Why does bleeding occur in the late stages of cirrhosis?
Disease description:
I have a colleague who was diagnosed with cirrhosis, and it's already at an advanced stage. Today I visited him in the hospital, and he told me he has experienced bloody stools. May I ask what causes bloody stools in the late stage of cirrhosis?
Doctor's answer (1)
Dr. Shen Yonghua
The main causes of hematochezia (passing blood through rectum) in end-stage liver cirrhosis are as follows:
1. Coagulation dysfunction: Liver cirrhosis leads to impaired liver synthetic function, resulting in reduced production of coagulation factors. Additionally, decreased platelet count and dysfunction make blood clotting difficult.
2. Portal hypertension: In end-stage cirrhosis, portal hypertension is commonly present, leading to esophageal and gastric varices. These dilated veins are prone to rupture and bleeding when pressure becomes excessive.
3. Increased anticoagulant substances: In cirrhosis, reduced hepatic synthesis of heparinase results in elevated levels of heparin in the bloodstream, further impairing coagulation function.
4. Vascular injury: Liver cirrhosis may also cause endothelial damage to blood vessels and increased capillary permeability, making bleeding more likely.
