Why is octreotide used in GI bleed?
Octreotide reduces portal and variceal pressures as well as splanchnic and portal-systemic collateral blood flows [2]. It also prevents postprandial splanchnic hyperemia in patients with portal hypertension [3] and lowers gastric mucosal blood flow in normal and portal hypertensive stomachs [4].
What tests are done for GI bleed?
Doctors most often use upper GI endoscopy and colonoscopy to test for acute GI bleeding in the upper and lower GI tracts. Upper GI endoscopy. In an upper GI endoscopy, your doctor feeds an endoscope down your esophagus and into your stomach and duodenum.
How does octreotide stop GI bleed?
It inhibits the release of many endocrine peptides including insulin and glucagon. In addition, it inhibits the release of gastric acid. Because glucagon is a vasodilator, octreotide indirectly decreases splanchic blood flow by its action inhibiting the release of glucagon.
What is the priority treatment in GI bleeding?
Current guidelines recommend a regimen of an intravenous (IV) PPI 80-mg bolus, followed by a continuous infusion of 8 mg/hour for 72 hours. Lau et al demonstrated that high-dose IV omeprazole can accelerate the resolution of the stigmata of recent hemorrhage and reduce the need for endoscopic therapy.
Can a CT scan detect GI bleeding?
CT angiography is an accurate examination for identifying the source of acute GI bleeding. A meta-analysis of data from 672 patients with moderate to severe UGIB and/or LGIB revealed an overall sensitivity of 85% and a specificity of 92% for detection of the bleeding site.
Will a CT scan show abdominal bleeding?
A CT scan of the abdomen may be performed to assess the abdomen and its organs for tumors and other lesions, injuries, intra-abdominal bleeding, infections, unexplained abdominal pain, obstructions, or other conditions, particularly when another type of examination, such as X-rays or physical examination, is not …
Does a GI bleed require surgery?
Treatment for GI bleeding usually includes hospitalization because blood pressure may drop and heart rate may increase and this needs to be stabilized. In some cases, IV fluids or blood transfusions are needed, and surgery may be required.
What are the 3 types of bleeding?
There are three main types of bleeding: arterial, venous, and capillary bleeding. Arterial bleeding occurs in the arteries, which transport blood from the heart to the body. Venous bleeding happens in the veins, which carry blood back to the heart.
How long is octreotide given for acute GI bleeding?
Forty-three patients with acute upper GI bleeding were treated with octreotide infusion. After endoscopy, 16 patients in the variceal group and 22 patients in the non-variceal group were randomized to receive 48 hours infusion or 48 hours infusion plus 72 hours subcutaneous infusion.
When do you start octreotide for variceal bleeding?
Variceal bleeding occurs as a result of liver cirrhosis, so it is reasonable to start octreotide in patients who are known to or who may have cirrhosis. This would include patients with known or suspected alcoholic liver disease or patients with jaundice, ascites,…
How is octreotide used to treat fistulas?
Fistulas refractory to medical management alone generally require surgical closure (1,2). Octreotide is an analog of somatostatin which can reduce gastrointestinal, biliary, and pancreatic secretions, as well as decrease gastrointestinal motility (1).
What are the exclusion criteria for octreotide therapy?
Exclusion criteria were: A recent gastrointestinal bleeding; Hepatic encephalopathy; Serum creatinine > 1.5 mg/dl; Ultrasonographic evidence of renal disease or urinary tract obstruction.