TITLE

DECREASED POST-PRANDIAL 5 HT IN CONSTIPATION PREDOMINANT IRRITABLE BOWEL SYNDROME (C-IBS)

AUTHOR(S)
Dunlop, S.P.; Coleman, N.S.; Blackshaw, P.E.; Perkins, A.C.; Singh, G.; Marsden, C.A.; Spiller, R.C.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA16
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: 5 HT (5-hydroxytryptamine), an important stimulator of intestinal motility and secretions, is stored predominantly within enterochromaffin cells (EC) of the Gl tract, which are increased in post-infectious lBS (PI-lBS). Recent reports have associated diarrhoeapredominant lBS with increased 5HT release but whether reduced release plays a role in causing constipation has not been examined. Aims: To determine the relationship between postprandial plasma serotonin release and colonic transit in C-lBS compared with PI-lBS and healthy controls. Methods: 15 C-lBS, 15 PI-lBS with diarrhoea predominant symptoms, and 15 healthy volunteers recruited through advertisement, underwent serial plasma serotonin measurement after a standard 520 kcal meal for 3 hours. Blood was taken through an 18G cannula into a syringe containing citrate, adenosine, dipyrimadole, and theophylline to inhibit platelet activation. Platelet poor plasma (PPP) and platelet rich plasma (PRP) was assessed for 5 HT using HPLC with electrochemical detection. Colonic transit was measured using marker pellets. Results: Mean (SEM) colonic transit was prolonged in C-lBS (49.4±3.8 h) compared with PI-lBS (26.7±4.5) and controls (34.1±4.5) (p = 0.002). The area under the curve (AUC) of PPP serotonin from immediately after the meal to 180 min was lower in C-lBS (2593±309 nmol/L.min) compared with PI-lBS (5623±721) and controls (4822±598) (p < 0.001). Although PI-lBS showed increased AUC compared with controls, these differences were not significant owing to substantial variability. There was a negative correlation between AUC and transit in all subjects (r = 0.354, p = 0.02). Platelet 5HT was greater in C-IBS (652±56.1) compared with PI-lBS (PRP = 484.1±40.7 ng/109 platelets, p = 0.039) but not significantly different from controls (598.5±36.4). Conclusions: Reduced 5 HT release may be an important contributor to slow intestinal...
ACCESSION #
9747363

 

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