Recall liver disease from previous lesson, why does liver cirrhosis leads to increased risk of haemorrhage?

Liver cirrhosis can lead to an increased risk of haemorrhage due to several reasons:

1. Portal Hypertension: Cirrhosis causes resistance to blood flow in the liver, resulting in high blood pressure in the portal vein system (portal hypertension). This can lead to the development of large, swollen veins (varices) within the esophagus, stomach, and rectum. These varices are fragile and can easily bleed, leading to significant haemorrhage.

2. Decreased Production of Clotting Factors: The liver is responsible for producing many of the proteins involved in blood clotting (coagulation). In cirrhosis, the liver's ability to produce these clotting factors can be impaired, leading to a tendency to bleed more easily.

3. Thrombocytopenia: This is a condition characterized by low platelet count. Platelets are cells that help in blood clotting. In cirrhosis, the spleen can become enlarged (splenomegaly) due to portal hypertension and can sequester or hold onto too many platelets, leading to thrombocytopenia. This can further contribute to an increased bleeding risk.

4. Coagulopathy: This is a condition in which the blood's ability to clot is impaired. This can be caused by Vitamin K deficiency, which is common in people with cirrhosis because the diseased liver is unable to store vitamin K.

So, these are the reasons why liver cirrhosis leads to an increased risk of haemorrhage.