Double blind, placebo-controlled trial of tranexamic acid on recent internal haemorrhoid bleeding

Abstract

A double blind randomized placebo controlled trial was conducted to evaluate the efficacy of Tranexamic acid in 54 patients with recent haemorrhoid bleeding. Age, gender, body weight, height, grade of haemorrhoid, time of onset of recent bleeding were comparable between two groups. Analysis of haemostatic effect or cessation of bleeding as an immediate outcome of this study revealed that in the grade 2 patients, 23/23 (100%) of tranexamic group and 18/23(78.26%) of placebo group the bleeding stopped. After 3 days of observation, there was statistically significant differences for the rapidity of cessation of bleeding as well as at the end of observation. Bleeding stopped earlier in the tranexamic group with a median of 4 days (3-5 days), compared to placeo which showed a median of 11(9.55-12.45) days. Analysis of recurrent bleeding in this study revealed that in the placebo group 9/18(50%) of grade 2 patients and all of grade 3 (100%)patients suffered from recurrent bleeding. Since day 4, both group have significant different time for recurrent bleeding and at the end of observation, cumulative probability of absence of bleeding between the two groups were significantly different. Median til cessation of bleeding in the placebo group was 36 days, and the tranexamic group never reaches the median until the end of observation. Conclusion: tranexamic acid was an effective drug to stop haemorrhoid bleeding and prevent further recurrent bleeding.