Why is prevention of hemorrhage in cirrhotic patients more important than treatment?

  Hemorrhage in patients with cirrhosis is a very serious and life-threatening complication. Some patients die due to violent bleeding, or other causes of failure to resuscitate. With the development of medical technology, death due to hemorrhage in cirrhotic patients is becoming less and less frequent. However, there are still some patients who die due to bleeding.  Some patients, who usually have no discomfort, suddenly bleed and are rushed to the hospital, only to be diagnosed with cirrhosis later, while other patients know their condition and do not pay attention to frequent recurrent hemorrhage.  The consequences of hemorrhage are mainly manifested in the following aspects: First, hemorrhage directly leads to death or cannot be saved after various treatment measures are still ineffective.  Second, although the bleeding stops after treatment, it is immediately followed by ascites, jaundice, hepatic encephalopathy, and decompensated liver function, which further aggravates the liver condition. It also increases the patient’s pain and economic burden.  Third, according to the results of the study, about 30% of the patients will bleed again within one year after the occurrence of bleeding. The incidence of rebleeding is higher within two to three years. The consequences of repeated bleeding can be imagined.  Therefore, it is very important to prevent bleeding. First of all, the individual should start with diet, rest and living. Avoid smoking, alcohol, spicy and rough food, fatigue, cold, etc. The medical aspect of prevention focuses on intervention before bleeding. When a patient is diagnosed with severe varices of esophageal and gastric veins, even though no bleeding has occurred, it is necessary to deal with the severe varices, and variceal ligation can be done under gastroscopy, and some experts even recommend vascular sclerotherapy.  In patients who have had severe bleeding, the varicose veins should also be treated aggressively after the bleeding has stopped, with endoscopic ligation, sclerotherapy, tissue gel injection, etc., to eventually make the varicose veins disappear completely. Endoscopic treatment is minimally invasive, short in time, low in cost and quick in patient recovery. We often encounter patients or family members who are afraid to do gastroscopy, in fact, they do not understand the development of gastroscopy and new technologies. In general, endoscopic treatment is very short and can be tolerated by many patients. Patients who cannot tolerate it can do tracheal intubation followed by painless gastroscopic treatment.  In conclusion, it is more important to prevent bleeding in patients with cirrhosis than to treat after bleeding.