Table 5.

Antisecretory Agents²³

Agent	Form	Clinical Considerations
Histamine-2 receptor antagonists	Oral or IV	Compatible with parenteral nutrition solution Loss of efficacy with long-term use
Proton pump inhibitors	Oral or IV	Requires adequate small bowel surface area for oral absorption. If efficacy is in question, try IV route (and stop oral route). Cannot be added to parenteral nutrition Increased risk of Clostridium difficile Potential for hypomagnesemia Reevaluate need at 6 months
Octreotide (somatostatin analogue)	SC or IV	Overused in clinical practice; reserve for secretory diarrhea, not osmotic. (Make the patient nil per os for 24 hours to determine the difference.) Risk of hyperglycemia and cholelithiasis Painful and expensive May inhibit intestinal adaptation
Clonidine	Oral or patch	Risk of hypotension

IV, intravenous; SC, subcutaneous.