Related Experiment Video
Updated: Mar 16, 2026
Validation of Therapeutic Agent Conjugation to Polyvinyl Alcohol-Coated Medical Devices
Published on: November 29, 2024
Utility of Octreotide in Advancing Enteral Feeds in Children with Chronic Intestinal Pseudo-Obstruction
Lusine Ambartsumyan1,2, Alejandro Flores1, Samuel Nurko1
1Division of Gastroenterology, Department of Medicine, Center for Motility and Functional Gastrointestinal Disorders, Children's Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.
Insights
Octreotide improves enteral feeding tolerance in children with chronic intestinal pseudo-obstruction (CIPO). Antroduodenal manometry can help predict treatment response in these pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
- Pharmacotherapy
Background:
- Chronic intestinal pseudo-obstruction (CIPO) presents significant challenges in pediatric care, often necessitating total parenteral nutrition (TPN) due to poor enteral tolerance.
- Limited therapeutic options exist for improving enteral feeding in children with CIPO, highlighting the need for effective interventions.
Purpose of the Study:
- To evaluate the efficacy and safety of octreotide in improving enteral tolerance in TPN-dependent children diagnosed with CIPO.
- To identify factors that predict a positive response to octreotide therapy in this patient population.
Main Methods:
- A cohort of TPN-dependent children with CIPO receiving octreotide treatment was retrospectively analyzed.
- Octreotide response was defined as an increase in enteral feeding of at least 10 cc/kg/day.
- Antroduodenal manometry was utilized to assess intestinal motility before and after octreotide administration.
Main Results:
- Octreotide administration led to improved enteral feeding in 69% (11/16) of the pediatric patients, with 44% (7/16) classified as responders.
- A significant association was observed between octreotide response and the induction of intestinal phase III of the migrating motor complex (MMC) and increased intestinal motility index post-octreotide challenge (p=0.03 and <0.01, respectively).
- No correlation was found between octreotide response and patient age, ileostomy presence, or colonic manometry parameters. Adverse events included allergic reaction, hyperglycemia, hypertension, and cholecystitis, with most managed by dose adjustment or discontinuation.
Conclusions:
- Octreotide demonstrates safety and efficacy in enhancing enteral feeding tolerance for children suffering from CIPO and relying on TPN.
- Antroduodenal manometry appears to be a valuable tool for predicting the likelihood of a positive response to octreotide therapy in pediatric CIPO cases.
- Further prospective research is warranted to comprehensively assess the long-term safety and effectiveness of octreotide in the pediatric CIPO population.
Objectives:
Chronic intestinal pseudo-obstruction (CIPO) is a challenging disorder with high morbidity and mortality due to limited effective therapies that improve enteral tolerance. We aimed to present our experience using octreotide in children with CIPO and evaluate factors predicting therapy response.
Methods:
The study population included total parenteral nutrition (TPN)-dependent children with CIPO receiving octreotide at a tertiary care center. Octreotide response was defined as an enteral feeding increase of ≥10 cc/kg/day.
Results:
A total of 16 children were included (median age 5 years, range 1-18; 88 % female). We observed an overall feed increase in 11/16 (69 %) subjects and 7/16 (44 %) were considered responders: three tolerated >65 cc/kg/day (discontinued TPN), one tolerated >30 cc/kg/day (decreased TPN) and three patients tolerated 10-12 cc/kg/day. We found an association between therapeutic octreotide response and both the presence of octreotide-induced intestinal phase III of the migrating motor complex (MMC) as well as a higher median increase in intestinal motility index after octreotide challenge during the antroduodenal manometry (p = 0.03 and <0.01, respectively). We did not find an association between octreotide response and age, presence of ileostomy, and colonic manometry testing parameters. Side effects were observed in four patients: an allergic reaction and hyperglycemia requiring octreotide discontinuation, hypertension that responded to dose reduction, and cholecystitis (gallstones) with octreotide successfully restarted after cholecystectomy.
Conclusions:
Octreotide is safe and effective in improving enteral tolerance in TPN-dependent children with CIPO and the antroduodenal manometry may be helpful in predicting octreotide response. Prospective studies are needed to evaluate the safety and efficacy of octreotide in children with CIPO.
Related Concept Videos
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
01:26Enteral Nutrition I: Orogastric and Nasogastric Feeding
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:18Drug Delivery: Enteral Route
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...