Diseases of the Colon & Rectum

, Volume 50, Issue 3, pp 376–388 | Cite as

Serotonin and Its Role in Colonic Function and in Gastrointestinal Disorders

Current Status

Serotonin (5-HT) is most commonly thought of as a neurotransmitter in the central nervous system. However, the predominant site of serotonin synthesis, storage, and release is the enterochromaffin cells of the intestinal mucosa. Within the intestinal mucosa, serotonin released from EC cells activates neural reflexes associated with intestinal secretion, motility, and sensation. Two important receptors for serotonin that are located in the neural circuitry of the intestines are the 5-HT3 and 5-HT4 receptors; these are the targets of drugs designed to treat gastrointestinal disorders. 5-HT3 receptor antagonists are used to treat nausea and emesis associated with chemotherapy and for functional disorders associated with diarrhea. 5-HT4 receptor agonists are used as promotility agents to promote gastric emptying and to alleviate constipation. Because of the importance of serotonin in normal gut function and sensation, a number of studies have investigated potential changes in mucosal serotonin signaling in pathologic conditions. Despite the inconsistencies in the current literature, changes in serotonin signaling have now been demonstrated in inflammatory bowel disease, irritable bowel syndrome, postinfectious irritable bowel syndrome, and idiopathic constipation. Emerging evidence has led to many contradictory theories regarding serotonin signaling and its roles in the pathology of gut disorders. This review summarizes the current medications affecting serotonin signaling and provides an overview of our current knowledge of the changes in serotonin that occur in pathologic conditions.

Key words

Irritable bowel syndrome Constipation Enterochromaffin cells 5-HT3 and 5-HT4 receptors 

Notes

Acknowledgment

The authors thank Michael J. Callahan Ph.D. for valuable input during the preparation of this review.

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Copyright information

© The American Society of Colon and Rectal Surgeons 2007

Authors and Affiliations

  • Meagan M. Costedio
    • 1
  • Neil Hyman
    • 1
  • Gary M. Mawe
    • 2
  1. 1.Department of SurgeryUniversity of Vermont College of MedicineBurlingtonUSA
  2. 2.Department of Anatomy and NeurobiologyUniversity of Vermont College of MedicineBurlingtonUSA

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