Skip to main content
Log in

Octreotide increases thresholds of colonic visceral perception in IBS patients without modifying muscle tone

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Effects of octreotide (1.25 µg/kg subcutaneously) on colonic tone and visceral perception were evaluated in 10 IBS patients, using a barostat and compared to placebo in a double-blind crossover study. Colonic sensory thresholds were also studied in healthy controls for comparison with IBS patients. Colonic tone was reflected by variations in volume of the barostat balloon. Baseline volume was 117±38 ml and was not modified by placebo (122±40 ml) or octreotide (106±42 ml). After the meal, maximal decrease in balloon volume was 75±4% following placebo (P<0.001) beginning after 9±3 min and lasting 136±17 min. Following octreotide, the maximal decrease was 69±16% (NS vs placebo), after 10±3 min and lasting 140±22 min. In the second part, discomfort and pain thresholds were evaluated during isobaric distensions (4 mm Hg increments, 5-min duration, 5-min interval with return to pressure 0 between each). The pressure inducing discomfort was 21.2±5.9 mm Hg following placebo vs 29.6±6.6 mm Hg following octreotide (P<0.01). The pressure inducing pain was 24.8±7.3 mm Hg following placebo vs 33.2±7.3 mm Hg following octreotide (P<0.01). In healthy subjects, discomfort and pain were induced by colonic distensions at a mean intraballoon pressure of 32.7±5.8 mm Hg and 36.7±3.9 mm Hg, respectively. Compliance curves were not different following placebo and octreotide. Octreotide significantly increases thresholds for visceral perception in IBS patients without modifying compliance during distension nor colonic tone.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Buéno L, Fioramonti J, Rukebusch Y, Frexinos J, Coulom P: Evaluation of colonic myoelectric activity in health and in functional disorders. Gut 21:480–485, 1985

    Google Scholar 

  2. Frexinos J, Fioramonti J, Buéno L: Colonic myoelectrical activity in IBS painless diarrhoea. Gut 28:1613–1618, 1987

    Google Scholar 

  3. Whitehead WE, Engle BJ, Schuster MM: Irritable bowel syndrome: Physiological and psychological difference between diarrhea-predominant and constipation-predominant patients. Dig Dis Sci 35:404–413, 1990

    Google Scholar 

  4. Sullivan MA, Cohen S, Snape WJ Jr: Colonic myoelectrical activity in irritable bowel syndrome. Effect of eating and anticholinergics. N Engl J Med 298:878–883, 1978

    Google Scholar 

  5. Snape WJ Jr: Irritable bowel syndrome.In Functional Disorders of the Gastrointestinal Tract. S Cohen, RD Soloway (eds). New York, Churchill Livingstone, 1987, pp 69–83

    Google Scholar 

  6. Bradette M, Paré P: Visceral perception in health and in functional dyspepsia. A cross-over study of gastric distension with placebo and domperidone. Dig Dis Sci 36:52–58, 1991

    Google Scholar 

  7. Richter JE, Barish CF, Castell DO: Abnormal sensory perception in patients with esophageal chest pain. Gastroenterology 91:845–852, 1986

    Google Scholar 

  8. Ritchie J: Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut 14:125–132, 1973

    Google Scholar 

  9. Whitehead WE, Holtkotter B, Enck P, Hoelzl R, Holmes KO, Anthony J, Shasbin HS, Schuster MM: Tolerance for rectosigmoid distension in irritable bowel syndrome. Gastroenterology 98:1187–1192, 1990

    Google Scholar 

  10. Dawson AM: Origin of pain in the irritable bowel syndrome.In Irritable Bowel Syndrome. NW Read (ed). Philadelphia, Grune and Stratton, 1985, pp 155–162

    Google Scholar 

  11. Bauer C: Octreotide: Drug development of a constrained somatostatin analogue. Eur J Pharmacol 183:55, 1990

    Google Scholar 

  12. Binimelis J, Webb SM, Mones J: Somatostatin and irritable bowel syndrome. Lancet 2(8574):1533, 1989

    Google Scholar 

  13. Talley NJ, Turner I, Middleton WR: Somatostatin and symptomatic relief of irritable bowel syndrome. Lancet 2:1144, 1987

    Google Scholar 

  14. O'Donnell LJ, Davidson K, Cameron D, Wass JA, Farthing MJ: Short report: Plasma somatostatin concentration in the irritable bowel syndrome. Aliment Pharmacol Ther 659–663, 1991

  15. Plourde V, Mertz B, Sytnick Y, Taché Y, Mayer EA: Effects of somatostatin analogue on sensory perception to rectal balloon distension. Dig Dis Sci 37:976, 1992

    Google Scholar 

  16. Hasler W, Soudah H, Owyang C: Somatostatin analog inhibits sensory afferent response to rectal distension in irritable bowel patients with rectal urgency. Gastroenterology 102:457, 1992

