In comparison to placebo or an H2RA, somatostatin or its long-acting variant, Octreotide, given intravenously may reduce the incidence of rebleeding from peptic ulcers, according to a meta-analysis. 154 A decrease in GI motility, an inhibition of gastric acid secretion, an inhibition of pepsin secretion, and effects on gastric mucosal cytoprotection are a few of the mechanisms of action that have been postulated. Nevertheless, these medications have not been investigated in the age of endoscopic or PPI treatment and cannot be recommended for regular use.
Patients with significant persistent bleeding who are unresponsive to endoscopic treatment, an IV PPI, or both and are not surgical candidates might be evaluated for somatostatin or Octreotide, albeit their efficacy in these individuals is unknown. In addition to endoscopic hemostasis and a PPI, IV octreotide may be helpful in individuals with portal hypertension and peptic ulcer bleeding.
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