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Related Concept Videos

Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents01:24

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The gastric mucosa produces prostaglandins E2 (PGE2) and prostacyclin (PGI2), crucial in maintaining gastric health. They exert cytoprotective effects, including increasing bicarbonate secretion, releasing protective mucin, reducing gastric acid output, and preventing harmful vasoconstriction. These effects are mediated through various receptors, such as EP1, EP2, EP3, and EP4.
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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Esophageal Varices-II: Clinical Features and Management01:28

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Updated: May 5, 2026

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Octreotide in variceal bleeding

A K Burroughs1

  • 1Hepato-biliary and Liver Transplantation Unit, Royal Free Hospital, London.

Gut
|January 1, 1994
PubMed
Summary

Somatostatin and octreotide effectively treat esophageal variceal bleeding, showing improved efficacy over placebo or H2 antagonists. These vasoactive agents offer fewer adverse effects and are a valuable option for managing this critical condition.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Clinical Pharmacology

Background:

  • Esophageal variceal bleeding is a life-threatening condition with high mortality.
  • While injection sclerotherapy is preferred, its availability is limited.
  • Balloon tamponade and vasoactive therapies serve as temporary measures.

Purpose of the Study:

  • To evaluate the efficacy and safety of somatostatin and octreotide in treating esophageal variceal bleeding.
  • To compare somatostatin and octreotide against other treatments, including placebo and H2 antagonists.
  • To assess the potential role of these agents as adjuvant therapy.

Main Methods:

  • Systematic review and meta-analysis of clinical trials comparing somatostatin or octreotide with placebo or H2 antagonists.

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  • Summarization and discussion of trial results regarding efficacy and adverse effects.

    • Main Results:

    • Meta-analysis showed a significant advantage for somatostatin or octreotide in efficacy compared to placebo or H2 antagonists.
    • No significant difference in mortality was observed between the treatment groups.
    • Somatostatin and octreotide demonstrated comparable efficacy to other treatments with fewer adverse effects.

    Conclusions:

    • Somatostatin and octreotide are effective vasoactive agents for esophageal variceal bleeding, offering a favorable safety profile.
    • These agents are at least as effective as current treatments and represent an optimal choice.
    • Further investigation is warranted for their use as adjuvant therapy in emergency sclerotherapy.