1. Department of Gastroenterology, Çanakkale Onsekiz Mart University School of Medicine, Çanakkale, Turkey;
2. Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey;
3. Department of Pathology, Ankara Education and Research Hospital, Ankara, Turkey;
4. Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey;
5. Department of General Surgery, Ankara Education and Research Hospital, Ankara, Turkey;
6. Department of Gastroenterology, Yuksek Ihtisas Hospital, Ankara, Turkey;
7. Department of Medical Biochemistry, Ankara Education and Research Hospital, Ankara, Turkey;
8. Department of Neurology, Sakarya University Education and Research Hospital, Sakarya, Turkey;
9. Department of Chest Diseases, Occupational Diseases Hospital, Ministry of Health, Ankara, Turkey;
10. Department of Hematology, Hacettepe University School of Medicine, Ankara, Turkey.
Background and aims: Ankaferd Blood Stopper (ABS) is a herbal extract obtained from five different plants. It has a therapeutic potential for the management of external hemorrhage and controlling gastrointestinal bleeding. However, ABS's effects are not unknown on gastrointestinal systems. The aim of this study was to assess the effect of short- and long-term systemic exposure and gastrointestinal safety following the oral administration of high-dose ABS in rats.
Methods: Eighteen healthy adult male rats were included into the study. The rats were divided into 4 groups: group A was fed with high dose ABS (2ml/Kg) for one week, group B for one month, group C for three months and group D's diet did not contain any ABS. On termination of the ABS treatment, the gastrointestinal system from the esophagus to the anus and the liver were surgically removed and histological investigated.
Results: During the study period, there was no mortality; signs of intoxication in any of the studied groups. No gastrointestinal tissue fibrosis, dysplasia, or metaplasia was detectable in any of the groups. The stomach had a normal morphology in all groups. However, the other gastrointestinal tract sections showed mucosal inflammation, goblet cell decrements, and intra-epithelial lymphocyte infiltration. The most common changes were mucosal inflammation in all rats in group B and C. Frequency of inflammation was greater in groups B and C in comparison to group A (P= 0.001). Loss of goblet cell and intra-epithelial lymphocyte infiltration were not significantly different between groups A and B (P=0.308 and P=0.189, respectively). However, there was significantly higher intra-epithelial lymphocyte infiltration in group C than in group A (P=0.04). Histopathological examination of the liver showed no inflammation, fibrosis, bile duct destruction or proliferation in any of the groups. However, each groups revealed vascular dilatation and erythrocyte accumulation at the sinusoidal structures of the liver.
Conclusions: ABS seems to be a safe agent and it can be used for hemorrhage originated from gastric lesions. Further work needs to be done to establish whether ABS leads to be used to stop gastrointestinal bleeding.
Keywords: Ankaferd blood stopper, systemic effects, oral administration, high dose.