Managing Bleeding in Cirrhosis: Recommended Medications for Hemostasis

Liver cirrhosis can lead to life-threatening bleeding due to portal hypertension, particularly in cases of upper gastrointestinal hemorrhage. When this occurs, immediate hospitalization and aggressive treatment are essential. A key component of therapy involves continuous intravenous administration of medications that reduce portal pressure.

Among the most widely used and clinically effective drugs for this purpose is somatostatin, which is recognized for its ability to significantly lower portal venous pressure. In combination with somatostatin, proton pump inhibitors (PPIs) such as esomeprazole are routinely prescribed. These medications help suppress gastric acid secretion and increase gastric pH levels. Maintaining a gastric pH above 6.0 is crucial, as it promotes the formation and stabilization of blood clots at the bleeding site.

In addition to these foundational therapies, oral hemostatic agents may also be administered. One commonly used option is lyophilized thrombin powder, which aids in promoting localized blood coagulation and supports clot formation. Another supportive treatment is the use of oral solutions like Kangfuxin liquid, which has been shown to accelerate the healing of mucosal injuries and support gastric mucosal repair after bleeding episodes.

Combining intravenous and oral therapies provides a comprehensive approach to managing acute bleeding episodes in patients with liver cirrhosis. This multi-targeted strategy not only helps control active bleeding but also supports tissue healing and reduces the risk of rebleeding.