VASOACTIVE SUBSTANCES IN EARLY DUMPING SYNDROME - EFFECTS OF BUMPING PROVOCATION WITH AND WITHOUT OCTREOTIDE

In patients after gastric surgery, early dumping symptoms can be provo ked by oral glucose challenge. Octreotide effectively prevents the occ urrence of dumping symptoms. We have studied plasma renin activity (PR A), aldosterone and atrial natriuretic peptide (ANP) concentrations in nine patients with early dumping, 10 surgical control subjects and ni ne healthy control subjects after an oral glucose challenge preceded b y either placebo or 25 mu g of octreotide subcutaneously (s.c.). In th e dumping group, basal PRA was significantly (P<0.01) higher (3.9 +/- 0.6 mu g L-1 h(-1)) than in either surgical or healthy control subject s (1.1 +/- 0.3 mu g L-1 h(-1) and 1.1 +/- 0.2 mu g L-1 h(-1) respectiv ely) and showed a significant rise after glucose ingestion to 5.4 +/- 0.9 mu g L-1 h(-1) that did not occur in control subjects. Aldosterone concentration showed a concomitant rise. In dumping patients, plasma ANP decreased after glucose ingestion from 31 +/- 6 ng L-1 to 21 +/- 5 ng L-1 (P<0.05). This decrease did not occur in control subjects. Ear ly dumping is associated with an activation of the renin-aldosterone a xis and a decrease in plasma ANP, reflecting a hypovolaemic state. Oct reotide prevents the occurrence of these changes.