Advertisement

Somatostatin pp 327-331 | Cite as

Somatostatin in the Treatment of Hematemesis and Melena

  • Michael Langman
Part of the Serono Symposia, USA book series (SERONOSYMP)

Summary

Clinical trials generally show a trend towards reduced rebleeding rates in patients with hematemesis and melena due mainly to nonvariceal causes. Evidence of benefit to patients by reduced mortality is lacking. This may in part be due to the failure of investigators to accept that very large trials are needed if confident answers are to be obtained. Hardly any trials of any treatment are of adequate size.

In the United Kingdom about 1 in 2000 of the population is likely to suffer from upper gastrointestinal bleeding in an average year, or about 30,000 cases in all, and up to 10% will be likely to die. Improving treatment is therefore a worthwhile exercise. The possibilities include drug and electrophysical methods, but these are not mutually exclusive. Drug treatments also have the attraction that they are not dependent on clinical expertise for administration.

Available evidence suggests that useful improvements in outcome may be obtainable using histamine H2 antagonists (1), and with tranexamic acid (2) although the evidence is not certain. As somatostatin has powerful actions in inhibiting gastric acid secretion and reducing blood flow, it has, logically, been examined as a treatment for upper gastrointestinal bleeding.

Keywords

Confidence Limit Gastric Acid Secretion Tranexamic Acid Severe Bleeding Reduce Blood Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Collins R, Langman MIS. Treatment with histamine H2 antagonists in acute upper gastrointestinal hemorrhage. Implications of randomized trials. N Engl J Med 1985; 313: 660–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Barer D, Ogilvie A, Henry D, et al. Cimetidine and tranexamic acid in the treatment of acute upper gastrointestinal bleeding. N Engl J Med 1983; 308: 1571–5.PubMedCrossRefGoogle Scholar
  3. 3.
    Coraggio F, Scarpato P, Spina M, Lombardi S. Somatostatin and ranitidine in the control of iatrogenic haemorrhage of the upper gastrointestinal tract. Br Med J 1984; 288: 244.CrossRefGoogle Scholar
  4. 4.
    Kayasseh L, Gyr K, Keller U, Stalder GA, Wall M. Somatostatin and cimetidine in peptic ulcer haemorrhage. Lancet 1980; 1: 844–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Magnusson I, Ihre T, Johansson C, Seligson U, Torngren S, Uvnas-Moberg K. Randomized double-blind trial of somatostatin in the treatment of massive upper gastrointestinal haemorrhage. Gut 1985; 26: 221–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Somerville KW, Henry DA, Davies JG, Hine KR, Hawkey CJ, Langman MJS. Somatostatin in treatment of haematemesis and melaena. Lancet 1985; 1: 130–2.PubMedCrossRefGoogle Scholar
  7. 7.
    Torres AJ, Landa I, Hernandes F, et al. Somatostatin (SS) in the treatment of upper gastrointestinal (GI) bleeding. A multicentre controlled trial [Abstract]. International Conference on Somatostatin, Washington, DC, May 6–8, 1986.Google Scholar

Copyright information

© Springer Science+Business Media New York 1987

Authors and Affiliations

  • Michael Langman
    • 1
  1. 1.Department of TherapeuticsUniversity HospitalNottinghamEngland

Personalised recommendations