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Very helpful and accurate explanation! -nt- new
      #354332 - 01/09/10 10:13 AM
Windchimes

Reged: 09/05/09
Posts: 581
Loc: Northern California



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Senior female, IBS-D, presently stable thanks to Heather & Staff

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For PMartin new
      #354333 - 01/09/10 10:20 AM
Windchimes

Reged: 09/05/09
Posts: 581
Loc: Northern California

There is often a common misunderstanding about serotonin prescription medications. These are Selective Serotonin Re-uptake 'Inhibitors' (SSRI's) and are of benefit to many of those who have IBS, among other things. These drugs do not add serotonin to your body, they simply help regulate how the body uses what your body naturally produces, and help the gut and mind communicate more comfortably as far as physical symptoms among other things, including feelings of depression.

Hope this helps.

--------------------
Senior female, IBS-D, presently stable thanks to Heather & Staff

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Re: Seratonin follow-up new
      #354335 - 01/09/10 11:00 AM
shawneric

Reged: 01/30/03
Posts: 1738
Loc: Oregon

PMartin, are you a member of medscape by any chance? Its free and they don't spam you and its an excellent resource.

"excessive levels of serotonin could cause symptoms of diarrhea?"

Not excessive in the entire body so much as bad transportation from the actual EC cells that release it to start gut contractions and the way serotonin signaling in the whole body.

To much released from the ec cells causes d and to little cause c and alternators to little sometimes and to much at others, hence alternating.

"Serotonin signaling has been implicated in the pathophysiology of IBS."

This has been figured out partly now for years in regards to altered motility and pain, but the exact mechanisms are not fully understood, there are different receptors, 5ht4 receptors are connected to c and 5ht3 receptors connected to D. Hence lotronex worked on 5ht3 recpetors and zelmac on 5ht4 receptors. There are still other receptors under investigation.

In Medscape is an article by DR Gersho, the Dr that found the second brain in the gut.

The article is called

IBS With Diarrhea: An Expert Interview With Michael Gershon, MD

actually this might work

http://74.6.146.127/search/cache?ei=UTF-8&p=gershon+and+serotonin+and+ibs&fr=fp-yie8&u=www.medscape.com/viewarticle/477681&w=gershon+serotonin+ibs&d=Xak2gd29UEoY&icp=1&.intl=us&sig=422iJx_0hP_ZDA60qrkV6w--

If you can sign up for it then I can point out articles to you about it all.


Another reason that serotonin is implicated, is it can cause altered motility but its also what the gut uses to signal to the brain pain or discomfort.

Taking a 5ht supplement, might not help IBS or for some it may, but I can't tell you what it would do in your body. For years they have known about this but they don't rusally commend taking them that I am aware of. One reason if I remember corectly is this just works on the brain NOT the gut receptors. I am sure its more complex, but can't remember the exact reasons. It may help people at the brain level also and that could in trun help the gut for other reasons.

It may help some people with lower levels in the brain to help with relaxation. But others it would cause restlessness, and anxiety which would not be helpful.

"How can one determine their level of serotonin and whether it's normal, too low or too high"

I believe there is a test for this, but not for IBS, for serotonin conditions. Its not the total amount in the body, but the regulation of it from the gut from specific cells. This causes a domino effect really to the rest of the body.

serotonin is a very important neurotransmitter that does a lot in the body. It is involved in digestion, sleep, sex, mucle contractions, moods and other important functions, including homeostasis. One reason perhaps why some of the non gi symptoms associated with IBS. Nausea for example is also part a serotonin issue as well as gerd, but others as well.

"What's the current status of alosetron (also known as Lotronex"

As far as I know you have to get special permission for it used and be monitored taking it.

Its mechanism of action is different then Lomotil. Lomotil is chemically related to an opioid drug.

" Is there a diet (or any other method/drug) for managing your desired level of serotonin?"

Foods have an effect on creating serotonin, certain foods break down to create amino acid Tryptophan which is then metabolised to create serotonin.

http://www.relieve-migraine-headache.com/food-and-serotonin.html

This though may increase D. Which is why the low carb diet for some, to Possibly reduce Tryptophan production. This is somewhat being studied at the moment.

I would read this also, this is complex and not well understood yet.

http://www.goaskalice.columbia.edu/0515.html

There are also foods that trigger IBS for completely different reasons. That is really important also and as far as foods, ask Heather.

Out of curiosity have you tried Mike's tapes?

