No prolonged effect of Ankaferd Blood Stopper on chronic radiation proctitis.

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 20–30ml 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 heaterprobe 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.