Summary
The effects of somatostatin on diarrhea and on small intestinal flow of water and electrolytes (slow-maker perfusion technique) in a patient with pancreatic cholera are reported. Continuous intravenous infusion of somatostatin (8 μg/kg/hr) suppressed the diarrhea, but a rebound was observed after somatostatin. Infusion of somatostatin at the same dosage decreased the ileal fluid flow rate to within control values. This effect was mainly due to a sharp reduction in the rate fluid entered the jejunum, but was also due to a suppression of the abnormal water and electrolyte secretion in the proximal jejunum. Secretion in the rest of the small bowel remained unchanged. Somatostatin did not noticeably after the high preinfusion plasma level of prostaglandin E1, but decreased the initially high plasma concentration of vasoactive intestinal peptide to normal values. These results suggest that long-acting somatostatin analogs could be of value in the symptomatic treatment of diarrhea in pancreatic cholera.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Lennon J, Bloom SR, Sircus W,: Studies on blood levels of vasoactive inhibitory peptide (VIP) and pancreatic polypeptide (PP) and their relation to clinical behaviour in a case of Verner-Morrison syndrome. Ital J Gastroenterol 18:104–106, 1978
Long RG, Barnes AJ, Adrian TE, Mallinson CN, Brown MR, Vale W, Riner JE, Christofides ND, Bloom SR: Suppression of pancreatic endocrine tumour secretion by long-acting somatostatin analogue. Lancet 2:764, 1979
Whalen GE, Harris JA, Greenen JE, Soergel KH: Sodium and water absorption from human small intestine. The accuracy of the perfusion method. Gastroenterology 51:975–984, 1966
Hyden S: A turbidimetric method for the determination of high polyethylene glycols in biological materials. Ann R Agr Coll (Sweden) 22:139–145, 1955
Guzman S, Lonovics J, Chayvialle JA, Hejtmancik KE, Rayford PL, Thompson JC: Effects of gastrin on circulating levels of somatostatin, pancreatic polypeptide, and vasoactive intestinal peptide in dogs. Endocrinology 107:231–236, 1980
Dray F, Charbonnel B, Maclouf J: Radioimmunoassay of prostaglandins Fα, E1 and E2 in human plasma. Eur J Clin Invest 5:311–318, 1975
Efendic S, Mattson O: Effect of somatostatin on intestinal motility. Acta Radiol Diag 19:348–352, 1978
Rambaud JC, Modigliani R, Matuchansky C, Bloom S, Said S, Pessayre D, Bernier JJ: Pancreatic cholera. Studies on tumoral secretions and pathophysiology of diarrhea. Gastroenterology 69:110–122, 1975
Krejs GJ, Walsh JH, Morawski SG, Fordtran JS: Intractable diarrhea. Intestinal perfusion studies and plasma VIP concentrations in patients with pancreatic cholera syndrome and surreptitious ingestion of laxatives and diuretics. Am J Dig Dis 22:280–292, 1977
Debongnie JC, Phillips SF: Capacity of the human colon to absorb fluid. Gastroenterology 74:698–703, 1978
Krejs GJ, Browne R., Raskin P: Effect of intravenous somatostatin on jejunal absorption of glucose, amino acids, water and electrolytes. Gastroenterology 78:26–31, 1980
Dharmasathaphorn K, Binder HJ, Dobbins JW: Somatostatin stimulates sodium and chloride absorption in the rabbit ileum.. Gastroenterology 78:1559–1565, 1980
Davis GR, Santa Ana CA, Morawski SG, Fordtran JS: Inhibition of water and electrolyte absorption by polyethylene glycol (PEG). Gastroenterology 79:35–39, 1980
Bloom SR, Polak JM: VIP measurement in distinguishing Verner-Morrison syndrome, and pseudo-Verner-Morrison syndrome. Clin Endocrinol 5:223s-228s, 1978
Bloom SR, Polak JM, Pearse AGE: Vasoactive intestinal peptide and watery diarrhea syndrome., Lancet 2:14–16, 1973
Jaffe BM, Condon S: Prostaglandins E and F in endocrine diarrheogenic syndromes. Ann Surg 184:516–524, 1976
Jaffe BM, Kopen DF, De Schryver-Kecskemeti K Gingerich RI, Greider M: Indomethacin-responsive pancreatic cholera. N Engl J Med 297:817–821, 1977
Rambaud JC, Nisard A, Modigliani R, Calmette C, Moukhtar MS, Hill PA, Besterman H: Hypercalcitoninaemia in vipomas. Lancet 1:220, 1978
Hanssen LE, Hanssen KF, Myren J: Inhibition of secretin release and pancreatic bicarbonate secretion by somatostatin infusion in man. Gastroenterology. 12:391–394, 1977
Schrumpf E: The inhibitory action of somatostatin on the stomach. Adv Exp Med Biol 106:235–240, 1978
Meyers WC, Hanks JB, Jones RS: Inhibition of basal and meal-stimulated choleresis by somatostatin. Surgery 86:301–306, 1979
Carter RF, Bitar KN, Zfass AM, Makhlouf GM: Inhibition of VIP-stimulated intestinal secretion and cyclic AMP production by somatostatin in the rat. Gastroenterology 74:726–730, 1978
Dharmsathaphorn K, Sherwin RS, Dobbins JW: Somatostatin inhibits fluid secretion in the rat jejunum. Gastroenterology 78:1554–1558, 1980
Author information
Authors and Affiliations
Additional information
Supported by INSERM C.R.L. 79.5.453.7 to J.A.C.
A part of this work has appeared as a letter in theLancet (2:476, 1979).
Rights and permissions
About this article
Cite this article
Ruskoné, A., René, E., Chayvialle, J.A. et al. Effect of somatostatin on diarrhea and on small intestinal water and electrolyte transport in a patient with pancreatic cholera. Digest Dis Sci 27, 459–466 (1982). https://doi.org/10.1007/BF01295657
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01295657