Other trials

Overview

Acute gastrointestinal bleeding is a significant cause of mortality worldwide. Bleeding occurs from within the gastrointestinal tract, this can be from the upper tract (eg. oesophagus or stomach) or from the lower tract (eg. small or large intestine, rectum or anus). Upper gastrointestinal bleeding accounting for most cases.

The main causes include:

• • Peptic ulcers, which are open sores that develop on the inside lining of the stomach and the upper part of the small intestine.
  • Erosive mucosal disease, which includes a number of conditions that cause damage to the stomach lining.
  • Oesophageal varices, which are enlarged veins in the oesophagus. They can be due to obstructed blood flow through the portal vein, which carries blood from the intestine to the liver.
  • Malignancy, which refers to the presence of cancerous cells.

In numbers

The case fatality rate is around 10% for upper gastrointestinal bleeding and 3% for lower gastrointestinal bleeding.

Rebleeding effects between 5% and 40% of patients and is associated with a four-fold increased risk of death.

One of the treatments for acute gastrointestinal bleeding can be blood transfusions.

Due to the relatively high fatality rates and the use of blood transfusions as treatment, we undertook the HALT-IT Trial.

The trial – which took place between 2013 and 2019 – assessed whether early administration of tranexamic acid in participants with acute gastrointestinal bleeding could reduce their risk of dying in the hospital.

Tranexamic acid was found to not reduce deaths from gastrointestinal bleeding and showed an increased risk of thromboembolic events.

As well as gastrointestinal bleeding, there is also ongoing research looking at how tranexamic acid could be used for other bleeding conditions.