Octreotide lowers gastric mucosal blood flow in normal and portal hypertensive stomachs

Background: The vasoactive peptide octreotide has an established role in controlling variceal hemorrhage. The mechanism of action is believed to be a reduction in splanchnic blood flow. A decrease in splanchnic blood flow should be mirrored by a decrease in gastric mucosal blood flow (GMBF). Laser Doppler flowmetry (LDF) should detect changes in GMBF. Methods: In seven normal volunteers and four patients with portal hypertension, 100 µg of octreotide was administered as an intravenous bolus. Continuous LDF measurements were then made at a single point on the midantrum for at least 10 min and plotted against time for each subject. Results: After a variable period of stabilization, GMBF decreased in all subjects except one. This was statistically significant in both the controls and the patients with portal hypertension. Conclusions: Octreotide decreases GMBF in normal and portal hypertensive stomachs. Laser Doppler is a useful and minimally invasive tool to assess the effect of drugs on GMBF.