Effects of octreotide on lower esophageal sphincter in patients with cirrhosis and portal hypertension

We investigated the effects of octreotide infusion on the contractile activity of the esophageal body and lower esophageal sphincter in cirrhotic patients with esophageal varices. Esophageal manometry was performed in 36 alcoholic cirrhotic patients. They were randomly allocated to three groups and received the following treatments blindly for 90 min: an initial 100-mu g intravenous bolus followed by a continuous 25 mu g/hr octreotide infusion (group I, N = 13), a continuous 25 mu g/hr octreotide infusion without an initial bolus (group II, N 13), and a continuous placebo infusion (group III, N = 10). Before drug infusion, mean lower esophageal sphincter pressure and mean esophageal body contraction pressure and duration were similar in the three groups. Compared to the placebo group, lower esophageal sphincter pressure increased significantly in groups I and II, 30 min (30%, 22%, 3% respectively; P = 0.006), 60 min (44%, 35%, 0.6%; P = 0.0002), and 90 min (67%, 41%, 2.5%; P = 0.0001) after octreotide infusion, as did esophageal body contraction pressure and duration. We conclude that octreotide has a potent effect on LES tone in cirrhotic patients.