[Experimental and clinical studies on the effect of combined treatment with cimetidine and somatostatin (author's transl)]

Abstract

Spontaneous hemostasis in the upper gastrointestinal hemorrhage is inhibited by the influence of gastric acid on blood coagulation and platelet aggregation in the mucosal lesions. In a clinical trial with the H2-receptor antagonist cimetidine and the peptide hormone somatostatin, applied continuously, rebleeding occurred in 25%. That may be caused by an insufficient reduction of acid secretion. Therefore in 4 dogs with gastric fistula we studied the inhibition of maximal stimulated gastric acid secretion (histamine, pentagastrin, insulin hypoglycemia) after simultaneous application of the two drugs. We found an additive effect by combining cimetidine and somatostatin. That was observed not only in the degree of reduction of acid secretion but also in prolongation of the inhibiting effect. In 4 patients with acute upper gastrointestinal hemorrhage and continuous bleeding after single cimetidine treatment we used the combined therapy (cimetidine and somatostatin) with good success. The patients could be operated after cessation of bleeding under good conditions.