Circadian Rhythms in Patients With Abdominal Pain Syndromes

Roberts‐Thomson, Ian C.; Knight, Ross; Kennaway, David J.; Pannall, P R

doi:10.1111/j.1445-5994.1988.tb00126.x

Cited by 16 publications

(10 citation statements)

References 17 publications

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“…Of note is that those rats with an incorrect cannula placement did not show improvement in either immobility score or mechanical allodynia, suggesting a selective effect of melatonin within ACC. This behavioral data is also consistent with a low plasma melatonin level in WKY rats and in patients suffering from abdominal pain, idiopathic pain, neuropathic pain, or cluster headache (Waldenlind et al, 1987;Almay et al, 1987;Roberts-Thompson et al, 1988;von Knorring, Ekselius, 1994;Leone et al, 1995). It should be noted that the role of a specific MT receptor subtype was not examined in this study, because luzindole (MT2 > MT1) is not a highly selective antagonist for an MT receptor subtype.…”

Section: Discussionsupporting

confidence: 61%

Exacerbated mechanical allodynia in rats with depression-like behavior

et al. 2008

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Although a clinical connection between pain and depression has long been recognized, how these two conditions interact remains unclear. Here we report that both mechanical allodynia and depression-like behavior were significantly exacerbated after peripheral nerve injury in Wistar-Kyoto (WKY) rats, a genetic variation of Wistar rats with demonstrable depression-like behavior. Administration of melatonin into the anterior cingular cortex contralateral to peripheral nerve injury prevented the exacerbation of mechanical allodynia with a concurrent improvement of depressionlike behavior in WKY rats. Moreover, there was a lower plasma melatonin concentration and a lower melatonin receptor expression in the anterior cingular cortex in WKY rats than in Wistar rats. These results suggest that there exists a reciprocal relationship between mechanical allodynia and depression-like behavior and the melotoninergic system in the anterior cingular cortex might play an important role in the interaction between pain and depression.

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Section: Discussionsupporting

confidence: 61%

Exacerbated mechanical allodynia in rats with depression-like behavior

et al. 2008

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“…16 Melatonin may also be involved in mediating gut visceral sensation because patients with functional abdominal pain are reported to have lower urinary excretion of 6-sulphatoxy melatonin and to exhibit a circadian rhythm of lower amplitude compared with healthy controls. 17 In view of the high prevalence of sleep disturbance in IBS patients, and the possible double effects of melatonin in regulating sleep pattern and bowel function, we hypothesised that melatonin may be useful in the treatment of IBS, and its therapeutic effects might be most evident if it was used in IBS patients who suffer from concomitant sleep disturbance. The present study, therefore, aimed to assess the efficacy of exogenous melatonin given at bedtime in relieving IBS bowel symptoms, and in improving rectal sensitivity.…”

mentioning

confidence: 99%

Melatonin improves abdominal pain in irritable bowel syndrome patients who have sleep disturbances: a randomised, double blind, placebo controlled study

Song

Leng²,

Gwee³

et al. 2005

Gut

157

131

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Background and aims: Melatonin, a sleep promoting agent, is involved in the regulation of gastrointestinal motility and sensation. We aimed to determine if melatonin was effective in improving bowel symptoms and sleep disturbances in irritable bowel syndrome (IBS) patients with sleep disturbance. Methods: Forty IBS patients (aged 20-64 years; 24 female) with sleep disturbances were randomly assigned to receive either melatonin 3 mg (n = 20) or matching placebo (n = 20) at bedtime for two weeks. Immediately before and after the treatment, subjects completed bowel, sleep, and psychological questionnaires, and underwent rectal manometry and overnight polysomnography. Results: Compared with placebo, melatonin taken for two weeks significantly decreased mean abdominal pain score (2.35 v 0.70; p,0.001) and increased mean rectal pain threshold (8.9 v 21.2 mm Hg; p,0.01). Bloating, stool type, stool frequency, and anxiety and depression scores did not significantly differ after treatment in both groups. Data from sleep questionnaires and polysomnography showed that the two week course of melatonin did not influence sleep parameters, including total sleep time, sleep latency, sleep efficiency, sleep onset latency, arousals, duration of stages 1-4, rapid eye movement (REM) sleep, and REM onset latency. Conclusions: Administration of melatonin 3 mg at bedtime for two weeks significantly attenuated abdominal pain and reduced rectal pain sensitivity without improvements in sleep disturbance or psychological distress. The findings suggest that the beneficial effects of melatonin on abdominal pain in IBS patients with sleep disturbances are independent of its action on sleep disturbances or psychological profiles.

