Secretory diarrhea in villous adenoma of rectum: effect of treatment with somatostatin and indomethacin.
The effects of treatment with the synthetic long-acting somatostatin analogue SMS-201-995 were studied in a patient with a fluid and electrolyte secreting villous adenoma of the rectum. The effects of SMS-201-995 on rectal fluid volume and electrolyte loss, and local and general prostanoid production were compared with those of treatment with indomethacin. During treatment with the somatostatin analogue iso-osmolar rectal fluid production increased about 25%; the quantity of prostaglandin E2 in the rectal fluid rose almost 20-fold. Prostaglandin F2 alpha, 6-keto-prostaglandin F1 alpha and 13,14-dihydro-15-keto-prostaglandin F2 alpha output showed similar, though less impressive increments during somatostatin treatment. The somatostatin analogue did not affect urinary prostanoid excretion except for levels of 2,3-dinor-thromboxane B2, which doubled. With indomethacin treatment diurnal rectal fluid production dropped by about 50% and all prostanoids measured in urine and rectal fluid decreased below control values. It appears that the somatostatin analogue SMS-201-995 has a marked stimulatory effect on the in vivo prostanoid production by the villous adenoma. Perhaps this stimulation is not confined to the tumor only, but also affects thromboxane synthesis.
Smelt
A H
AH
Department of General Internal Medicine, Leiden University Hospital, The Netherlands.
Meinders
A E
AE
Hoekman
K
K
Noort
W A
WA
Keirse
M J
MJ
D000236:Adenoma / Q000150:complications* / Q000378:metabolism; D000368:Aged; D001826:Body Fluids / Q000378:metabolism; D003967:Diarrhea / Q000188:drug therapy* / Q000209:etiology; D004573:Electrolytes / Q000378:metabolism; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D008297:Male; D015282:Octreotide / Q000627:therapeutic use*; D011453:Prostaglandins / Q000096:biosynthesis / Q000652:urine; D012004:Rectal Neoplasms / Q000150:complications* / Q000378:metabolism
D004573:Electrolytes; D011453:Prostaglandins; D015282:Octreotide; D007213:Indomethacin