A prospective within-patient comparison clinical trial on the effect of parenteral cimetidine for improvement of fluid secretion and electrolyte balance in patients with short bowel syndrome.
OBJECTIVE
Survival of patients with gastrointestinal cancer has improved recently with various multidisciplinary treatments. However, complications associated with the latter also increased, leading to impairment of quality of life and functional disability in patients. Short bowel syndrome, characterized by severe watery diarrhea and electrolyte losses, is one of the major problems caused by gastrointestinal cancer and subsequent treatments. We investigated whether cimetidine, a gastric antisecretory agent, would ameliorate short bowel syndrome in patients after massive small bowel resection.


METHODS
The study design was such that the evaluation of cimetidine effects was an intra-patient comparison. The randomized block method was used for statistical analyses of frequency and amount of daily watery fluid excretion and urine output, electrolyte levels in fluid secretions, as well as blood biochemistry, body weight and performance status.


RESULTS
Cimetidine administered at an early stage after bowel surgery, especially while patients are receiving parenteral nutrition, significantly decreased stool fluid excretion (p=0.0001), urine output (p=0.0010) and electrolyte loss, which was no longer apparent a week after initiation of oral intake.


CONCLUSIONS
Cimetidine appears to be beneficial for cancer patients who have had extensive small bowel resection.
Kato
Junji
J
Department of Surgery, Aichi Prefectural Hospital, Japan.
Sakamoto
Junichi
J
Teramukai
Satoshi
S
Kojima
Hiroshi
H
Nakao
Akimasa
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000187:drug effects / Q000378:metabolism*; D002927:Cimetidine / Q000008:administration & dosage*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000601:surgery; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D012778:Short Bowel Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance / Q000187:drug effects*
D002927:Cimetidine