Which statement best describes the major bleeding risk in cirrhosis?

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In cirrhosis, major bleeding risk comes from a combination of impaired clotting factor production and the effects of portal hypertension. The diseased liver makes fewer clotting factors, so the blood’s ability to form clots is reduced, which raises the chance of bleeding. At the same time, increased pressure in the portal system promotes the development and potential rupture of varices, especially in the esophagus and stomach, leading to life‑threatening GI bleeding. Platelet count can be low due to splenic sequestration, which adds to the risk, but bleeding is not determined by platelets alone; the overall balance between procoagulant and anticoagulant forces is altered, and the liver’s function ties directly into this balance. Bleeding risk is not explained by cholestasis alone and is clearly linked to both coagulation factor deficiency and portal hypertension.