title: Targeting the 5-HT(3) receptor in the treatment of irritable bowel syndrome.
abstract: Irritable bowel syndrome, which affects 5-10% of the population includes around 25% with predominantly diarrhoea (IBS-D). Several lines of evidence suggest an increase in mucosal 5-HT availability in IBS-D including a decrease in the serotonin transporter (SERT) which is also seen following acute diverticulitis. 5-HT(3) receptor antagonists have proved effective in suppressing urgency, prolonging small and large bowel transit and relieving symptoms in IBS-D. Alosetron continues to be used under restricted availability without any serious morbidity despite ischemic colitis which occurs at a rate of <1/1000 patient year. Other agents such as ramosetron and ondansetron are still in use and have not been associated with ischemic colitis. 5-HT(3) receptor agonists stimulate intestinal motility, shorten transit times and in a pilot trial accelerated transit in patients with IBS-C.
authors.affiliation: NIHR Biomedical Research Unit, Nottingham Digestive Diseases Centre, University Hospital, Nottingham NG7 2UH, United Kingdom. robin.spiller@nottingham.ac.uk
authors.forename: Robin C
authors.initials: RC
authors.lastname: Spiller
mesh_terms: D000818:Animals; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000378:metabolism*; D058990:Molecular Targeted Therapy; D044406:Receptors, Serotonin, 5-HT3 / Q000378:metabolism*; D012701:Serotonin / Q000378:metabolism; D058827:Serotonin 5-HT3 Receptor Agonists / Q000494:pharmacology* / Q000627:therapeutic use; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D050486:Serotonin Plasma Membrane Transport Proteins / Q000378:metabolism
chemical_list: D044406:Receptors, Serotonin, 5-HT3; D058827:Serotonin 5-HT3 Receptor Agonists; D058831:Serotonin 5-HT3 Receptor Antagonists; D050486:Serotonin Plasma Membrane Transport Proteins; D012701:Serotonin