© 2003 by BMJ Publishing Group & British Society of Gastroenterology
COMMENTARY
Irritable bowel syndrome
Of actors, bolting horses, and drops in oceans!
Emeritus Professor of Medicine, University of Ottawa, Ottawa, Ontario, Canada. K2H 8C4; wgthompson@rogers.com
Correspondence to:
Correspondence to:
Dr M Camilleri, Mayo Clinic, Charlton 8-110, 200 First Street SW, Rochester, MN 55905, USA;
camilleri.michael@mayo.edu
Does serotonin mediate postprandial symptoms in irritable bowel syndrome?
Keywords: 5-hydroxytryptamine; 5-hydroxyindole acetic acid; diarrhoea; irritable bowel syndrome serotonin; postprandial symptoms
| The first 150 words of the full text of this article appear below. |
Postprandial symptoms are a common feature in patients with irritable bowel syndrome (IBS). In one study, one half of patients presenting with IBS reported symptom occurrence or exacerbation following a meal.1 This effect of meals on gastrointestinal symptoms has been attributed to an increased colonic contractile response to meals in IBS patients. This colonic response has several components.
The first and most rapid component occurs within a few minutes of distension of the stomach by the meal and is mediated by gastric mechanoreceptors that evoke colonic contraction through a vagally mediated afferent pathway.
A second phase, mediated by chemoreceptors in the small intestine, results in colonic contraction that may last up to two hours after meal ingestion.2 Prolonged manometry3 and barostat studies4 demonstrated that the increase in colonic motility after meals was almost immediate, and subsequently we and others reported that patients with diarrhoea and urgency predominant
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