Topical hemostatic powders in the management of gastrointestinal bleeding

Hemostatic powders were developed to overcome limitations associated with conventional endoscopic techniques, and their use in gastrointestinal bleeding is increasing exponentially. Various hemostatic powder preparations exist, each differing in properties, efficacy, and potential side effects. In t...

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Main Authors: Jongbeom Shin, Boram Cha, Ji Taek Hong, Jin Hee Maeng, Kye Sook Kwon
Format: Article
Language:English
Published: Society of Gastrointestinal Intervention 2025-07-01
Series:International Journal of Gastrointestinal Intervention
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Online Access:https://www.ijgii.org/journal/view.html?doi=10.18528/ijgii250041
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author Jongbeom Shin
Boram Cha
Ji Taek Hong
Jin Hee Maeng
Kye Sook Kwon
author_facet Jongbeom Shin
Boram Cha
Ji Taek Hong
Jin Hee Maeng
Kye Sook Kwon
author_sort Jongbeom Shin
collection DOAJ
description Hemostatic powders were developed to overcome limitations associated with conventional endoscopic techniques, and their use in gastrointestinal bleeding is increasing exponentially. Various hemostatic powder preparations exist, each differing in properties, efficacy, and potential side effects. In this study, we aimed to review three representative hemostatic powders approved by the FDA (U.S. Food and Drug Administration). A literature review of hemostatic powders used for gastrointestinal bleeding was conducted via a MEDLINE database search, supplemented by manual article searches spanning from 2000 to 2024. Relevant literature was critically evaluated, focusing on key components, hemostatic efficacy, rebleeding rates, and adverse events. Hemospray and Endoclot are the most extensively studied hemostatic powders, demonstrating successful applications across a wide spectrum of upper and lower gastrointestinal bleeding etiologies. Nexpowder, a newer agent, has shown comparable efficacy to these established powders in early clinical studies. All three powders achieve high immediate hemostasis rates, particularly beneficial in cases where conventional endoscopic methods are challenging. Nevertheless, notable limitations remain, including reduced effectiveness in cases of active arterial spurting hemorrhage (Forrest Ia) and ongoing concerns regarding rebleeding rates. Adverse events such as visceral perforation, venous embolism, and transient abdominal pain have been documented with Hemospray. Conversely, no agent-related adverse events have yet been reported for Nexpowder and Endoclot. Recent studies have begun investigating whether hemostatic powders offer additional benefits in reducing post-procedural rebleeding and major upper gastrointestinal bleeding. The rapid advancement of hemostatic powders and accumulating clinical experience affirm these agents as valuable therapeutic options in gastrointestinal bleeding management. Ongoing research is crucial to further enhance their efficacy and extend their clinical applicability.
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spelling doaj-art-cb907208a2cf45beba8e81a817e515a72025-08-20T02:50:49ZengSociety of Gastrointestinal InterventionInternational Journal of Gastrointestinal Intervention2636-00042025-07-0114310310710.18528/ijgii250041ijgii250041Topical hemostatic powders in the management of gastrointestinal bleedingJongbeom Shin0Boram Cha1Ji Taek Hong2Jin Hee Maeng3Kye Sook Kwon4Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, KoreaDepartment of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, KoreaDepartment of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, KoreaUtah-Inha DDS and Advanced Therapeutics Research Center, Incheon, KoreaDepartment of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, KoreaHemostatic powders were developed to overcome limitations associated with conventional endoscopic techniques, and their use in gastrointestinal bleeding is increasing exponentially. Various hemostatic powder preparations exist, each differing in properties, efficacy, and potential side effects. In this study, we aimed to review three representative hemostatic powders approved by the FDA (U.S. Food and Drug Administration). A literature review of hemostatic powders used for gastrointestinal bleeding was conducted via a MEDLINE database search, supplemented by manual article searches spanning from 2000 to 2024. Relevant literature was critically evaluated, focusing on key components, hemostatic efficacy, rebleeding rates, and adverse events. Hemospray and Endoclot are the most extensively studied hemostatic powders, demonstrating successful applications across a wide spectrum of upper and lower gastrointestinal bleeding etiologies. Nexpowder, a newer agent, has shown comparable efficacy to these established powders in early clinical studies. All three powders achieve high immediate hemostasis rates, particularly beneficial in cases where conventional endoscopic methods are challenging. Nevertheless, notable limitations remain, including reduced effectiveness in cases of active arterial spurting hemorrhage (Forrest Ia) and ongoing concerns regarding rebleeding rates. Adverse events such as visceral perforation, venous embolism, and transient abdominal pain have been documented with Hemospray. Conversely, no agent-related adverse events have yet been reported for Nexpowder and Endoclot. Recent studies have begun investigating whether hemostatic powders offer additional benefits in reducing post-procedural rebleeding and major upper gastrointestinal bleeding. The rapid advancement of hemostatic powders and accumulating clinical experience affirm these agents as valuable therapeutic options in gastrointestinal bleeding management. Ongoing research is crucial to further enhance their efficacy and extend their clinical applicability.https://www.ijgii.org/journal/view.html?doi=10.18528/ijgii250041gastrointestinal hemorrhagehemostasisendoscopichemostatics
spellingShingle Jongbeom Shin
Boram Cha
Ji Taek Hong
Jin Hee Maeng
Kye Sook Kwon
Topical hemostatic powders in the management of gastrointestinal bleeding
International Journal of Gastrointestinal Intervention
gastrointestinal hemorrhage
hemostasis
endoscopic
hemostatics
title Topical hemostatic powders in the management of gastrointestinal bleeding
title_full Topical hemostatic powders in the management of gastrointestinal bleeding
title_fullStr Topical hemostatic powders in the management of gastrointestinal bleeding
title_full_unstemmed Topical hemostatic powders in the management of gastrointestinal bleeding
title_short Topical hemostatic powders in the management of gastrointestinal bleeding
title_sort topical hemostatic powders in the management of gastrointestinal bleeding
topic gastrointestinal hemorrhage
hemostasis
endoscopic
hemostatics
url https://www.ijgii.org/journal/view.html?doi=10.18528/ijgii250041
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AT jinheemaeng topicalhemostaticpowdersinthemanagementofgastrointestinalbleeding
AT kyesookkwon topicalhemostaticpowdersinthemanagementofgastrointestinalbleeding