OCTREOTIDE IN DUMPING AND SHORT-BOWEL SYNDROMES

Octreotide inhibits intestinal motility and reduces gastrointestinal secretions. These actions have led to its evaluation in two postsurgical conditions: dumping syndrome and short bowel syndrome. Octreotide substantially reduces symptoms of early and late dumping and prevents the associated phenomena including the increase in packed cell volume considered to be indicative of reduced plasma volume. Its therapeutic benefit probably relates both to slowing of gastric emptying and small bowel transit and inhibition of the release of putative mediators (peptide hormones) of the vasomotor symptoms. Octreotide also reduces intestinal efflux in some patients with the short bowel syndrome. This can lead to a reduction in the volume of intravenous fluid requirements but does not allow an intravenous fluid-dependent patient to change back to an oral regimen. The major mechanism of octreotide's therapeutic effect in this situation may be its ability to reduce endogenous gastric acid secretion.