Precise and optimal delivery techniques of hemostatic powders in gastrointestinal bleeding

Gastrointestinal (GI) bleeding is associated with a high risk of mortality. While conventional endoscopic hemostasis methods, including epinephrine injection, heater probe coagulation, hemostatic clips, and band ligation, achieve an overall hemostasis rate of 85%-90%, 10%-20% of patients do not respond to these treatments. Several novel powders have shown promise as effective hemostatic agents. In this review, we discuss the evolution of endoscopic hemostasis and explore the potential of innovative hemostatic powder treatments in managing GI bleeding. Relevant articles were identified by searching PubMed from 2010 to 2025 using the keywords "hemostatic powder", "GI bleeding", and "endoscopic hemostasis". A review of recent PubMed articles on topical hemostatic powders used in endoscopy, including Hemospray, EndoClot, Ankaferd Blood Stopper, Nexpowder, and various drug-based powders, demonstrated that these agents offered high immediate hemostasis rates exceeding 90%. Topical hemostatic powders are valuable for managing active GI bleeding, especially when conventional endoscopic techniques are unsuccessful or technically challenging, such as refractory and tumor bleeding.