Also remeber when your relaxed in the brain, its serotonin causing that effect. There is the central nervous system which is connected to the autonomic nervous system and the the enteric nervous system-the gut brain. There is also something really important here, the sympathetic and parasympathetic nervous system. Relax the brain and it can relax the gut, relax the gut and it can reelax the brain. This is very important for the serotonin issue, but also for another issues called mast cells and the fight or flight responce. The fight or flight responce IS VERY important in IBS. I will post more on that if you like.

"I've had issues with insomnia and restlessness and know there is a connection between whether I get a good night's sleep (which is not often) and how bad my symptom's are; is this an indication of anything?"

When you don't get a good nights sleep it stresses the body more and that physical stress can trigger the IBS.

I had bad insomnia until I did Mike's tapes and have not had it except for a couple nights here and there for over 6 years. It also really helped all my symptoms.

But yes lack of sleep can make IBS worse and that is common.

There are other psychological treatments that work naturally on serotonin regulation in the body. There are antidepressants also, like Amitriptyline that work for some on Pain and also at the gut level to help stop D. Usally they do this by giving you very low doses.





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My website on IBS is www.ibshealth.com


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Re: Seratonin follow-up new
      #354369 - 01/10/10 05:44 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

excessive levels of serotonin could cause symptoms of diarrhea?

In the GI tract the predominant site of serotonin synthesis, storage, and release is the enterochromaffin cells of the intestinal mucosa. Within the intestinal mucosa, serotonin released from enterochromaffin cells (EC cells) activates neural reflexes associated with intestinal secretion, motility, and sensation. The excessive levels of serotonin come from the EC cells and are not determined by levels in the blood or other body tissue. Ingestion of 5-HT has little effect on the serotonin levels released from EC cells. Generally speaking dietary approaches have little effect on serotonin levels released from EC cells.

However, ingested serotonin or l-tryptophan may effect the levels of melatonin in the GI tract. There is hundreds of times more melatonin in the GI tract than is involved in promoting sleep in the brain. Melatonin in the GI tract is produced from serotonin in the GI mucosa in serotonin-rich enteroendocrine cells. Melatonin plays a role GI motility and sensitivity possibly by blocking nicotinic channels or Ca2+ activated K+ channels. Oral ingestion of 5-ht and 5-htp are known to effect the levels of melatonin in the GI tract. The levels of melatonin in the GI tract increase with food intake particularly with high intake of dietary tryptophan. Oral administration of melatonin is known to affect colonic transit time in IBS & healthy individuals and reduce pain in IBS individuals. It does not effect sleep. I have been experimenting with melatonin to control IBS pain with good results. For the first time in more than 20 years after trying a variety of drugs I have been relatively pain free for over 2 months using melatonin.

For a complete description of how serotonin works in the GI tract see Serotonin and Its Role in Colonic Function and in Gastrointestinal Disorders. For a discussion of the role of melatonin in IBS see Is Melatonin Involved in the Irritable Bowel Syndrome?

Sleep disturbances are known to occur in IBS. This article in GUT titled Sleep and gastric function in irritable bowel may be of interest to you. They find that during REM sleep in patients with IBS and have documented alterations in normal gastric functioning during sleep.

--------------------
STABLE: ♂, IBS-D 50+ years - Science of IBS

The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS

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Syl re: Seratonin/Melatonin new
      #354371 - 01/10/10 09:46 AM
PMartin

Reged: 08/05/08
Posts: 140
Loc: Niagara Region

I'm surprised that you are IBS-D but have issues with pain. Most posters who have issues with pain/gas seem to be IBS-C.
Anyway, some questions...

" Oral ingestion of 5-ht and 5-htp are known to effect the levels of melatonin in the GI tract.

Do you mean effect them by increasing it?

" The levels of melatonin in the GI tract increase with food intake particularly with high intake of dietary tryptophan. "

Other than turkey, what are the best tryptophan containing foods (I'll look into this myself too)? Are there non-food souces of tryptophan (i know there is some in the protein I take) that you would recommend?

"Oral administration of melatonin is known to affect colonic transit time in IBS & healthy individuals and reduce pain in IBS individuals."

How does it affect transit time? Slowing it down or speeding it up? Obviously this is important depending on your symptoms. What is the source of Melatonin you use; OTC or is a prescription required? Would 5-htp work?

