Premium
Octreotide acts on anorectal physiology: A dynamic study in healthy subjects
Author(s) -
Siproudhis Laurent,
Bellissant Eric,
Juguet Frédéric,
Allain Hervé,
Bretagne JeanFrançois,
Gosselin Michel
Publication year - 1998
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/s0009-9236(98)90073-x
Subject(s) - octreotide , barostat , medicine , placebo , internal anal sphincter , anal canal , somatostatin , glucagon , distension , ghrelin , crossover study , rectal administration , rectum , endocrinology , anesthesia , hormone , pathology , alternative medicine
Background Somatostatin is localized in the intestinal and pelvic nerves of the anorectum and it seems to act as an important neurotransmitter. However, previous analyses of octreotide (a somatostatin analog) effects on anal function showed conflicting results. By use of a dynamic model in healthy subjects, with comparison to the myogenic effect of glucagon, the aim of our study was to further investigate the pharmacologic targets of octreotide. Methods This was a placebo‐controlled, randomized, double‐blinded crossover study performed in 12 healthy volunteers who received octreotide, glucagon, or placebo intravenously on separate days. During each sequence, several pressure steps in 3 different protocols of rectal isobaric distension were applied with an electronic barostat. Manometric responses of the anal canal, adaptative volumes, and perception scores of the rectum were recorded. Results During both phasic and stepwise distensions, a significant drug effect was encountered at the anal level. Compared with placebo, octreotide significantly increased pressures at both upper and lower levels of the anal canal. In contrast, glucagon decreased pressures at the upper part of the anal canal. Octreotide significantly decreased rectal volumes to phasic distension, but glucagon did not induce any change on rectal adaptation. In addition, neither drug modified perception scores. Conclusion This study suggests that octreotide acts on reflex arcs and rectal myenteric neurons rather than on anal myogenic targets that respond to glucagon. Clinical Pharmacology & Therapeutics (1998) 64 , 424–432; doi: