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. 1994;35(3 Suppl):S5–10. doi: 10.1136/gut.35.3_suppl.s5

Octreotide in the treatment of refractory diarrhoea and intestinal fistulae.

M J Farthing 1
PMCID: PMC1374388  PMID: 8206397

Abstract

Persistent, refractory diarrhoea continues to be an important clinical problem. The mechanisms involved are associated with reduced intestinal absorption and increased intestinal secretion. Reduced intestinal absorption can result from small intestinal resection or from disorders in which there is damage to the small intestine. Motility disorders may also impair absorptive function. The rationale for using octreotide in refractory diarrhoea, intestinal motility disorders, and fistulae relates to its ability to promote intestinal absorption and inhibit gastric, pancreatic, and intestinal secretion. Several clinical studies in patients with short bowel syndrome have reported a reduction of intestinal output in patients taking octreotide compared with controls. Additionally, a number of studies have shown that octreotide improves secretory diarrhoea resulting from neuroendocrine tumours, intestinal infections in AIDS patients, and intestinal graft v host disease. Octreotide may be of use in patients suffering from intestinal motility disorders such as those associated with systemic sclerosis. Octreotide may also be of value in promoting closure of gastrointestinal and pancreatic fistulae.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bianco J. A., Higano C., Singer J., Appelbaum F. R., McDonald G. B. The somatostatin analog octreotide in the management of the secretory diarrhea of the acute intestinal graft-versus-host disease in a patient after bone marrow transplantation. Transplantation. 1990 Jun;49(6):1194–1195. doi: 10.1097/00007890-199006000-00040. [DOI] [PubMed] [Google Scholar]
  2. Chayvialle J. A. Sandostatin and carcinoid tumours in France: experience in the Lyon area. Digestion. 1990;45 (Suppl 1):23–26. doi: 10.1159/000200257. [DOI] [PubMed] [Google Scholar]
  3. Cooper J. C., Williams N. S., King R. F., Barker M. C. Effects of a long-acting somatostatin analogue in patients with severe ileostomy diarrhoea. Br J Surg. 1986 Feb;73(2):128–131. doi: 10.1002/bjs.1800730219. [DOI] [PubMed] [Google Scholar]
  4. Couper R. T., Berzen A., Berall G., Sherman P. M. Clinical response to the long acting somatostatin analogue SMS 201-995 in a child with congenital microvillus atrophy. Gut. 1989 Jul;30(7):1020–1024. doi: 10.1136/gut.30.7.1020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dean A. P., Reed W. D. Diarrhoea--an unrecognised hazard of coeliac plexus block. Aust N Z J Med. 1991 Feb;21(1):47–48. doi: 10.1111/j.1445-5994.1991.tb03001.x. [DOI] [PubMed] [Google Scholar]
  6. Dharmsathaphorn K., Gorelick F. S., Sherwin R. S., Cataland S., Dobbins J. W. Somatostatin decreases diarrhea in patients with the short-bowel syndrome. J Clin Gastroenterol. 1982 Dec;4(6):521–524. doi: 10.1097/00004836-198212000-00008. [DOI] [PubMed] [Google Scholar]
  7. Dharmsathaphorn K., Sherwin R. S., Cataland S., Jaffe B., Dobbins J. Somatostatin inhibits diarrhea in the carcinoid syndrome. Ann Intern Med. 1980 Jan;92(1):68–69. doi: 10.7326/0003-4819-92-1-68. [DOI] [PubMed] [Google Scholar]
  8. Dudl R. J., Anderson D. S., Forsythe A. B., Ziegler M. G., O'Dorisio T. M. Treatment of diabetic diarrhea and orthostatic hypotension with somatostatin analogue SMS 201-995. Am J Med. 1987 Sep;83(3):584–588. doi: 10.1016/0002-9343(87)90777-7. [DOI] [PubMed] [Google Scholar]
  9. Eriksson B., Oberg K., Andersson T., Lundqvist G., Wide L., Wilander E. Treatment of malignant endocrine pancreatic tumors with a new long-acting somatostatin analogue, SMS 201-995. Scand J Gastroenterol. 1988 May;23(4):508–512. doi: 10.3109/00365528809093902. [DOI] [PubMed] [Google Scholar]
  10. Gorden P., Comi R. J., Maton P. N., Go V. L. NIH conference. Somatostatin and somatostatin analogue (SMS 201-995) in treatment of hormone-secreting tumors of the pituitary and gastrointestinal tract and non-neoplastic diseases of the gut. Ann Intern Med. 1989 Jan 1;110(1):35–50. doi: 10.7326/0003-4819-110-1-35. [DOI] [PubMed] [Google Scholar]
  11. Kvols L. K., Moertel C. G., O'Connell M. J., Schutt A. J., Rubin J., Hahn R. G. Treatment of the malignant carcinoid syndrome. Evaluation of a long-acting somatostatin analogue. N Engl J Med. 1986 Sep 11;315(11):663–666. doi: 10.1056/NEJM198609113151102. [DOI] [PubMed] [Google Scholar]
  12. Ladefoged K., Christensen K. C., Hegnhøj J., Jarnum S. Effect of a long acting somatostatin analogue SMS 201-995 on jejunostomy effluents in patients with severe short bowel syndrome. Gut. 1989 Jul;30(7):943–949. doi: 10.1136/gut.30.7.943. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Lamireau T., Galpérine R. I., Ohlbaum P., Demarquez J. L., Vergnes P., Kurzenne Y., Hehunstre J. P. Use of a long acting somatostatin analogue in controlling ileostomy diarrhoea in infants. Acta Paediatr Scand. 1990 Aug-Sep;79(8-9):871–872. doi: 10.1111/j.1651-2227.1990.tb11572.x. [DOI] [PubMed] [Google Scholar]
  14. Maton P. N., O'Dorisio T. M., Howe B. A., McArthur K. E., Howard J. M., Cherner J. A., Malarkey T. B., Collen M. J., Gardner J. D., Jensen R. T. Effect of a long-acting somatostatin analogue (SMS 201-995) in a patient with pancreatic cholera. N Engl J Med. 1985 Jan 3;312(1):17–21. doi: 10.1056/NEJM198501033120104. [DOI] [PubMed] [Google Scholar]
  15. Mourad F. H., Gorard D., Thillainayagam A. V., Colin-Jones D., Farthing M. J. Effective treatment of diabetic diarrhoea with somatostatin analogue, octreotide. Gut. 1992 Nov;33(11):1578–1580. doi: 10.1136/gut.33.11.1578. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Mozell E., Woltering E. A., O'Dorisio T. M., Fletcher W. S., Sinclair A. J., Hill D. Effect of somatostatin analog on peptide release and tumor growth in the Zollinger-Ellison syndrome. Surg Gynecol Obstet. 1990 Jun;170(6):476–484. [PubMed] [Google Scholar]
  17. Nightingale J. M., Lennard-Jones J. E., Walker E. R., Farthing M. J. Jejunal efflux in short bowel syndrome. Lancet. 1990 Sep 29;336(8718):765–768. doi: 10.1016/0140-6736(90)93238-k. [DOI] [PubMed] [Google Scholar]
  18. Nightingale J. M., Walker E. R., Burnham W. R., Farthing M. J., Lennard-Jones J. E. Octreotide (a somatostatin analogue) improves the quality of life in some patients with a short intestine. Aliment Pharmacol Ther. 1989 Aug;3(4):367–373. doi: 10.1111/j.1365-2036.1989.tb00223.x. [DOI] [PubMed] [Google Scholar]
  19. Nightingale J. M., Walker E. R., Farthing M. J., Lennard-Jones J. E. Effect of omeprazole on intestinal output in the short bowel syndrome. Aliment Pharmacol Ther. 1991 Aug;5(4):405–412. doi: 10.1111/j.1365-2036.1991.tb00044.x. [DOI] [PubMed] [Google Scholar]
  20. Nubiola-Calonge P., Badía J. M., Sancho J., Gil M. J., Segura M., Sitges-Serra A. Blind evaluation of the effect of octreotide (SMS 201-995), a somatostatin analogue, on small-bowel fistula output. Lancet. 1987 Sep 19;2(8560):672–674. doi: 10.1016/s0140-6736(87)92452-4. [DOI] [PubMed] [Google Scholar]
  21. Nubiola P., Badia J. M., Martinez-Rodenas F., Gil M. J., Segura M., Sancho J., Sitges-Serra A. Treatment of 27 postoperative enterocutaneous fistulas with the long half-life somatostatin analogue SMS 201-995. Ann Surg. 1989 Jul;210(1):56–58. doi: 10.1097/00000658-198907000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. O'Donnell L. J., Davidson K., Cameron D., Wass J. A., Farthing M. J. Short report: plasma somatostatin concentrations in the irritable bowel syndrome. Aliment Pharmacol Ther. 1991 Dec;5(6):659–663. doi: 10.1111/j.1365-2036.1991.tb00534.x. [DOI] [PubMed] [Google Scholar]
