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Somatostatin in gastroenterology

BMJ 1994; 308 doi: (Published 28 May 1994) Cite this as: BMJ 1994;308:1381
  1. A Shulkes,
  2. J S Wilson

    Somatostatin was isolated from ovine hypothalamus in 1973, and eight years later a long acting analogue, octreotide, was synthesised. More than 1000 clinical applications have since been suggested for these paninhibitory peptides, particularly in gastroenterology. The enormous clinical potential in the gastrointestinal tract for a universal inhibitor and the remarkable non - toxicity of the agents fuelled this enthusiasm. Although a lack of randomised controlled trials with sufficient numbers of subjects hampered clinical progress, the recent publication of several large,well controlled trials has helped to delineate a role for somatostatin and its analogues in gastroenterology. In clinical practice octreotide is preferable to the native compound because of its longer half life, which permits intermittent subcutaneous administration. Recently an orally active somatostatin analogue has been described.1

    Octreotide is useful in the management of unresectable hormone secreting neuroendocrine tumours, particularly carcinoids and vipomas.2 It inhibits both the secretion and the effect of the active agent. For example, in vipomas characterised by profuse secretory diarrhoea, octreotide reduces the diarrhoea by inhibiting …

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