From the Guidelines

TXA (tranexamic acid) is not recommended to stop a GI (gastrointestinal) bleed.

The use of tranexamic acid in acute GI bleeding has been evaluated in several studies, but the evidence is not strong enough to support its routine use 1.
A large randomized placebo-controlled trial including 12,009 patients with acute upper gastrointestinal bleeding found no beneficial effect of tranexamic acid on mortality, and an increased risk of venous thromboembolic events 1.
The EASL clinical practice guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis recommend against the use of tranexamic acid in patients with cirrhosis and active variceal bleeding, and also discourage its routine use in patients with cirrhosis undergoing invasive procedures 1.
A meta-analysis of tranexamic acid therapy in non-variceal upper gastrointestinal haemorrhage found that it tends to reduce mortality in ulcer bleeding patients, but further studies are necessary before it can be recommended as routine therapy 1.

Tranexamic acid may not be effective in stopping GI bleeds, especially in patients with cirrhosis and variceal bleeding.
The use of tranexamic acid may increase the risk of venous thromboembolic events.
More research is needed to fully understand the effects of tranexamic acid in GI bleeding.
Current guidelines recommend against the routine use of tranexamic acid in GI bleeding, except in specific cases where the benefits may outweigh the risks.

The FDA Drug Labels for tranexamic acid (PO) do not address this question.

From the Research

The use of tranexamic acid (TXA) in gastrointestinal (GI) bleeding has been studied in several trials, with varying results 2, 3, 4, 5, 6.
Some studies suggest that TXA may reduce rebleeding and mortality in patients with upper GI bleeding 2, 3, 4.
A systematic review and meta-analysis of randomized controlled trials found that TXA significantly reduced the rates of continued bleeding, urgent endoscopic intervention, and mortality compared to placebo 3.
However, another systematic review and meta-analysis found no significant difference in mortality between TXA and placebo, and did not recommend the use of TXA in acute gastrointestinal bleeding 6.

The safety of TXA in GI bleeding has also been evaluated, with some studies finding no increased risk of thromboembolic events 2, 4.
However, one trial reported an increased risk of seizure in the TXA group 6.
The HALT-IT trial, a large international randomized controlled trial, aimed to provide reliable evidence about the effects of TXA in acute upper and lower GI bleeding, but the results are not yet fully published 5.

Subgroup analyses have considered factors such as time to treatment, location of bleeding, cause of bleed, and clinical Rockall score 5.
These analyses may help to identify specific patient populations that may benefit from TXA treatment.

The overall evidence on the use of TXA in GI bleeding is mixed, with some studies suggesting benefit and others finding no significant effect 2, 3, 4, 5, 6.
Further research is needed to fully understand the efficacy and safety of TXA in this setting.