Abstract
Isolated reports suggest that somatostatin may be effective in patients with (SSD). We have assessed the effect of parenteraly administered somatostatin on the secretory function of the jejunum in 4 patients with (SSD) due to a variety of conditions. Using a steady state perfusion technique we have measured jejunal H2O and ion movement from a glucose (G2 + G56mM) electrolyte solution both before and after the infusion of somatostatin (3.5ug/kg stat + 3.5ug/kg/hr).
Where villous structure and function was intact net secretion of water was reversed following somatostatin from -62(G2mM) +10 (G56mM) to +3(G2mM) +31.5(G56mM) ul/min/cm. In 2 patients with severe villous atrophy somatostatin was of little or no benefit. [PRE -19(G2mM) -32(G56mM) POST -13(G2mM) -3(G56mM)]. In a patient with a morphologically normal mucosa populated with poorly differentiated enterocytes somatostatin exacerbated the secretion and the symptoms. [PRE -19 (G2mM) -96(G56raM) POST -119(G2mM) -323(G56mM)]. Glucose absorption was unaffected and Na+ and Cl− movement followed that of water. These data show that in (SSD) if absorptive processes, particularly Na+ coupled Cl− absorption, are intact somatostatin is helpful in reducing secretion in keeping with its known alpha adrenergic agonist like action but where villous absorptive mechanisms are disrupted it is of little use and may exacerbate symptoms.
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Bisset, W., Jenkins, H., Booth, I. et al. THE EFFECTS OF SOMATOSTATIN ON JEJUNAL SECRETION IN PATIENTS WITH SEVERE SECRETORY DIARRHOEA (SSD). Pediatr Res 20, 693 (1986). https://doi.org/10.1203/00006450-198607000-00046
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DOI: https://doi.org/10.1203/00006450-198607000-00046