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DOI: 10.1055/s-0030-1255773
© Georg Thieme Verlag KG Stuttgart · New York
No prolonged effect of Ankaferd Blood Stopper on chronic radiation proctitis
E. OzaslanMD
Numune Education and Research Hospital, Department of Gastroenterology
Cukurambar Mah. 40. Cad. 5/13
Cankaya
Ankara
Turkey
Fax: +90-312-3125026
eMail: er72@hotmail.com
Publikationsverlauf
Publikationsdatum:
07. Oktober 2010 (online)
Ankaferd Blood Stopper (ABS) is a Turkish folk-medicine herbal extract which forms a hemostatic web on bleeding areas by inducing erythrocyte aggregation [1]. We previously reported the first case of successful ABS usage in severe radiation colitis [2]. In this observational study, a total of eight patients with bleeding due to chronic radiation proctitis (CRP) were treated with endoscopic ABS application as a primary therapy. The lesions were severe in all cases according to Wachter’s classification [3]. ABS was instilled onto the bleeding areas by sclerotherapy needle or heater probe catheter, once a week, at a dose of 20 – 30 ml per session. ABS-induced hemostasis lasted for 1 – 8 days per session, and was achieved in seven of eight cases ([Fig. 1]).
In the eighth case bleeding was only lessened. However, recurrence of bleeding was the rule and the ABS had no effect on telangiectasia at the last follow-up. So, its blood-stopping activity for bleeding telangiectasia is only temporary. However, it was found to be effective in healing radiation-induced ulcers (n = 4) ([Fig. 2]).
Afterwards, six patients underwent argon plasma coagulation (APC; complete hemostasis in 5, lessened bleeding in 1), 1 patient underwent successful heater-probe coagulation, and 1 (patient no. 5) required no therapy.
The optimal treatment of bleeding due to CRP is still debated. Currently, APC and local application of formalin are being used as the main successful measures to treat CRP; APC appears safer than formalin [4]. ABS has a transient hemostatic effect lasting 1 – 8 days in bleeding due to CRP. It may well lead to apparent healing of ulcers, but it is not useful for healing of telangiectasia or as a definitive therapy for bleeding. So, its use is not recommended as a routine treatment for CRP.
Patient no. | Patient age, years; sex | Hb (Hct) | Details of bleeding lesion | ABS dose per session (no. of sessions) | Early response* | Final result† |
1 | 65; M | 7.9 g/dL (24.2 %) | T: grade 3 CM: grade 1 U: none S, N: none | 20 mL (5) | Bleeding stopped for 3 days | No change |
2 | 61; M | 12.1 g/dL (35 %) | T: grade 3 CM: grade 2 U: none S, N: none | 20 – 30 mL (5) | Bleeding stopped for 2 – 8 days | No change |
3 | 60; M | 11.0 g/dL (33.2 %) | T: grade 3 CM: grade 2 U: none S, N: none | 30 mL (7) | Bleeding lessened for 3 days | No change |
4 | 68; M | 11.8 g/dL (34 %) | T: grade 3 CM: grade 1 U: none S, N: none | 20 mL (5) | Bleeding stopped for 1 – 3 days | No change |
5 | 56; F | 10.1 g/dL (32 %) | T: grade 1 CM: grade 2 U: grade S, N: none | 20 mL (7) | Bleeding stopped for 3 – 5 days | No change (except healed ulcers) |
6 | 71; M | 12.2 g/dL (36 %) | T: grade 3 CM: grade 2 U: grade 3 S, N: none | 20 mL (5) | Bleeding stopped for 1 – 2 days | No change (except healed ulcer) |
7 | 70; F | 8.0 g/dL (24.3 %) | T: grade 3 CM: grade 2 U: grade 3 S, N: none | 20 mL (5) | Bleeding stopped for 1 – 3 days | No change (except healed ulcer) |
8 | 61; M | 11.6 g/dL (35.3 %) | T: grade 2 CM: grade 1 U: grade 3 S, N: none | 20 mL (5) | Bleeding stopped for 3 days | No change (except healed ulcer) |
T, telangiectasia; CM, congested mucosa; U, ulcer; S, stricture; N, necrosis (Wachter classification [3]). * Immediate hemostasis lasting for given number of days after every session. † Final appearance of the lesion compared to initial. |
Competing interests: None
Endoscopy_UCTN_Code_TTT_1AQ_2AZ
#References
- 1 Ozaslan E, Purnak T, Haznedaroglu I C. Ankaferd Blood Stopper in GI bleeding: alternative for everything?. Gastrointest Endosc. in press DOI: 10.1016/j.gie.2010.05.010
- 2 Ozaslan E, Purnak T, Yildiz A. et al . The effect of Ankaferd Blood Stopper on severe radiation colitis. Endoscopy. 2009; 41 (Suppl 2) E321-E322
- 3 Wachter S, Gerstner N, Goldner G. et al . Endoscopic scoring of late rectal mucosal damage after conformal radiotherapy for prostatic carcinoma. Radiother Oncol. 2000; 54 11-19
- 4 Postgate A, Saunders B, Tjandra J. et al . Argon plasma coagulation in chronic radiation proctitis. Endoscopy. 2007; 39 361-365
E. OzaslanMD
Numune Education and Research Hospital, Department of Gastroenterology
Cukurambar Mah. 40. Cad. 5/13
Cankaya
Ankara
Turkey
Fax: +90-312-3125026
eMail: er72@hotmail.com
References
- 1 Ozaslan E, Purnak T, Haznedaroglu I C. Ankaferd Blood Stopper in GI bleeding: alternative for everything?. Gastrointest Endosc. in press DOI: 10.1016/j.gie.2010.05.010
- 2 Ozaslan E, Purnak T, Yildiz A. et al . The effect of Ankaferd Blood Stopper on severe radiation colitis. Endoscopy. 2009; 41 (Suppl 2) E321-E322
- 3 Wachter S, Gerstner N, Goldner G. et al . Endoscopic scoring of late rectal mucosal damage after conformal radiotherapy for prostatic carcinoma. Radiother Oncol. 2000; 54 11-19
- 4 Postgate A, Saunders B, Tjandra J. et al . Argon plasma coagulation in chronic radiation proctitis. Endoscopy. 2007; 39 361-365
E. OzaslanMD
Numune Education and Research Hospital, Department of Gastroenterology
Cukurambar Mah. 40. Cad. 5/13
Cankaya
Ankara
Turkey
Fax: +90-312-3125026
eMail: er72@hotmail.com