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“…23 Melatonin may also play a role in modulating gut visceral sensation because patients with functional abdominal pain disorders have been reported to have reduced urinary excretion of 6-sulphatoxy melatonin and a lower amplitude circadian rhythm compared to healthy controls. 24 Previous studies on adult patients with IBS or FD showed that exogenous melatonin given at bedtime for 2-12 weeks was effective in fully or partially relieving abdominal pain. [13][14][15][16] To date, melatonin did not reduce abdominal pain in children with FD in the only paediatric study available.…”

Section: Discussionmentioning

confidence: 99%

“…The exact mechanism through which melatonin modulates gastrointestinal motility is unclear, although some studies suggest that it may be related to the inhibition of nicotinic channels by melatonin 22 and/or the interplay between melatonin and Ca 2+ ‐activated K + channels 23 . Melatonin may also play a role in modulating gut visceral sensation because patients with functional abdominal pain disorders have been reported to have reduced urinary excretion of 6‐sulphatoxy melatonin and a lower amplitude circadian rhythm compared to healthy controls 24 . Previous studies on adult patients with IBS or FD showed that exogenous melatonin given at bedtime for 2–12 weeks was effective in fully or partially relieving abdominal pain 13–16 .…”

Section: Discussionmentioning

confidence: 99%

Randomised controlled trial of melatonin for paediatric functional abdominal pain disorders

Dipasquale

Palermo

Barbalace

et al. 2023

J Paediatrics Child Health

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Aim Melatonin seems to have a positive impact on the brain–gut axis and many direct and indirect effects on the gastrointestinal tract. This trial aimed at assessing the efficacy of melatonin combined with Lactobacillus Rhamnosus GG given in the treatment of paediatric patients with functional abdominal pain disorders. Methods Forty‐two patients aged 4–18 years old who fulfilled the Rome IV Diagnostic Criteria for functional abdominal pain disorders were enrolled. Melatonin 3 or 5 mg in combination with Lactobacillus Rhamnosus GG (group 1, n = 22) or a placebo in combination with Lactobacillus Rhamnosus GG (control group, n = 20) were taken in the evening for a period of 4 weeks. The study duration was 12 weeks. The primary study endpoint was represented by clinical improvement at week 12 – defined as at least a 50% reduction in mean abdominal pain index (API) from baseline to week 12. Results The mean API was reduced by more than 50% between T0 and T2 in the group of children treated with melatonin. However, the difference in the distributions of the variations of the scores between the two groups was not significant between T0 and T2 (P = 0.082), while it was significant between T0 and T1 (P = 0.001). Similar results were obtained by analysing the API variables ‘weekly frequency of pain’ (item 1) and ‘perceived intensity of pain’ (item 4) individually. Conclusions This is the first study to investigate the role of the combination of melatonin and Lactobacillus Rhamnosus GG in the treatment of children with functional abdominal pain disorders. Melatonin combined with Lactobacillus Rhamnosus GG can be considered a therapeutic option for these conditions in children.

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Circadian Rhythms in Patients With Abdominal Pain Syndromes

Cited by 16 publications

References 17 publications

Exacerbated mechanical allodynia in rats with depression-like behavior

Exacerbated mechanical allodynia in rats with depression-like behavior

Melatonin improves abdominal pain in irritable bowel syndrome patients who have sleep disturbances: a randomised, double blind, placebo controlled study

Randomised controlled trial of melatonin for paediatric functional abdominal pain disorders

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