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Pharmacotherapy

https://doi.org/10.1136/gut.51.suppl_1.i96

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    Serotonergic modulation of visceral sensation: upper gut

    Selective serotonin reuptake inhibitors (SSRIs), and 5-HT4, 5-HT1P, and 5-HT1A receptor agonists all have an effect on postprandial tone in the stomach and therefore have therapeutic potential for the treatment of visceral hypersensitivity. Further clinical evaluation of these agents should focus on collecting data at the time of peak postprandial symptoms, which occurs approximately 75 minutes after a meal, and data collection should continue for up to four hours.

    Serotonergic modulation of visceral sensation: lower gut

    Novel serotonergic agents have a significant impact on symptoms of irritable bowel syndrome (IBS) as a result of their visceral analgesic properties and diverse effects on motor function in the lower gut. Antagonism of 5-HT3 receptors in the sensory apparatus reduces visceral pain whereas 5-HT3 inhibition in the motor apparatus retards colonic transit and enhances small intestinal absorption. Alosetron, a selective 5-HT3 antagonist, has been shown to relieve pain, normalise bowel frequency, and reduce urgency in female patients with diarrhoea predominant IBS. Alosetron was withdrawn because of reports of significant adverse events, including ischaemic colitis …

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