Skip to main content
SpringerLink
Log in

Reduction of the effluent volume in high-output ileostomy patients by a somatostatin analogue, SMS 201-995

  • Original Articles
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Twelve ileostomy patients were given subcutaneous SMS 201-995 therapy (100 μg t.d.s. for 5 days) in a randomized placebo-controlled trial. All patients had ileostomies constructed 60 cm proximal to the terminal ileum (proximal ileostomy) following restorative proctocolectomy. SMS 201-995 reduced the daily ileostomy output from 997±52 g to 736±28 g, P<0.05, along with a decrease in daily sodium and chloride excretion (sodium: 92.60±8.51 to 75.22±8.64 mEq, chloride: 143.46±8.54 to 113.60±15.84 mEq; both P<0.05). There were no significant changes in the plasma levels of glucagon, C peptide, insulin, renin or aldosterone with SMS 201-995 therapy. Patients developed no severe side effects and reported easier management of the ileostomy and a reduction in thirst. Our results suggest a possible clinical role for SMS 201-995 in the management of proximal ileostomy.

Résumé

12 patients avec iléostomie ont reçu une injection sous cutanée de SMS 201-995 (100 μg t.d.s. pour 5 jours) au cours d'une étude randomisée contre placebo. Tous ces patients avaient une iléostomie réalisée à 60 centimètres de la fin de l'iléon (iléostomie proximale) après proctocolectomie restaurative. Le SMS 201-995 diminuait le débit journalier de l'iléostomie de 997±52 g à 736±28 g, P<0.05 allant de pair avec une diminution de l'excrétion de sodium et de chlore (sodium: 92.60±8.51 à 75.22±8.64 mEq, chlore: 143.46±8.54 à 113.60±15.84 mEq, tous les deux P<0.05). Il n'y avait pas de variations significatives des taux plasmatiques de glucagon, peptide-C, insuline, renine, et aldostérone au cours du traitement par SMS 201-995. Les malades n'ont pas developpé d'autres effets sévères et rapportaient un entretien plus facile de leur iléostomie et une réduction de la soif. Nos résultats suggèrent un possible rôle clinique pour SMS 201-995 dans le management d'une iléostomie proximale.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Brazeau P, Vale W, Burbus R, Ling N, Rivier J, Guillemin R (1973) Hypothalamic polypeptide that inhibits the secretion of immunoreactive pituitary growth hormone. Science 179:77–79

    Google Scholar 

  2. Shally AV, Dupont A, Arimura A, Redding TW, Nishi N, Linthicum GL, Schlesinger DH (1976) Isolation and structure of somatostatin from porcine hypothalami. Biochemistry 15:509–514

    Google Scholar 

  3. Vale W, Brazeau P, Rivier C, Brown M, Bross B, Rivier J, Burgus R, Ling N, Guillemein R (1975) Somatostatin. Recent Prog Horm Res 31:365–397

    Google Scholar 

  4. Brownstein M, Arimura A, Sato H, Schally AV, Kizer JS (1975) The regional distribution of somatostatin in the rat brain. Endocrinology 96:1456–1461

    Google Scholar 

  5. Arimura A, Sato H, Dupont A, Nishi N, Schally AV (1975) Somatostatin: abundance of immunoreactive hormone in rat stomach and pancreas. Science 189:1007–1009

    Google Scholar 

  6. Hall R, Snow M, Scanlon M, Mora B, Gomez-Pan A (1978) Pituitary effects of somatostatin Metabolism 27:1257–1262

    Google Scholar 

  7. Reichlin S (1983) Somatostatin. N Engl J Med 309:1495–1501

    Google Scholar 

  8. Bloom SR, Mortimer CH, Thorner MO, Besser GM, Hall R, Gomez-Pan A, Roy VM, Russel RCG, Coy DH, Kastin AJ, Schally AV (1974) Inhibition of gastrin and gastric acid secretion by growth hormone release-inhibiting hormone. Lancet II: 1106–1109

    Google Scholar 

  9. Boden G, Sivitz MC, Owen OE, Essa-Koumar N, Landor JH (1975) Somatostatin suppresses secretion and pancreatic exocrine secretion. Science 190:163–165

    Google Scholar 

  10. Bloom SR, Polak JM (1980) Glucagonomas, VIPomas and somatostatinomas. Clin Endocrinol Metab 9:285–297

    Google Scholar 

  11. Krejs GJ, Browne R, Raskin P (1980) Effect of intravenous somatostatin on jejunal absorption of glucose, amino acids, water and electrolytes. Gastroenterology 78:26–31