  23. O'Donnell L. J., Watson A. J., Cameron D., Farthing M. J. Effect of octreotide on mouth-to-caecum transit time in healthy subjects and in the irritable bowel syndrome. Aliment Pharmacol Ther. 1990 Apr;4(2):177–181. doi: 10.1111/j.1365-2036.1990.tb00463.x. [DOI] [PubMed] [Google Scholar]
  24. Ohlbaum P., Galperine R. I., Demarquez J. L., Vergnes P., Martin C. Use of a long-acting somatostatin analogue (SMS 201-995) in controlling a significant ileal output in a 5-year-old child. J Pediatr Gastroenterol Nutr. 1987 May-Jun;6(3):466–470. doi: 10.1097/00005176-198705000-00026. [DOI] [PubMed] [Google Scholar]
  25. Rodrigues C. A., Lennard-Jones J. E., Thompson D. G., Farthing M. J. The effects of octreotide, soy polysaccharide, codeine and loperamide on nutrient, fluid and electrolyte absorption in the short-bowel syndrome. Aliment Pharmacol Ther. 1989 Apr;3(2):159–169. doi: 10.1111/j.1365-2036.1989.tb00202.x. [DOI] [PubMed] [Google Scholar]
  26. Ruskoné A., René E., Chayvialle J. A., Bonin N., Pignal F., Kremer M., Bonfils S., Rambaud J. C. Effect of somatostatin on diarrhea and on small intestinal water and electrolyte transport in a patient with pancreatic cholera. Dig Dis Sci. 1982 May;27(5):459–466. doi: 10.1007/BF01295657. [DOI] [PubMed] [Google Scholar]
  27. Santangelo W. C., Dueno M. I., Krejs G. J. Pseudopancreatic cholera syndrome: effect of a synthetic somatostatin analogue, SMS 201-995. Am J Med. 1987 May 29;82(5B):84–87. doi: 10.1016/0002-9343(87)90431-1. [DOI] [PubMed] [Google Scholar]
  28. Smith S., Anthony L., Roberts L. J., Oates J. A., Pincus T. Resolution of musculoskeletal symptoms in the carcinoid syndrome after treatment with the somatostatin analog octreotide. Ann Intern Med. 1990 Jan 1;112(1):66–68. doi: 10.7326/0003-4819-112-1-66. [DOI] [PubMed] [Google Scholar]
  29. Soudah H. C., Hasler W. L., Owyang C. Effect of octreotide on intestinal motility and bacterial overgrowth in scleroderma. N Engl J Med. 1991 Nov 21;325(21):1461–1467. doi: 10.1056/NEJM199111213252102. [DOI] [PubMed] [Google Scholar]
  30. Souquet J. C., Sassolas G., Forichon J., Champetier P., Partensky C., Chayvialle J. A. Clinical and hormonal effects of a long-acting somatostatin analogue in pancreatic endocrine tumors and in carcinoid syndrome. Cancer. 1987 May 1;59(9):1654–1660. doi: 10.1002/1097-0142(19870501)59:9<1654::aid-cncr2820590922>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  31. Tsai S. T., Vinik A. I., Brunner J. F. Diabetic diarrhea and somatostatin. Ann Intern Med. 1986 Jun;104(6):894–894. doi: 10.7326/0003-4819-104-6-894_1. [DOI] [PubMed] [Google Scholar]
  32. Vinik A. I., Tsai S. T., Moattari A. R., Cheung P., Eckhauser F. E., Cho K. Somatostatin analogue (SMS 201-995) in the management of gastroenteropancreatic tumors and diarrhea syndromes. Am J Med. 1986 Dec 22;81(6B):23–40. doi: 10.1016/0002-9343(86)90582-6. [DOI] [PubMed] [Google Scholar]
  33. Williams N. S., Cooper J. C., Axon A. T., King R. F., Barker M. Use of a long acting somatostatin analogue in controlling life threatening ileostomy diarrhoea. Br Med J (Clin Res Ed) 1984 Oct 20;289(6451):1027–1028. doi: 10.1136/bmj.289.6451.1027. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Woods H. F., Bax N. D., Ainsworth I. Abdominal carcinoid tumours in Sheffield. Digestion. 1990;45 (Suppl 1):17–22. doi: 10.1159/000200256. [DOI] [PubMed] [Google Scholar]

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