Effects of a long-acting somatostatin analogue in patients with severe ileostomy diarrhoea

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Abstract
Proctocolectomy (PC) with small bowel resection may lead to profuse ileostomy diarrhoea which can be difficult to treat. The effect of a recently developed long acting somatostatin analogue (SMS 201-995) on ileostomy output was investigated in 5 patients who had undergone PC and ileal resection (median 120 cm) and who suffered severe diarrhoea (4–7 litres/24 h). Gastric emptying, transit of a standard meal through the small bowel and the amounts of nutrients excreted were simultaneously determined during double blind infusion of SMS (25 fig/h) and placebo (isotonic saline 125 ml/h). SMS 201–995 significantly reduced ileostomy output (P < 0.05) and water excretion (P < 0.05) and prolonged small bowel transit time (P < 0.05). Whilst having little effect on gastric emptying, or on the excretion of glucose or nitrogen, fat excretion was significantly increased (P < 0–05). In two patients subcutaneous administration of SMS 201-995 (50 μg b.d.) has maintained a reduced ileostomy output for 4 and 6 months respectively.
Funding Information
  • Yorkshire Regional Health Authority