SOMATOSTATIN IN THE TREATMENT OF NONVARICEAL UPPER GASTROINTESTINAL-BLEEDING

The efficacies of somatostatin and octreotide have been widely studied in the control of bleeding from oesophageal varices. It has also been suggested that these drugs may be useful for the control of non-varic eal upper gastrointestinal (UGI) bleeding, including that from peptic ulcers. In approximately 80% of patients presenting with non-variceal UGI bleeding, haemorrhage ceases spontaneously and does not recur. How ever, the remaining 20% of patients require active treatment. Results from recent studies have indicated that somatostatin is an effective t reatment for the control of non-variceal UGI bleeding in high-risk pat ients, i.e. those in whom haemorrhage does not cease spontaneously or is likely to recur. In contrast there is no good evidence available at present to support a role for octreotide in this indication. The effi cacy of somatostatin in controlling bleeding in patients with non-vari ceal UGI bleeding at high risk of mortality upon admission, or rebleed ing following endoscopy, coupled with an excellent safety and tolerabi lity profile, suggests that it may be a valuable therapeutic option in the management of non-variceal bleeding.