Increased platelet depleted plasma 5-hydroxytryptamine concentration following meal ingestion in symptomatic female subjects with diarrhoea predominant irritable bowel syndrome

Houghton, L.A.; Atkinson, W.; Whitaker, R.P.; Whorwell, P.J.; Rimmer, M.J.
May 2003
Gut;May2003, Vol. 52 Issue 5, p663
Academic Journal
Background: Meal ingestion is often associated with exacerbation of gastrointestinal symptoms in subjects with irritable bowel syndrome (lBS). Furthermore, recent preliminary data suggest that 5-hydroxytryptamine (5-HT) concentration in platelet poor plasma is elevated following meal ingestion in some subjects with diarrhoea predominant lBS (d-lBS) compared with healthy subjects, although it is not known whether this is related to postprandial symptomatology. Aim: To expand on previous data by evaluating a larger number of subjects but also to assess plasma 5-hydroxyindole acetic acid (5-HIAA) concentrations, 5- HT turnover, platelet 5-HT stores, and any relationship to symptomatology. Methods: We assessed platelet depleted plasma 5-HT and 5-HIAA concentrations for two hours (60 minute intervals) under fasting conditions, and then for a further four hours (30 minute intervals) after a standard carbohydrate meal (457 kcal), together with fasting platelet 5-HT concentrations in 39 female subjects with d-lBS (aged 19-52 years; mean age 33) and 20 healthy female volunteers (aged 20-46 years, mean age 28). lBS symptomatology, in particular abdominal pain and bloating, and urgency to defecate were assessed throughout the study Results: When related to fasting levels, there was no statistically significant difference in postprandial plasma 5-HT concentrations between d-lBS and healthy subjects. However, when fasting levels were not taken into consideration, d-lBS subjects exhibited higher postprandial plasma 5-HT concentrations compared with healthy subjects (p=0.040). Furthermore, d-lBS subjects who exhibited postprandial symptomatology had higher levels of postprandial plasma 5-HT, whether assessed with respect to fasting baseline levels (p=0.069) or not (p=0.047), compared with d-lBS subjects who did not report postprandial symptomatology. This appeared to be associated with a concomitant increase in plasma 5-HIAA (p=0.161) but reduction in turnover (p=0.058)....


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