Liver Cirrhosis Patients Can Experience Vomiting Blood

Vomiting blood is a serious and urgent clinical symptom that can occur in patients with liver cirrhosis. While gastrointestinal ulcers are a common cause of hematemesis (vomiting blood), in cirrhotic patients, the underlying issue often stems from portal hypertension. This condition leads to the development of varices—abnormally enlarged veins—in the esophagus or stomach.

Portal hypertension significantly increases the risk of life-threatening bleeding. Due to the high pressure in the portal venous system, these varices become prone to rupture. Eating coarse or hard foods can easily tear the thin walls of these swollen veins, resulting in massive internal bleeding. Unlike other forms of gastrointestinal bleeding, this type of hemorrhage is often difficult to control with medication alone.

When blood loss exceeds 1000 mL in a short period, patients may rapidly progress into hypovolemic shock. This severe blood loss can also trigger hepatic encephalopathy—a decline in brain function due to liver failure. Without prompt medical intervention, the mortality rate increases dramatically, especially in those with advanced liver disease.

In emergency situations, healthcare providers may use a Sengstaken-Blakemore tube (triple-lumen double-balloon tube) to apply pressure and stop the bleeding temporarily. However, advancements in endoscopic techniques have improved treatment outcomes. Endoscopic variceal ligation or the application of hemostatic clips can effectively target and seal off the bleeding vessels during an upper endoscopy, offering a more precise and lasting solution.