    Google Scholar 

  12. Schusdzirra V (1980) Somatostatin — a regulatory modulator connecting nutrient entry and metabolism. Horm Metab Res 12:563–577

    Google Scholar 

  13. Johansson C, Wisen O, Efendic S, Uvnas-Wallensten K (1981) Effects of somatostatin on gastrointestinal propagation and absorption of oral glucose in man. Digestion 22:126–137

    Google Scholar 

  14. Mulvihill S, Pappas TN, Passaro E Jr, Debas HT (1986) The use of somatostatin and its analogs in the treatment of surgical disorders. Surgery 100:467–476

    Google Scholar 

  15. Bauer W, Briner U, Doepfner W, Haller R, Huguenin R, Marbach P, Petcher TJ, Pless J (1982) SMS 201-995: a very potent and selective octapeptide analogue of somatostatin with prolonged action. Life Sci 31:1133–1140

    Google Scholar 

  16. Fazio VW (1990) Current therapy in colon and rectal surgery. Decker, Toronto

    Google Scholar 

  17. Kusunoki M, Yamamura T, Ichii S, Fujita S, Nakai T, Utsunomiya J (1988) The effects of sodium valproate on plasma somatostatin and insulin in humans. J Clin Endocrinol Metab 67:1060–1063

    Google Scholar 

  18. Cooper JC, Williams NS, King RFGJ, Barker MCJ (1986) Effects of a long-acting somatostatin analogue in patients with severe ileostomy diarrhoea. Br J Surg 73:128–131

    Google Scholar 

  19. Ruskone A, Rene E, Chayvialle JA, Bonin N, Pignal F, Kremer M, Bonfils S, Rambaud JC (1982) Effect of somatostatin on diarrhea and on small intestinal water and electrolyte transport in a patient with pancreatic cholera. Dig Dis Sci 27:459–466

    Google Scholar 

  20. Davis GR, Camp RC, Raskin P, Krejs GJ (1980) Effect of somatostatin infusion on jejunal water and electrolyte transport in a patient with secretory diarrhea due to malignant carcinoid syndrome. Gastroenterology 78:346–349

    Google Scholar 

  21. Molla AM, Gyr K, Bardhan PK, Molla A (1984) Effect of intravenous somatostatin on stool output in diarrhea due to Vibrio cholerae. Gastroeterology 87:845–847

    Google Scholar 

  22. Vinik AI, Tsai ST, Moattari AR, Cheung P, Cckhauser, PE, Cho K (1986) Somatostatin analogue (SMS 201-995) in the management of gastroenteropancreatic tumors and diarrhea syndromes. Am J Med 81:23–40

    Google Scholar 

  23. Bloom SR (1978) Somatostatin and the gut. Gastroenterology 75:145–147

    Google Scholar 

  24. Carter RF, Bitar KN, Zfass AM, Makhlouf GM (1978) Inhibition of VIP-stimulated intestinal secretion and cyclic AMP production by somatostatin in the rat. Gastroenterology 74:726–730

    Google Scholar 

  25. Dharmasthaphorn K, Sherwin RS, Dobbins JW (1980) Somatostatin inhibits fluid secretion in the rat jejunum. Gastroenterology 78:1554–1558

    Google Scholar 

  26. Dharmsathaphorn K, Binder HJ, Dobbins JW (1980) Somatostatin stimulates sodium and chloride absorption in the rabbit ileum. Gastroenterology 78:1559–1565

    Google Scholar 

  27. Mulvihill S, Passaro E, Debas H, Yamada T (1984) Severe diarrhea after colonic pseudo-obstruction: treatment with somatostatin. N Engl J Med 310:467

    Google Scholar 

  28. Vora JP, Owens DR, Ryder R, Atiea J, Luzio S, Hayes TM (1986) Effect of somatostatin on renal function. BMJ 292:1701–1702

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Second Department of Surgery, Hyogo College of Medicine, Hyogo, Japan

    K. Kusuhara, M. Kusunoki, T. Okamoto, Y. Sakanoue & J. Utsunomiya

Authors
  1. K. Kusuhara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Kusunoki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. Okamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y. Sakanoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Utsunomiya
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kusuhara, K., Kusunoki, M., Okamoto, T. et al. Reduction of the effluent volume in high-output ileostomy patients by a somatostatin analogue, SMS 201-995. Int J Colorect Dis 7, 202–205 (1992). https://doi.org/10.1007/BF00341221

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00341221

Keywords

Search

Navigation