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Short bowel syndrome.

J M Nightingale1, E R Walker, W R Burnham

  • 1St Mark's Hospital, London, UK.

Digestion
|January 1, 1990
PubMed
Summary
This summary is machine-generated.

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Octreotide effectively reduced intestinal output in short bowel syndrome patients with secretory issues. Long-term use decreased fluid replacement needs in some patients.

Area of Science:

  • Gastroenterology
  • Clinical Pharmacology

Background:

  • Short bowel syndrome (SBS) is characterized by high intestinal output, leading to dehydration and malnutrition.
  • Octreotide, a synthetic analog of somatostatin, is used to manage symptoms like diarrhea and high output.

Purpose of the Study:

  • To evaluate the efficacy of octreotide in patients with short bowel syndrome and high intestinal output.
  • To assess the impact of octreotide on intestinal fluid and electrolyte balance.

Main Methods:

  • Nine patients with short bowel syndrome and high intestinal output participated.
  • Octreotide was administered intravenously (50-100 mcg t.i.d.) or subcutaneously (100 mcg b.i.d.) over two test days.
  • Intestinal output, fluid intake, and electrolyte levels were monitored.

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Main Results:

  • Six patients with net secretory output showed a significant reduction in mean daily intestinal output (0.5-5.0 kg).
  • Total daily intestinal sodium and potassium output was also significantly reduced in secretory patients.
  • Three patients with a net absorptive state experienced worsening output or no improvement.
  • Two patients with secretory output on long-term octreotide therapy reduced daily intravenous fluid intake by 1.0-1.5 liters.

Conclusions:

  • Octreotide is effective in reducing intestinal output and fluid/electrolyte losses in short bowel syndrome patients with a net secretory state.
  • Octreotide may not be beneficial and could worsen output in patients with a net absorptive state.
  • Long-term octreotide therapy can decrease the need for intravenous fluid replacement in selected SBS patients.