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Gastroenterology Research and Practice
Volume 2015, Article ID 702921, 5 pages
Review Article

Somatostatin Analogs in the Medical Management of Occult Bleeding of the Lower Digestive Tract

1Department of Medicine, St. Michael’s Hospital, Dun Laoghaire, County Dublin, Ireland
2Department of General Internal Medicine, St. Columcille’s Hospital, Loughlinstown, County Dublin, Ireland

Received 31 October 2014; Accepted 3 March 2015

Academic Editor: Caroline Nordenvall

Copyright © 2015 Julie Martin-Grace and Gianluca Tamagno. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The management of occult bleeding from the lower digestive tract can be very challenging. In cases of identified angiodysplasia, the first line management options can be limited by a number of clinical or anatomical factors and an alternative approach might be required, including the use of medications. Somatostatin analogs have been considered as an effective and well-tolerated alternative management option in a number of cases where the endoscopic therapeutic approach is not practical or is unsuccessful, in patients with coagulopathies or who need concomitant anticoagulation or antiplatelet treatment. Despite the lack of double-blinded randomized placebo-control trials and despite the limitations of the available evidence in the literature, including small sample size, variable dosing, and administration routes, there is a consistent agreement in the literature that somatostatin analogs are a safe, well-tolerated, and effective therapeutic option for managing refractory or occult bleeding from the lower digestive tract, with particular reference to patients with angiodysplasia, where endoscopic or surgical management is either not feasible or unsuccessful and other pharmacological options are not preferred.