Recently, an interesting Spanish multicenter cohort study by Ardevol et al. (1) found that the risk of further bleeding and 45-day mortality were statistically similar in cirrhotic patients with acute upper gastrointestinal bleeding (AUGIB) from varices and peptic ulcer. Notably, the researchers employed the same first-line treatment strategy before endoscopy regardless of source of upper gastrointestinal bleeding, which included vasoconstrictors, proton pump inhibitors (PPIs), and prophylactic antibiotics. This seems to be different from the current recommendations from the mainstream consensus and guidelines (Figure 1).The Asia-Pacific Working Group consensus and A m e r i c a n C o l l e g e o f G a s t r o e n t e r o l o g y p r a c t i c e guideline (2,3) recommend that high-dose PPIs are the core treatment options for acute peptic ulcer bleeding. However, there is no recommendation regarding the use of vasoconstrictors for acute peptic ulcer bleeding, in spite of its potential benefit in scattered case reports (4). On the other hand, the Baveno VI consensus (5), 2016 American Association for the Study of Liver Diseases (AASLD) practice guidance (6), and updated UK guideline (7) recommend that