Hemostatic sprays to control active nonvariceal upper gastrointestinal bleeding

As nonvariceal upper gastrointestinal bleeding remains a critical health concern, there is a need for ongoing optimization of endoscopic hemostasis modalities. Current methods for endoscopic hemostasis include epinephrine injection, thermal coagulation, and mechanical clips. Although these modalities have proven efficacy, there are limitations to their use, including significant learning curves and the requirement of expert assistants. Moreover, there still remains an ongoing risk of rebleeding after therapy. Therefore, a need exists for a safe and easy-to-use method for endoscopic hemostasis, specifically in the setting where current methods for hemostasis are limited or in the setting when hemostasis has not been achieved despite their application. Hemostatic sprays have emerged as novel methods for achieving hemostasis. Therefore, we sought to appraise the evidence concerning the use of hemostatic sprays. Our review highlights that hemostatic spray is a safe and effective method for endoscopic hemostasis, specifically, when current methods are infeasible, unsuccessful, and in malignant nonvariceal upper gastrointestinal bleeding.