Role of serotonin in the pathophysiology of the irritable bowel syndrome

Michael D. Crowell

Research output: Contribution to journalReview articlepeer-review

166 Scopus citations


The irritable bowel syndrome (IBS) is a complex disorder that is associated with altered gastrointestinal motility, secretion, and sensation. Serotonin (5-HT) is an important neurotransmitter and paracrine signalling molecule in the gastrointestinal tract. 5-HT release from enterochromaffin (EC) cells initiates peristaltic, secretory, vasodilatory, vagal and nociceptive reflexes. The enteric nervous system (ENS) comprises a semiautonomous effector system that is connected to the central autonomic network. Parasympathetic and sympathetic nerves modulate the ENS via afferent and efferent communications. Ongoing, bidirectional brain-gut interactions involving 5-HT pathways occur that significantly influence the effector systems. Altered 5-HT signalling may lead to both intestinal and extraintestinal symptoms in IBS. 5-HT directly and indirectly affects intestinal motor and secretory function and abnormalities may lead to either constipation or diarrhea. 5-HT modulates sensation and perception of visceral stimulation at peripheral and central sites. Therapeutic agents targeting altered 5-HT signalling may provide new, effective treatments for patients with IBS.

Original languageEnglish (US)
Pages (from-to)1285-1293
Number of pages9
JournalBritish Journal of Pharmacology
Issue number8
StatePublished - Apr 2004


  • Brain-gut axis
  • Constipation
  • Diarrhea
  • Enteric nervous system
  • Irritable bowel syndrome
  • Serotonin
  • Visceral pain

ASJC Scopus subject areas

  • Pharmacology


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