    Google Scholar 

  17. Geer R, Richards WO, O'Dorisio TM, Woltering EO, Williams S, Rice D, Abumrad NN: Efficacy of octreotide acetate in treatment of severe postgastrectomy dumping syndrome. Ann Surg 212:678–687, 1990

    Google Scholar 

  18. Soudah HC, Hasler WL, Owyang C: Effect of octreotide on intestinal and bacterial overgrowth in scleroderma. N Engl J Med 325:1461–1467, 1991

    Google Scholar 

  19. Manning AP, Thompson WG, Heaton KW, Morris AF: Towards a positive diagnosis of the irritable bowel syndrome. Br Med J 2:653–654, 1978

    Google Scholar 

  20. Hachet T, Caussette M: A multifunction and programmable computerized barostat. Gastroenterol Clin Biol 17:347–351, 1993

    Google Scholar 

  21. Steadman CJ, Phillips SF, Camilleri M, Talley NJ, Haddad A, Hanson R: Control of muscle tone in the human colon. Gut 33:541–546, 1992

    Google Scholar 

  22. Bradette M, Staumont G, Delvaux M, Fioramonti J, Buéno L, Frexinos J: Evaluation of colonic sensory thresholds in IBS patients using a barostat: Definition of optimal conditions and comparison with healthy subjects. Dig Dis Sci 39:449–457, 1994

    Google Scholar 

  23. Nicholls J, Wynick D, Domin J, Sandler LM, Bloom SR: Pharmacokinetics of the long-acting somatostatin analogue octreotide (SMS 201-995) in acromegaly. Clin Endocrinol 32:545–550, 1990

    Google Scholar 

  24. Fredstorp L, Harris A, Haas G, Werner S: Short term treatment of acromegaly with the somatostatin analog octreotide: The first double-blind randomized placebo-controlled study on its effects. J Clin Endocrinol Metab 71:1189–1194, 1990

    Google Scholar 

  25. Clark RV, York RM, Lauer RM, Welch NS Jr: Control of Cushing's syndrome secondary to ectopic ACTH with octreotide. Clin Res 38:943A, 1990

    Google Scholar 

  26. Souquet JC: Long-acting soimatostatin analogues in pancreatic islet cell carcinoma. Horm Res 32:74–76, 1989

    Google Scholar 

  27. Vinick AZ, Moattari AR: Use of somatostatin analog in management of carcinoid syndrome. Dig Dis Sci 34:14S-27S, 1989

    Google Scholar 

  28. Sherlock S: Esophageal varices. Am J Surg 160:9–13, 1990

    Google Scholar 

  29. Metrakos P, Rosenberg L, Duguid WP, Fried GM: Does prophylactic Sandostatin prevent or diminish the severity of pancreatitis. Clin Invest Med 13:237, 1990

    Google Scholar 

  30. Cello JP, Grendell J, Basuk P, et al: Controlled clinical trial of octreotide for refractory AIDS-associated diarrhea. Gastroenterology 98:A163, 1990

    Google Scholar 

  31. O'Donnell LJ, Watson AJ, Cameron D, Farthing MJ: Effect of octreotide on mouth-to-caecum transit time in healthy subjects and in the irritable bowel syndrome. Aliment Pharmacol Ther 4:177–181, 1990

    Google Scholar 

  32. Aspiroz F, Malagelada JR: Physiological variations in canine gastric tone by an electronic barostat. Am J Physiol 248:G229-G237, 1985

    Google Scholar 

  33. Aspiroz F, Malagelada JR: Gastric tone measured by an electronic barostat in health and postsurgical gastroparesis. Gastroenterology 92:934–943, 1987

    Google Scholar 

  34. Steadman CJ, Phillips SF, Camilleri M, Haddad A, Hanson R: Variations of muscle tone in the human colon. Gastroenterology 101:373–381, 1991

    Google Scholar 

  35. Reubi JC, Lamberts SWJ, Maurer R: Somatostatin receptors in normal and tumoral tissue. Horm Res 29:65–69, 1988

    Google Scholar 

  36. Wolfe F, Cathey MA: Somatostatin therapy in patients with severe fibromyalgia: A preliminary report. Pain Suppl 5:Abs 105, 1990

    Google Scholar 

  37. Hasler W, Soudah H, Wiley J, Owyang C: Somatostatin analog inhibits afferent response to rectal distension: Inhibition ofN-type calcium current by pertussis toxin sensitive pathway in dorsal root ganglia. Gastroenterology 100:A448, 1992

    Google Scholar 

  38. Ellis WV: Octreotide, a small peptide, alleviates burning pain and hyper aesthesia: A preliminary report. Pain Clin 3:239–242, 1990

    Google Scholar 

  39. Penn RD, Paice JA, Kroin JS: Intrathecal octreotide for cancer pain. Lancet 335:738, 1990

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bradette, M., Delvaux, M., Staumont, G. et al. Octreotide increases thresholds of colonic visceral perception in IBS patients without modifying muscle tone. Digest Dis Sci 39, 1171–1178 (1994). https://doi.org/10.1007/BF02093780

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02093780

Key words

Navigation