# Rationale for the Use of Serotonin-Modulating



## eric (Jul 8, 1999)

this requires a registration to medscape, but its free and they don't spam you, they also have a great IBS resource center.This Doctor is an expert on PI IBS.From Medscape GastroenterologyIBS and Chronic Constipation Expert ColumnRationale for the Use of Serotonin-Modulating Agents in the Management of IBS and Chronic ConstipationPosted 11/01/2005Robin C. Spiller, MD IntroductionClinical Features of Irritable Bowel Syndrome"Evidence of Abnormal Serotonin Metabolism in IBSAnimal studies have indicated that acute inflammation increases EC cell numbers,[50] enhances 5-HT release,[41] and depresses the serotonin transporter.[51] Studies of 5-HT availability in humans have been limited so far to measurements of peripheral 5-HT in platelet-poor plasma following a test meal. This is a very indirect measure of intestinal 5-HT because most 5-HT released is taken up locally or by the liver or lung and metabolized. However, 4 studies have reported increased postprandial 5-HT in patients with IBS-D.[52-55] In one of these studies, the patients had PI-IBS, whereas in the other investigations, the mode of onset of IBS was not specified. Two studies agreed that in patients with IBS-C, the release of serotonin is abnormally depressed.[53,54] Dunlop and colleagues[53] reported reduction in the 5HIAA (5-hydroxyindoleacetic acid [metabolite of 5-HT])/5-HT ratio, an indication of impaired serotonin turnover compatible with the reduced blood levels noted postprandially. This study also showed that constipated IBS patients have more 5-HT per EC cell, in keeping with the idea of impaired release."http://www.medscape.com/viewarticle/514413


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