Effect of octreotide on intestinal motility and bacterial overgrowth in scleroderma

Article Abstract:

Scleroderma, a systemic disorder associated with the widespread deposition of collagen (a connective tissue) throughout the body, often affects the small intestine. Patients' symptoms include abdominal pain, nausea, bloating, diarrhea, constipation, and impaired intestinal contractility. The effectiveness of octreotide, an analogue of somatostatin, against these symptoms was evaluated in this study of five scleroderma patients with intestinal pseudoobstruction (a condition caused by bacterial overgrowth and impaired motility that simulates actual obstruction). Six normal patients were studied as controls. All patients fasted overnight and then underwent insertion of a manometric catheter (a device for recording pressure changes) into the stomach and first part of the small intestine (the duodenum). The motor activity (in particular, the migrating motor complex, the normal contractile pattern) of these regions was then assessed at baseline and after the administration of octreotide. Blood samples were withdrawn at intervals timed with phases of the migrating motor complex and analyzed for their content of motilin, a hormone that stimulates intestinal motor activity. The normal patients had propagative intestinal patterns (progressive contractions) at baseline, while those with scleroderma had no migrating motor complexes. Complexes were induced in the scleroderma patients by octreotide: these complexes propagated as rapidly, and had an amplitude two-thirds as great, as in normal patients. Patients with scleroderma had higher motilin levels than controls; these levels were reduced by octreotide, indicating that the effect of octreotide on the intestine is independent of motilin. A measure of the extent of bacterial overgrowth in the intestine, breath hydrogen excretion, decreased after three weeks of octreotide treatment. Abdominal pain, nausea, and related symptoms improved with treatment. The results indicate that a long-term study of the effectiveness of octreotide in scleroderma is warranted. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Scleroderma (Disease), Gastrointestinal system, Gastrointestinal motility

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Octreotide

Article Abstract:

Octreotide, a synthetic version of somatostatin, inhibits hormonal hypersecretion by endocrine tumors and has potential as a cancer therapy. Somatostatin regulates gastrointestinal functions and controls growth hormone, thyrotropin and neurotransmitter secretion. In cases of acromegaly, pituitary adenomas, and pancreatic islet-cell and carcinoid tumors, symptoms of excess hormone secretion can be reduced with long-term octreotide treatment because these tumors express somatostatin receptors. The ability of somatostatin to inhibit cell division indicates that octreotide has antitumor potential. Although octreotide-sensitive receptors on tumors do not seem to adapt to prolonged treatment, normal tissue does adapt, reducing the effectiveness of octreotide treatment of long-term gastrointestinal disease. This adaptation does, however, reduce side effects of the drug, leaving gallstones as the most serious concern for octreotide users.

Somatostatin, Neoplastic endocrine-like syndromes

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Octreotide therapy for tumor-induced osteomalacia

Article Abstract:

The drug octreotide may be beneficial in cancer patients with bone wasting. The bone wasting is similar to rickets and is believed to be caused by a substance released by the tumor that makes the kidneys excrete excess amounts of phosphate.

Complications, Osteomalacia

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