The role of serotonin in irritable bowel syndrome: implications for management.
Irritable bowel syndrome (IBS) is a poorly understood, common, chronic condition characterized by -abdominal discomfort associated with altered bowel habits in the absence of structural or biochemical abnormalities. Despite the significant economic and personal burden associated with IBS, treatment options remain limited. Serotonin is recognized as a key neurotransmitter in intestinal secretory, sensory, and motor function. Although the pathophysiology of IBS is incompletely understood, there is evidence that abnormalities in brain-gut signaling and serotonin metabolism play a role. This article reviews the evidence that serotonin, one of the better-understood neurotransmitters with respect to its role in human central and intestinal physiology, plays a role in IBS. Serotonin signaling is discussed, with a focus on receptor subtypes and the therapeutic agents that target these receptors. Evidence that IBS is associated with perturbations in serotonin metabolism at various steps in the signaling pathway is also addressed, along with the limitations on alteration in serotonin metabolism as the sole explanation for the constellation of symptoms observed in patients with IBS.
Garvin
Brian
B
Department of Internal Medicine, University of Michigan Health System, A7007 UH, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
Wiley
John W
JW
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D017615:Enteric Nervous System / Q000503:physiopathology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D011985:Receptors, Serotonin / Q000502:physiology; D044406:Receptors, Serotonin, 5-HT3 / Q000502:physiology; D044422:Receptors, Serotonin, 5-HT4 / Q000502:physiology; D012701:Serotonin / Q000502:physiology*; D012702:Serotonin Antagonists / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
D000929:Antidepressive Agents, Tricyclic; D011985:Receptors, Serotonin; D044406:Receptors, Serotonin, 5-HT3; D044422:Receptors, Serotonin, 5-HT4; D012701:Serotonin; D012702:Serotonin Antagonists; D017367:Selective Serotonin Reuptake Inhibitors