"For the first time in more than 20 years after trying a variety of drugs I have been relatively pain free for over 2 months using melatonin"

Have you enjoyed any other benefits like a decrease in urgency and frequency of BM's (typical D symptoms)?

Thanks Syl and I'll be checking out the links you provided!


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IBS-D. Or so a doctor says.

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Re: Syl re: Seratonin/Melatonin new
      #354375 - 01/10/10 10:34 AM
shawneric

Reged: 01/30/03
Posts: 1738
Loc: Oregon

Pain or discomfort is a must for the diagnoses of IBS.

Syl, glad its helping you.

Is melatonin involved in the irritable bowel syndrome?

http://www.ncbi.nlm.nih.gov/pubmed/19996484?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

Melatonin secretion and metabolism in patients with irritable bowel syndrome

http://www.ncbi.nlm.nih.gov/pubmed/19606692?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=4

The effects of melatonin on colonic transit time in normal controls and IBS patients.

http://www.ncbi.nlm.nih.gov/pubmed/18720001?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=7

Melatonin and serotonin effects on gastrointestinal motility.

http://www.ncbi.nlm.nih.gov/pubmed/18212403?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=10







--------------------
My website on IBS is www.ibshealth.com


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Shawneric re: Seratonin/Melatonin new
      #354376 - 01/10/10 10:59 AM
PMartin

Reged: 08/05/08
Posts: 140
Loc: Niagara Region

thanks and I am still working on the info you provided in the previous post.

--------------------
IBS-D. Or so a doctor says.

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Re: Syl re: Seratonin/Melatonin new
      #354378 - 01/10/10 11:11 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Bloating and pain are common symptoms found in all IBS subtypes.

Oral ingestion of 5-HT and 5-HTP increases melatonin production in the GI tract.

I am not sure that dietary sources of tryptophan are the most efficient way to modulate melatonin levels. A melatonin supplement is likely best. It is available as a supplement in health food stores. Be careful to check the ingredients. I found that Weber's sublingual was problematic for me because of some of the added ingredients it contains (lactose monohydrate and microcystalline cellulose). Eventually I found a melatonin supplement that contains nothing but 3 mg of pure synthetic melatonin. I believe natural melatonin supplements are not available as I recall due to risk of disease transfer. If you try a sublingual melatonin product be sure to swallow it and not put under you tongue. You want it to reach the stomach and duodenum not be absorbed into the blood stream under the tongue.

The colonic transit of constipation-predominant IBS patients was slower than normal controls. Diarrhea-predominant IBS did not differ from the normal control group. Another interesting result has been reported. IBS-C/D individuals (IBS-A were excluded from the study) showed about 1/2 the amount, compared to normal individuals, of the metabolite 6-sulphatoxymelatonin which is produced when melatonin is metabolized by the liver. Furthermore, IBS-C and IBS-D men produced 1/2 the amount of this metabolite compared to IBS-C/D women. It is unclear what these results mean and if the decrease in the metabolite is due to a decrease in production of melatonin or something else. There is strong evidence emerging to show melatonin plays a role in the pathophysiology of GI disorders.

I noticed a change in urgency, a slight change in frequency and a general improvement in sense of well being. My wife says she notices the later change the most in me. Something else I have found is I don't have to take it daily. It took about a week before I noticed a decrease in pain. After about two weeks the pain was minimal. After 3 weeks I quite taking melatonin and the pain did not re-occur until about a week or so later. Now I am only taking for about 2-3 days when I notice the pain coming back. The experiment continues on

I hope this helps.

--------------------
STABLE: ♂, IBS-D 50+ years - Science of IBS

The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS

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Re: Syl re: Seratonin/Melatonin new
      #354380 - 01/10/10 11:21 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Hi Shawneric,

Thank you for the links. I am affliated with the local university which gives me access to a wide variety of on-line science and medical journals. I have the complete papers for the links you provide in a personal database of functional GI disorder research papers I keep up to date. If you ever what to know the details in a particular paper provide me with the details and I will see what I can do to find it for you.

Have a wonderful day

--------------------
STABLE: ♂, IBS-D 50+ years - Science of IBS

The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS

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Re: Shawneric re: Seratonin/Melatonin new
      #354382 - 01/10/10 11:27 AM
shawneric

Reged: 01/30/03
Posts: 1738
Loc: Oregon

PMartin, I also have my own sites just for the info on IBS.

www.ibshealth.com

and www.ibshope.com

--------------------
My website on IBS is www.ibshealth.com


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