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.