Gastric mucosal bleeding time in cirrhosis

Area of Science:

• Gastroenterology
• Hepatology
• Internal Medicine

Background:

• Cirrhosis and portal hypertension are associated with gastrointestinal bleeding risks.
• Sclerotherapy is a common treatment for esophageal varices in these patients.
• Gastric mucosal bleeding time is a potential indicator of bleeding risk.

Purpose of the Study:

• To prospectively measure gastric mucosal bleeding time in patients with cirrhosis and portal hypertension undergoing sclerotherapy.
• To investigate correlations between gastric mucosal bleeding time and various clinical and endoscopic parameters.
• To determine if gastric mucosal bleeding time is an independent factor in cirrhosis.

Main Methods:

• Prospective measurement of gastric mucosal bleeding time in 25 cirrhosis patients and age/sex-matched controls.
• Assessment of correlations with age, platelet count, prothrombin time, skin bleeding time, Child-Pugh score, variceal size, and portal hypertensive gastropathy.
• Comparison of bleeding times between patient and control groups.

Main Results:

• Gastric mucosal bleeding time was prolonged in 12% of cirrhosis patients (mean 3.24 min) but not in controls (mean 3.0 min).
• No significant correlation was found between prolonged gastric bleeding time and age, platelet count, prothrombin time, skin bleeding time, Child-Pugh score, variceal size, or gastropathy.
• Gastric mucosal bleeding time appears to be a distinct physiological parameter in cirrhosis.

Conclusions:

• Gastric mucosal bleeding time is prolonged in a subset of patients with cirrhosis and portal hypertension.
• This prolonged bleeding time is independent of commonly assessed clinical and endoscopic variables.
• Gastric mucosal bleeding time may represent a unique aspect of the bleeding diathesis in cirrhosis.