Pathophysiology of Irritable bowel syndrome:The role of brain-gut axis and serotoninergic receptors

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Annals of Gastroenterology
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Pathophysiology of Irritable bowel syndrome:The role of brain-gut axis and serotoninergic receptors (EN)

D.G. Karamanolis, I. Kyrlagkitsis,

SUMMARY The last decade has been marked by substantial progress in the understanding of the pathophysiology of Irritable Bowel Syndrome (IBS). Considerable advances contributing to this progress include the decryption of the secrets of the enteric nervous system (ENS) and the neuronal pathways involved in the transmission of visceral nociception as well as the localisation of potential processing centres in the central nervous system (CNS). Serotonin is sequestered in the neterochromaffin cells and is an essential mediator in the ENS. It manifests its actions mainly by 5-HT3 and 5-HT4 receptors and plays a key role in intestinal motility and secretion. The “central processing unit” of serotoninergic actions in the ENS is the AH/Dogiel morphologic type II neuron which was formerly considered to be the primary afferent neuron. It remains unknown whether the neurologic disorder in IBS consists of an exaggerated response to noxious stimuli in the gut, or misinterpretation by the CNS of otherwise accurate information. The exact locus of projection of visceral information in the brain is not known, but there is increasing evidence for areas such as the thalamus, the prefrontal cortex and the amygdaloid nucleous in the limbic system. Anxiogenic colonic response is probably mediated by CRF-1 receptors. Autonomic pathways from the brain stem may also play a role by regulating the intensity of perception during visceral stimulation. More accurate localisation of the neurologic derangement along the brain-gut axis is required, thus permitting a more targeted therapeutic intervention. Gastroenterology department, Tzaneion Hospital, Pireus, Greece Key words: Serotonin, visceral nociception, affered neuron presynaptic inhibition (EN)


Αγγλική γλώσσα


Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 15, No 3 (2002) (EN)

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