Efficacy Of Tranexamic Acid on Recent Internal Haemorrhoid Bleeding as Singe Agent and in Combination with Calcium Dobesilate

Abstract

Background: Haemorrhoidal disease is a common anorectal condition characterized by bleeding, pain, and discomfort, particularly in early stages. Conservative pharmacological treatments aim to reduce symptoms and avoid invasive interventions in patients with Grade 1 and 2 haemorrhoids.

Objective: To determine the efficacy of tranexamic acid as a single agent and in combination with calcium dobesilate in reducing bleeding among patients with recent haemorrhoidal bleeding.

Methods: This randomized controlled trial was conducted at JSS Medical College, Mysuru, involving 60 patients with Grade 1 or 2 haemorrhoids and recent bleeding. Participants were allocated into two groups receiving either tranexamic acid alone or in combination with calcium dobesilate and were assessed for bleeding cessation on day 3 and day 5.

Results: In this study involving 60 patients with recent haemorrhoidal bleeding, both groups – those receiving tranexamic acid (TXA) alone and those receiving TXA with calcium dobesilate (CaD) – were comparable in baseline characteristics including age (mean: 39.6 vs. 38.7 years; p = 0.648), gender distribution (p = 0.301), symptom profile, anthropometric parameters (BMI: 26.1 vs. 25.7 kg/m²; p = 0.653), and haemorrhoid grade and position (p > 0.05). The mean duration from symptom onset to treatment was similar between the groups (9.9 vs. 10.8 days; p = 0.251). All participants presented with bleeding per rectum. By day 3 of treatment, 60.0% of the TXA group still had bleeding, compared to only 20.0% in the TXA + CaD group (p = 0.002). By day 5, bleeding persisted in 33.3% of the TXA group and only 6.7% of the TXA + CaD group (p = 0.010).

Conclusion: The combination of tranexamic acid and calcium dobesilate was significantly more effective than tranexamic acid alone in achieving early cessation of bleeding in recent haemorrhoidal cases. This supports the use of combination therapy as a superior conservative management strategy for early-grade haemorrhoids.