Role of serotonin in the pathophysiology of the irritable bowel syndrome.
The irritable bowel syndrome (IBS) is a complex disorder that is associated with altered gastrointestinal motility, secretion, and sensation. Serotonin (5-HT) is an important neurotransmitter and paracrine signalling molecule in the gastrointestinal tract. 5-HT release from enterochromaffin (EC) cells initiates peristaltic, secretory, vasodilatory, vagal and nociceptive reflexes. The enteric nervous system (ENS) comprises a semiautonomous effector system that is connected to the central autonomic network. Parasympathetic and sympathetic nerves modulate the ENS via afferent and efferent communications. Ongoing, bidirectional brain-gut interactions involving 5-HT pathways occur that significantly influence the effector systems. Altered 5-HT signalling may lead to both intestinal and extraintestinal symptoms in IBS. 5-HT directly and indirectly affects intestinal motor and secretory function and abnormalities may lead to either constipation or diarrhea. 5-HT modulates sensation and perception of visceral stimulation at peripheral and central sites. Therapeutic agents targeting altered 5-HT signalling may provide new, effective treatments for patients with IBS.
Crowell
Michael D
MD
Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Mayo Foundation, 13400 E. Shea Boulevard, Scottsdale, AZ 85259, U.S.A. crowell.michael@mayo.edu
D000818:Animals; D005769:Gastrointestinal Motility / Q000187:drug effects / Q000502:physiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy / Q000378:metabolism*; D011985:Receptors, Serotonin / Q000502:physiology; D012701:Serotonin / Q000502:physiology*; D018490:Serotonin Agents / Q000494:pharmacology / Q000627:therapeutic use
D011985:Receptors, Serotonin; D018490:Serotonin Agents; D012701:Serotonin