EFFECT OF OCTREOTIDE ON GASTROINTESTINAL MOTILITY IN CHILDREN WITH FUNCTIONAL GASTROINTESTINAL SYMPTOMS

Background: The somatostatin analogue octreotide has been proposed as a possible therapeutic agent in patients with abnormal gastrointestina l motility. This study was conducted to study the effects of 0.5 mu g/ kg and 1.0 mu g/kg subcutaneous octreotide on antroduodenal motility i n children with chronic gastrointestinal disorders. Methods: Twenty-th ree children were studied, eight with intestinal pseudo-obstruction, s ix with nonulcer dyspepsia, six with gastroesophageal reflux disease, and three with intractable constipation. After recording fasting motil ity for more than 4 hours, the children were randomized to receive 0.5 mu g/kg or 1 mu g/kg of subcutaneous octreotide. Motility was recorde d for another hour after feeding in 12 children. Results: Phase III of the motor migrating complex was present in 13 of 23 children before a nd in 21 after octreotide (p < 0.02). All phase III episodes after adm inistration of octreotide except one originated in the small intestine . Phase IIIs after octreotide were longer and were propagated faster t han the spontaneous phase IIIs. There were no antral contractions duri ng fasting after octreotide. There was a significant decrease in phase II intestinal motor activity in the hour after administration of octr eotide (p < 0.001). There was no difference in effect between the two doses. After feeding, antral contractions were present in all children , and intestinal phase ms were not abolished. Conclusions: In children with chronic bowel disorders, subcutaneous octreotide induced phase m s that differed from spontaneous phase IIIs and were not inhibited by meals. Octreotide decreased antral motility during Tasting and inhibit ed intestinal phase II. Feeding abolished the inhibitory effect of oct reotide on antral motility.