When should octreotide be used in short bowel syndrome and why?

• A. In early adaptation stage to promote adaptation
• B. For small-volume stool losses with good fluid balance
• C. For large-volume stool losses with fluid and electrolyte management problematic; avoid early adaptation due to cholelithiasis risk; effects are short lasting and not shown to improve absorption or eliminate parenteral nutrition
• D. Only after parenteral nutrition is discontinued

Answer: (C)