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Control of dumping symptoms by somatostatin analogue in patients after gastric surgery.

Abstract
Octreotide acetate is a long-acting analogue of the naturally occurring inhibitory gastrointestinal peptide, somatostatin. We tested the efficacy of octreotide in controlling the symptoms of dumping syndrome in response to a provocative meal in a randomized, double-blinded, crossover trial in nine severely affected patients. Pretreatment with octreotide acetate (100 micrograms injected subcutaneously) reduced postprandial dumping symptoms from a mean +/- SEM score of 15.7 +/- 1.6 (placebo treatment day) to 4.6 +/- 1.7. With placebo treatment, all nine patients became symptomatic in response to the meal, whereas with octreotide treatment, symptoms occurred in only two of nine patients. Similarly, all placebo-treated patients showed a postprandial increase in pulse rate to a mean +/- SEM of 105 +/- 6 beats per minute, whereas only one of nine octreotide-treated patients showed an increase in pulse rate (mean +/- SEM, 80 +/- 3 beats per minute). These differences were also statistically significant. While no significant changes were observed in postprandial hematocrit values or osmolality between placebo and octreotide treatments, octreotide prevented hypoglycemia in four affected patients and significantly inhibited insulin release. We conclude that octreotide is a useful tool in the treatment of patients with severe, refractory dumping syndrome.
AuthorsJ L Gray, H T Debas, S J Mulvihill
JournalArchives of surgery (Chicago, Ill. : 1960) (Arch Surg) Vol. 126 Issue 10 Pg. 1231-5; discussion 1235-6 (Oct 1991) ISSN: 0004-0010 [Print] United States
PMID1929823 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Blood Glucose
  • Insulin
  • Octreotide
Topics
  • Blood Glucose
  • Double-Blind Method
  • Dumping Syndrome (metabolism, physiopathology, prevention & control)
  • Female
  • Gastrectomy (adverse effects)
  • Hematocrit
  • Humans
  • Insulin (blood)
  • Male
  • Octreotide (therapeutic use)
  • Osmolar Concentration
  • Pulse

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