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. 1998 Jan;42(1):42–46. doi: 10.1136/gut.42.1.42

Postprandial plasma 5-hydroxytryptamine in diarrhoea predominant irritable bowel syndrome: a pilot study

C Bearcroft 1, D Perrett 1, M Farthing 1
PMCID: PMC1726971  PMID: 9505884

Abstract

Background—Increased concentrations of 5-hydroxytryptamine (5-HT) can be detected in the systemic circulation after a meal and may be involved in the physiological control of gastrointestinal motility. Abnormalities of 5-HT release after a meal might explain some of the postprandial symptoms associated with the irritable bowel syndrome (IBS). 
Aim—To investigate the effect of a standard meal on plasma 5-HT and urinary 5-hydroxyindole acetic acid (5-HIAA) concentrations in patients with diarrhoea predominant IBS and in healthy volunteers. 
Methods—After an overnight fast, six volunteers and five patients with IBS were given a carbohydrate-rich meal. Blood and urine samples were taken before and for four hours after the meal. Platelet-poor plasma 5-HT and urinary 5-HIAA were analysed by reversed phase high performance liquid chromatography with fluorometric detection. 5-HIAA was expressed as a ratio with urinary creatinine concentration, which was measured by spectrophotometry. 
Results—During the four hour postprandial period, 5-HT concentrations were significantly higher in patients with IBS than in healthy volunteers at 0.5 hours (p<0.05), 2 hours (p<0.05) and 2.5 hours (p<0.05). 5-HT was not detected in the plasma in the fasting state in patients or volunteers. Median peak 5-HT in patients with IBS (359 (198-796) nmol/l) was significantly greater than volunteers (83 (7-190)) (p<0.05). "Area under the curve" for 5-HT detection was greater for patients with IBS (317(138-771)) than for healthy volunteers (51 (4-129); p<0.05).The duration of the 5-HT peak was significantly longer in patients with IBS (3 (1-3) hours) than in the healthy volunteers (1 (1-1) hours; p<0.01). Postprandial urinary median 5-HIAA values in controls (5.6 (5.5-5.8) µmol/mmol creatinine) and patients with IBS (3.0(2.5-6.8) µmol/mmol creatinine) were not significantly different from preprandial values (controls: 5.9 (5.5-6.6) µmol/mmol creatinine; patients with IBS: (6.2 (2.4-9.3) µmol/mmol creatinine). 
Conclusion—These findings indicate that there may be a difference in the way that 5-HT is released in patients with diarrhoea predominant IBS, and could suggest a possible role for 5-HT in the postprandial symptoms of these patients. 



Keywords: 5-hydroxytryptamine; postprandial; diarrhoea predominant irritable bowel syndrome

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Figure 1 .

Figure 1

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(A) Postprandial 5-HT profiles in patients with diarrhoea predominant IBS after a meal at zero hours. (B) Postprandial 5-HT profiles in healthy volunteers after a meal at zero hours. 


Figure 2 .

Figure 2

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Plasma 5-HT "area under the curve" in patients with diarrhoea predominant IBS and healthy volunteers. 


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