Octreotide (a somatostatin analogue) improves the quality of life in some patients with a short intestine.
Six patients with short intestine (jejunal length 25-70 cm) on long-term parenteral nutrition, needing 4-5 L of intravenous fluid daily, were given octreotide (a somatostatin analogue, SMS 201-995) to investigate whether it would reduce beneficially their secretory diarrhoea (3.6-6.9 kg/day). They consumed the same diet for 2 control days, followed by 2 test days. Octreotide was given intravenously, initially in a dose of 50 micrograms b.d. through the central feeding line. There was a significant reduction of daily stomal output (0.5-5.0 kg) and daily sodium and potassium output; however there was no significant change in energy absorption. The response to octreotide was greatest in those patients who absorbed least nutrients. A dose increase to 100 micrograms t.d.s. gave no further measurable benefit though the patients found it smoothed-out the post-prandial rise in stomal output. Two patients were continued on long-term octreotide therapy, which allowed for a daily reduction in intravenous fluid of 1 and 1.5 L. Octreotide's anti-secretory effect was found to have been maintained when it was retested in one patient after a year of continuous therapy.
Nightingale
J M
JM
St Mark's Hospital, London, UK.
Walker
E R
ER
Burnham
W R
WR
Farthing
M J
MJ
Lennard-Jones
J E
JE
D003967:Diarrhea / Q000517:prevention & control; D004032:Diet; D004750:Enteral Nutrition; D005243:Feces / Q000737:chemistry; D006801:Humans; D007583:Jejunum / Q000473:pathology / Q000503:physiopathology; D015282:Octreotide / Q000009:adverse effects / Q000627:therapeutic use*; D011188:Potassium / Q000378:metabolism; D011788:Quality of Life; D012778:Short Bowel Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D012964:Sodium / Q000378:metabolism
D012964:Sodium; D015282:Octreotide; D011188:Potassium