The effect of Ankaferd blood stopper on severe radiation colitis.

ardized herbal extract obtained from five different plants Thymus vulgaris (thyme), Glycyrrhiza glabra (licorice), Vitis vinifera (grape), Alpinia officinarum (lesser galangal), and Urtica dioica (stinging nettle) [1–3]. Here, we present the first case of successful ABS usage in the therapy of radiation colitis. A 71-year-old woman who had undergone pelvic radiotherapy due to cancer of the cervix was admitted with rectal bleeding. Colonoscopy revealed radiation rectosigmoiditis involving the area between 13 cm and 20 cm from the anal verge (●" Fig. 1a). The lesion was severe according to Wachter et al. [4] classification (congested mucosa: grade 2; ulceration: grade 3; necrosis: grade 1). A total of 20mL ABS solution was sprayed with a sclerotherapy needle onto the lesion. This produced greyish–yellow discoloration and bleeding stopped within seconds (●" Fig. 1b,c). No sign of bleeding was observed in the following days, and three further sessions were carried out on a weekly basis to complete the healing. At follow-up, the giant ulcerated lesion had almost disappeared, with only mild residual erosions and friability remaining (●" Fig. 2a,b,c). The patient had only mild pelvic pain at the fifth week, despite ongoing friability of the lesion area. The optimal treatment of bleeding due to radiation proctitis is still controversial. Currently, argon plasma coagulation (APC) and local application of formalin are being used as the main successful measures for therapy of radiation colitis. APC treatment appears to be safer than formalin [5]. ABS as a new hemostatic agent has been reported in various gastrointestinal scenarios, namely Dieulafoy lesion [1], solitary rectal ulcer [2], and neoplastic gastrointestinal bleeding [3]. Upon application onto the injured area, it induces a hemostatic protein network that stimulates erythrocyte aggregation [1]. ABS may also offer an exciting option in the therapy of radiation colitis, due to the ease of application, speed of action, nontoxicity, and low cost.