Long-acting octreotide in the treatment of diarrhea after pelvic pouch surgery

Abstract

After pelvic pouch surgery (restorative proctocolectomy), periodic or continuous diarrhea is common. Distressing diarrhea may be triggered by pouchitis, cuffitis or an anastomotic stricture. Medical therapy with loperamide or diphenoxylate is often unsatisfactory even after the correction of the underlying problem. Seven patients, who earlier had undergone restorative proctocolectomy, were treated with a standard dose of 10 mg of long-acting octreotide (Sandostatin LAR) for prolonged and distressing diarrhea which had not responded to conventional medication. Five of the patients had complete relief of diarrhea. The effect lasted for at least two months after a single dose. Two patients did not respond. No sideeffects were reported. Long-acting octreotide is effective in the treatment of severe diarrhea in patients after pelvic pouch surgery.