Effect of a somatostatin analogue on gastric motor and sensory functions in healthy humans

Abstract

Background: Pharmacological approaches to alter satiation may have an impact on functional upper gastrointestinal disorders and potentially change food intake in obesity.

Aim: Our aim was to compare the effects of two doses of octreotide and placebo on postprandial symptoms, gastric accommodation, and gastric emptying using validated non-invasive techniques.

Methods: In a randomised, parallel group, two dose, double blind, placebo controlled study, 39 healthy participants (13 per group) were randomised to 30 or 100 micro g octreotide or placebo, administered subcutaneously, 30 minutes before each study. Studies were performed on three separate days and included scintigraphic gastric emptying of solids and liquids, (99m)Tc SPECT imaging to measure fasting stomach volume and gastric accommodation following a 300 ml Ensure meal, and a standardised nutrient drink test to measure maximum tolerated volume and postprandial symptoms.

Results: Relative to placebo, both doses of octreotide delayed gastric emptying of solids (not liquids), increased fasting gastric volume, reduced the change in gastric volume post meal, and decreased the sensation of fullness after a satiating meal.

Conclusion: The somatostatin analogue octreotide significantly alters human gastric functions, including inhibition of the normal reflex responses of gastric volume increase and emptying of the meal. These pharmacological effects suggest studies of the medication in disorders of satiation, including obesity and dyspepsia, are warranted.

Figure 1

Effect of octreotide 30 and 100 μg compared with placebo on gastric half emptying time for solids. (A) Median, interquartile range, and full range. (B) Scatterplot of all data. Note that both doses of octreotide retarded gastric emptying.

Figure 2

Effect of octreotide 30 and 100 μg compared with placebo on gastric emptying lag time (time at 10% emptied) for solids. (A) Median, interquartile range, and full range. (B) Scatterplot of all data. Note that only octreotide 100 μg prolonged gastric emptying lag time.

Figure 3

Effect of octreotide on gastric volumes measured by single photon emission computed tomography imaging after ^99mTc pertechnetate injection. (A) Reconstructed images of the stomach during fasting and postprandially after placebo and octreotide 30 and 100 μg treatment. (B) Median, interquartile range, and full range of fasting gastric volumes. (C) Scatterplot of all data. Note that both doses of octreotide retarded the increase in fasting gastric volumes.

Figure 4

Effect of octreotide 30 and 100 μg compared with placebo on change in gastric volume with ingestion of a standard 300 ml Ensure meal. Note that both doses of octreotide reduced the postprandial increase in gastric volume.

Figure 5

Comparison of postprandial volumes after octreotide 30 and 100 μg compared with placebo during two postprandial measurements, 0–16 minutes (A) and 17–32 minutes (B) minutes after the meal. Whereas volumes were comparable during placebo treatment, note that volumes were higher in the first than in the second period when volunteers received octreotide.

Figure 6

Effect of octreotide 30 and 100 μg compared with placebo on fullness scores 30 minutes after ingestion of a fully satiating meal of Ensure meal. A scatterplot of all of the data is shown. Note that octreotide 100 μg reduced fullness relative to placebo treatment. VAS, visual analogue scale.