Effect of octreotide on gastric and small bowel motility in patients with gastroparesis
Open accessAbstract
BACKGROUND: Octreotide has been shown to have effects on gastric and small bowel motility with implications for its role in treating patients with upper gastrointestinal dysmotility syndromes. Our aim was to investigate the effect of octreotide on antral and small bowel motility in patients with gastroparesis. METHODS: Upper gastrointestinal manometry was carried out continuously for a period of 30 h in 11 patients with gastroparesis. The spontaneous migrating motor complex (MMC) in the fasting state and octreotide-induced MMCs were characterized and compared with regard to site of origin, duration of phase III, amplitude of phase III and propagation velocity of the MMC along the gut. The 2-h postprandial motility index was compared after a control meal as well as after a 100 microg octreotide administration. RESULTS: In all 11 gastroparetic patients, octreotide induced a phase III-like activity front within minutes after administration and this primarily originated in the small bowel (86% of activity fronts compared with 32% of fronts originating in the small bowel prior to octreotide administration (P < 0.004)). Gastric initiation of these activity fronts dramatically decreased after octreotide administration, occurring in 68% of activity fronts prior to octreotide administration and 14% of occasions after octreotide injection (P < 0.05). The postprandial antral motility index was markedly reduced after octreotide administration (11.33 +/- 0.39 vs. 7.96 +/- 0.76, P < 0.0003) and octreotide re-established a motility pattern during the postprandial period that was similar to that normally seen in the interdigestive state. The octreotide-induced phase III activity fronts appeared at a higher frequency and had a higher propagative velocity compared to the spontaneous phase III fronts in the fasting state (9.27 +/- 0.82 vs. 5.56 +/- 0.81 cm/min, P < 0.05). CONCLUSIONS: We conclude that octreotide's marked inhibitory effect on antral contractility may serve to worsen clinical symptoms in patients with gastroparesis and therefore this agent should not be given in the periprandial period. Those gastroparetic patients with associated small bowel dysmotility and diarrhoea from bacterial overgrowth may benefit from the nocturnal administration of octreotide because of its stimulatory effect of phase III MMC activity as well as its known inhibitory effect on small bowel secretions.
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Somatostatin analogues target various steps in the pathophysiology of dumping syndrome, including delaying gastric emptying, delaying transit through the small intestine, inhibiting the release of GI hormones, inhibiting insulin secretion and inhibiting postprandial vasodilation.
“Somatostatin analogues target various steps in the pathophysiology of dumping syndrome, including delaying gastric emptying, delaying transit through the small intestine, inhibiting the release of GI hormones, inhibiting insulin secretion and inhibiting postprandial vasodilation (15,(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [67]
The Discussion (page unavailable) reports that octreotide reduces postprandial gastric and small-bowel motility and cites prior findings of slower gastric emptying and longer oro-cecal transit time. It also discusses inhibition of gastrointestinal hormones and insulin and reduced postprandial splanchnic blood flow, but some mechanisms are speculative. The study concerns patients with gastroparesis, not dumping syndrome, and does not establish that these effects target dumping syndrome’s pathophysiology. (LLM, conf=0.87)
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“Therefore, octreotide is recommended to be used at night (Edmunds et al., 1998).”
- Authors
- Edmunds, Chen, Soykan, Lin, & McCallum
- Affiliations
- University of Kansas Medical Center (US)
- University of Kansas (US)
- Corresponding author
- McCallum
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 1998-02
- Volume
- 12
- Issue
- 2
- Pages
- 167-174
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- OpenAlex
- W2040314262
- Cited by
- 41
- References
- 0
- Citations by year
- 2026: 2 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 5 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 1 · 2013: 2 · 2012: 1
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsches Krebsforschungszentrum
- National Institutes of Health
- National Center for Research Resources (M01RR000847, M01-RR 00847)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- octreotide, gastroparesis, gastric motility, small intestine motility, migrating motor complex, bacterial overgrowth, diarrhea, somatostatin analogue therapy
- MeSH terms
- Adult, Female, Gastrointestinal Agents, Gastrointestinal Motility, Humans, Male, Manometry, Middle Aged, Octreotide, Myoelectric Complex, Migrating, Gastroparesis
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