] system were significantly reduced after drug administration(p--0,001). But the congestion index was not decreased statistically. Blood flov, volume difference between the portal vein and the sum of splenic vein and superior mesenteric vein(P-SS) was significantly reduced after drug administration(p<0.001). Conslusions: The oral adrainistration of propranolo] and Isosorbide- 5-Mononitrate achieved an effective reduction in portal hypertension with cirrhosis. When pharmacologic treatment of portal hypertension is contemplated, Doppler u]trasonography would appear to be of considerable interest because of its availability, noninvasivity and repeatability.(Korean J Gastroenterol 1996; 28:241-250)