From the Guidelines
Tranexamic acid (TXA) is not recommended as a standard treatment to stop a gastrointestinal bleed.
Key Points
- The use of TXA in acute gastrointestinal bleeding is not supported by high-quality evidence 1.
- A study by the British Society of Gastroenterology suggests that TXA may have a benefit in acute GI bleeding, but this benefit was no longer apparent when the analysis was limited to trials at low risk of bias 1.
- The European Society of Intensive Care Medicine suggests not using high-dose IV TXA in critically ill patients with gastrointestinal bleeding, citing high certainty evidence 1.
- The optimal dosing regimen for TXA in gastrointestinal bleeding is uncertain, and its use is confined to clinical trials pending further evidence 1.
- In clinical practice, the use of TXA for gastrointestinal bleeding should be approached with caution, considering the lack of strong evidence supporting its effectiveness and the potential risks of thromboembolic events 1.
From the Research
Tranexamic Acid (TXA) and Gastrointestinal Bleeding
- TXA is not effective in reducing bleeding in upper and lower gastrointestinal bleeding, as stated in the study 2.
- The study 2 also mentions that some trials reported an increased rate of thrombotic complications with the use of TXA for gastrointestinal bleeding.
- Another study 3 notes that further studies are warranted for the use of TXA in gastrointestinal bleeding, indicating a lack of conclusive evidence for its effectiveness in this area.
TXA Efficacy in Other Bleeding Conditions
- TXA has been shown to reduce bleeding in various surgical procedures, such as orthopedic surgery, cardiac surgery, and obstetric surgery, as well as in patients with menorrhagia and trauma patients with bleeding 2, 3, 4.
- TXA has also been found to reduce mortality in patients suffering from trauma and postpartum hemorrhage 2, 3.