title: A clinicopathological study of serotonin of sigmoid colon mucosa in association with chronic symptoms in uncomplicated diverticulosis.
abstract: BACKGROUND
  Neurotransmitter imbalance is hypothesised as a pathogenetic mechanism in several bowel conditions. We previously reported increased 5-HT in the sigmoid mucosa of colon resected for complicated diverticular disease (DD). We aimed to identify if abnormal 5-HT expression is associated with symptoms of uncomplicated DD.
  
  
  METHODS
  This was a prospective, comparative study and follow-up survey of symptoms. We examined the differences in 5-HT between DD patients and controls, as well as the presence of bowel symptoms at time of endoscopy and also 2 years later. Sigmoid biopsies were collected at colonoscopy. Immunohistochemical staining for 5-HT cells was performed.
  
  
  RESULTS
  Eighty-seven patients were recruited, 37 (42.5 %) DD and 50 (57.5 %) controls. No patients underwent surgery. There was no significant difference in total mean number of 5-HT-positive cells in DD compared to controls or between patients and controls with abdominal symptoms. Forty-one patients (47.1 %) responded to questionnaires at median 57.8 months from biopsy. Eighteen (43.9 %) were DD and 23(56.1 %) controls. 5-HT counts showed no significant association to symptom persistence.
  
  
  CONCLUSIONS
  Although 5-HT expression has previously been found to be increased in complicated DD in whole bowel-resected specimens, the same is not confirmed on colonic mucosal biopsies. This raises the suggestion that 5-HT may be involved in the development of acute complications but may not be involved in the pathogenesis of chronic symptoms.
authors: Department of Colorectal Surgery, Kings College Hospital, London, UK. sanjeyarajah@doctors.net.uk
authors: S
authors: S
authors: Jeyarajah
authors: N
authors: N
authors: Akbar
authors: J
authors: J
authors: Moorhead
authors: A
authors: A
authors: Haji
authors: S
authors: S
authors: Banerjee
authors: S
authors: S
authors: Papagrigoriadis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D012809:Colon, Sigmoid / Q000378:metabolism* / Q000473:pathology*; D004239:Diverticulitis, Colonic / Q000378:metabolism* / Q000473:pathology*; D004724:Endoscopy; D004759:Enterochromaffin Cells / Q000378:metabolism / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012701:Serotonin / Q000378:metabolism*
chemical_list: D012701:Serotonin