Role of Somatostatin and Octreotide in Esophageal Varices, Dumping Syndrome and Diarrhea

Abstract

Bleeding from esophageal varices has a high mortality rate. Sclerotherapy is the most appropriate treatment, but is not always available. Alternatively, somatostatin and octreotide may be used for the treatment of variceal bleeding. They seem to be as effective as vasopressin but have fewer adverse effects. Their role as adjuvant treatment to emergency sclerotherapy for active variceal bleeding must be further investigated. Somatostatin and octreotide reduce symptoms of the early and late dumping syndrome. Their therapeutic benefit is probably associated with a slower gastric emptying and small bowel transit time and inhibition of the release of peptide hormones mediating vasomotor symptoms. In refractory diarrhea, octreotide is able to promote intestinal absorption and inhibit gastric, pancreatic and intestinal secretion. Octreotide positively affects short bowel syndrome, secretory diarrhea resulting from neuroendocrine tumors, intestinal infections in AIDS patients, and motility disorders in diabetes mellitus and systemic sclerosis.