Effect of chronic octreotide treatment on intestinal absorption in patients with acromegaly

The adverse gastrointestinal effects of octreotide, a synthetic analog of somatostatin, have not been fully elucidated. Low-dose octreotide frequently causes adverse gastrointestinal symptoms in normal individuals. We investigated the adverse gastrointestinal effects of high-dose octreotide, which is required for the normalization of growth hormone hypersecretion in some patients with acromegaly. Patients with acromegaly ( N =8) were treated with octreotide, 450 μg/day, then 1500 μg/day for two months at each dosage. Carbohydrate absorption was assessed using the d -xylose test, and fat absorption using fecal fat excretion and serum carotene concentrations, at baseline, at each dosage of octreotide, and after one month of washout. Ultrasonography was used to monitor for cholelithiasis. Growth hormone and insulin-like growth factor-I concentrations were significantly suppressed at both dosages. Adverse gastrointestinal symptoms were mild and transient. d -Xylose absorption remained normal at each dosage and after one month of washout. Fecal fat excretion increased from 7±2 to 12±2 g/24 hr ( P