Secretin inhibits gastric secretion of
acid and
gastrin in dog and a physiological role of
secretin as an
enterogastrone has been suggested in this species. In man there are diverging results concerning the effect of
secretin on gastric secretion.
Secretin has been used in patients with upper gastrointestinal
bleeding and positive results have been reported, but the patients included in these studies cannot be considered as massive bleeders. Until now no double-blind study comparing
secretin with placebo has been reported.
Somatostatin decreases splanchnic blood flow and gastric secretion in man.
Somatostatin seems to be effective in achieving initial haemostasis in patients with
bleeding oesophageal
varices. The
peptide has also been shown to stop severe and persistent
peptic ulcer haemorrhage and to stop
bleeding in patients treated with steroidal and non-steroidal anti-inflammatory drugs. In one double-blind trial in patients with upper gastrointestinal
bleeding,
somatostatin had no effect on either the number of emergency operations or the number of rebleedings. In another double blind study, when
somatostatin was compared with placebo in patients with massive upper gastrointestinal
bleeding, the
peptide reduced the number of emergency operations. In conclusion, most studies show positive effects of
somatostatin on variceal and
peptic ulcer haemorrhage.