# Patients with constipation-predominant irritable bowel syndrome (ibs) may have



## eric (Jul 8, 1999)

FYIigestion 2001;63(3):188-94 Books, LinkOut Patients with constipation-predominant irritable bowel syndrome (ibs) may have elevated serotonin concentrations in colonic mucosa as compared with diarrhea-predominant patients and subjects with normal bowel habits. Miwa J, Echizen H, Matsueda K, Umeda N. Division of Gastroenterology, International Medical Center of Japan, Tokyo, Japan. Background: Serotonin (5-HT) may play an important role in the regulation of colonic motility in humans. However, it is not known whether alterations in the colonic 5-HT system are involved in the pathophysiology of irritable bowel syndrome (IBS). Methods: Colonic mucosal specimens ranging from the ascending colon to the rectum were obtained from patients with diarrhea- or constipation-predominant IBS (n = 7 and n = 8, respectively) and from subjects with normal bowel habits (n = 7) by endoscopic biopsy in order to determine whether patients with different clinical manifestations of IBS have different mucosal disposition of 5-HT. The tissue concentrations of 5-HT and its major metabolite, 5-hydroxyindoleacetic acid, were determined by reversed-phase high-performance liquid chromatography with fluorescence detection. Results: In all study groups, the mean mucosal 5-HT concentrations obtained from the rectum were significantly (p < 0.05) higher than those obtained from more cephalic regions of the colon. In addition, the overall  mean mucosal 5-HT concentrations obtained from patients with constipation-predominant IBS were significantly (p < 0.05) higher than those obtained from the control subjects and patients with diarrhea-predominant IBS. No significant differences were observed in 5-hydroxyindoleacetic acid concentrations among the three groups. Conclusions: The mucosal 5-HT concentrations in the colon showed an ascending cephalocaudal gradient in all study groups. Although the mucosal 5-HT concentrations were elevated in patients with constipation-predominant IBS as compared with those with diarrhea-predominant IBS and the control subjects, further studies are necessary to determine whether the elevated mucosal 5-HT is a cause or a result of abnormal colonic motility. Copyright 2001 S. Karger AG, Basel PMID: 11351146------------------Moderator of the Cognitive Behavioral Therapy, Anxiety and Hypnotherapy forumI work with Mike and the IBS Audio Program. www.ibshealth.com www.ibsaudioprogram.com


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## Guest (May 16, 2001)

very interesting as there is a significant difference here and especiaaly so in view of the 5ht involvement. but as the authors note it's not clear whether this is a cause or effect of ibs-C.tom


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## Joan Gregg (Jun 6, 2000)

asked this this am EDT, but evidently got lost.Isn't Seratonin in Serzone and/or Klonopin?tyjoan


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## badfoot (Oct 5, 1999)

Thanks again, Eric, for your superb ability to ferret out interesting and important parts of the IBS puzzle.


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## wanderingstar (Dec 1, 1999)

Now I'm REALLY confused!!It has been my understanding that serotonin is responsibile for the contractions in the intestines that move food along. Too much serotonin in the gut can therefore lead to cramps and D, which is why some IBS D people get those symptoms when the take antidepressants which increase the amount of serotonin in the gut (SSRIs) but have a decrease in those symptoms when they take antidepressants which lower the amount of serotonin in the gut (Remeron). Or if IBS C people find SSRIs helpful but would have problems with Remeron causing constipatoin. So why has this study found this:In addition, the overallmean mucosal 5-HT concentrations obtained from patients withconstipation-predominant IBS were significantly (p < 0.05) higher thanthose obtained from the control subjects and patients withdiarrhea-predominant IBShuh?!







[This message has been edited by wanderingstar (edited 05-27-2001).]


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## Kathleen M. (Nov 16, 1999)

What serotonin does depends on WHERE it is in particular.There are two major serotonin receptors in the gut and one is the accelerator pedal and the other is the break.Lotronex blocks the accelerator pedal and Zelnorm blocks the brakes. Which is why Lotronex eases diarrhea. It's like putting a governer on the accelerator pedal so you can't speed and Zelnorm keeps you from riding the brakes the whole time your trying to drive.Antidepressants even the same one can cause both constipation and diarrhea (and thus can treat either C or D--althoug the main thing they probably do in IBS is block the tranmission of pain as they do for all the other chronic pain syndromes they are used for) depending on the person who is taking it.K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html


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