title: Effects of Sandostatin LAR on gastrointestinal motility in patients with neuroendocrine tumors.
abstract: BACKGROUND
  Diarrhea is part of the carcinoid syndrome and a significant clinical problem in neuroendocrine tumor (NET) patients. Somatostatin analog (SA) treatment usually alleviates carcinoid diarrhea, but little is known about the objective effects of SA on gastrointestinal transport.
  
  
  OBJECTIVE
  To compare gastrointestinal motility in healthy subjects and NET patients before and during SA treatment.
  
  
  METHODS
  Twelve NET patients were studied before and during 4 weeks of SA treatment and were compared with 12 healthy controls. Radio-opaque markers were used for the assessment of total gastrointestinal transit time (GITT). Gastric and small intestinal (SI) transit patterns were described via the external tracking of a small magnetic pill ingested by the subjects.
  
  
  RESULTS
  Compared with controls, NET patients had a significantly shorter GITT (0.7 days (0.5-1.5) vs. 1.9 days (1.0-2.3)), a shorter SI transit time (184 min (74-307) vs. 322 min (131-376)), and a faster SI velocity (2.16 cm/min (0.91-3.66) vs. 1.29 cm/min (0.76-2.60)) (all p < 0.05) but a similar gastric emptying time. SA treatment was followed by a reduction in bowel movements (five per day (3-12) vs. four per day (1-7; p < 0.02)) as well as an increase in GITT (1.4 days (0.5-2.2; p < 0.05)). Further, a trend was observed toward increased SI transit time (253 min (145-344; p = 0.08)). Gastric emptying time increased during SA treatment (19 min (4-200) vs. 179 min (5-389; p < 0.02)). Elevated chromogranin A (CgA), serotonin, and urinary 5-hydroxyindoleacetic acid (U-5HIAA) levels decreased during SA treatment.
  
  
  CONCLUSIONS
  NET patients have faster than normal total GITT and SI transit times. SA treatment prolongs gastric emptying and GITT, thereby reducing the number of bowel movements.
authors.affiliation: Neurogastroenterology Unit, Department of Medicine V (Hepatology & Gastroenterology), Aarhus University Hospital, Aarhus, Denmark. Tg@ki.au.dk
authors.forename: Tine
authors.initials: T
authors.lastname: Gregersen
authors.forename: Henning
authors.initials: H
authors.lastname: Grønbæk
authors.forename: Jonas
authors.initials: J
authors.lastname: Worsøe
authors.forename: Vincent
authors.initials: V
authors.lastname: Schlageter
authors.forename: Søren
authors.initials: S
authors.lastname: Laurberg
authors.forename: Klaus
authors.initials: K
authors.lastname: Krogh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology* / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D002432:Cecum / Q000503:physiopathology; D053379:Chromogranin A / Q000097:blood; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D007414:Intestinal Neoplasms / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology* / Q000652:urine; D007421:Intestine, Small / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects; D018358:Neuroendocrine Tumors / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology* / Q000652:urine; D015282:Octreotide / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D012701:Serotonin / Q000097:blood; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D053379:Chromogranin A; C541923:sandostatinLAR; D012701:Serotonin; D006897:Hydroxyindoleacetic Acid; D015282:Octreotide