Implications of Melatonin Therapy in Irritable Bowel Syndrome: A Systematic Review

Mozaffari, Shilan; Rahimi, Roja; Abdollahi, Mohammad

doi:10.2174/138161210794079254

Cited by 57 publications

(43 citation statements)

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“…Melatonin is produced at high levels in the gastrointestinal mucosa in response to food. It exhibits a large number of biologic effects which may be relevant to FD including both excitatory and inhibitory effects on the enteric nervous system, antiinflammatory properties, and both anxiolytic and antidepressant effects [8][9][10] . At pharmacologic doses, melatonin delays gastric emptying, in part acting as a partial 5-HT antagonist [10] .…”

Section: Introductionmentioning

confidence: 99%

Therapeutic effect of melatonin on pediatric functional dyspepsia: A pilot study

Zybach

Friesen

Schurman

2016

WJGPT

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AIM:To study the effectiveness of melatonin vs placebo in children with functional dyspepsia (FD). METHODS:The study was conducted as a double blind, randomized, placebo controlled crossover trial. Subjects were aged 8-17 years and diagnosed with FD based on Rome Ⅲ criteria. All subjects had failed to respond to 4 wk of acid suppression. Subjects receive a continuous two weeks of placebo and a continuous two weeks of melatonin in an order blinded to the participant and the study team. A Global Clinical Score was obtained to assess changes in abdominal pain. Pain was self-reported to be worse (grade 1), no change (grade 2), moderate improvement (grade 3), good (grade 4; minimal pain and not interfering with daily activities), or excellent (grade 5; no pain), respectively. A positive clinical response was defined as a grade 3 or greater response. Subjects wore an actigraph to assess sleep during a one week baseline period and during each treatment period. Subjects' sleep latency and total sleep time were recorded throughout the duration of the study. RESULTS:Fourteen subjects were enrolled and 12 completed the study. One withdrew prior to starting both melatonin and placebo and the other before starting melatonin. A positive clinical response (grade 3-5) was achieved in 42% of subjects on melatonin vs 50% of subjects on placebo (NS). Effect size was calculated

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Section: Introductionmentioning

confidence: 99%

Therapeutic effect of melatonin on pediatric functional dyspepsia: A pilot study

Zybach

Friesen

Schurman

2016

WJGPT

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“…It has been used in gastroenterology for therapeutic purposes in cases of its deficiency [14–16] or ineffectiveness of other treatments [17,18]. Functional dyspepsia (FD) belongs to diseases causing serious therapeutic problems.…”

Section: Introductionmentioning

confidence: 99%

Does Melatonin Homeostasis Play a Role in Continuous Epigastric Pain Syndrome?

Chojnacki

Popławski

Błasiak

et al. 2013

IJMS

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Two clinical forms of functional dyspepsia (FD) are listed in the Rome III criteria: postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS), differing in the recurrence of ailments depending on the diet. Continuous EPS (CEPS) is observed in some EPS patients, also at night, but its cause is still unknown. We showed previously that melatonin (MEL) homeostasis may be associated with FD. In the present work we evaluated selected components of melatonin homeostasis in patients with CEPS. The study included 30 patients with CEPS, 21 women and nine men, aged 21–49 years and 30 control subjects (EPS excluded); organic and mental diseases, as well as Helicobacter pylori infection, were excluded in both groups. The average severity of abdominal pain in the last three months was estimated in a 10-point scale (Visual Analog Scale). The levels of mRNA expression of arylalkylamine-N-acetyltransferase (AANAT) and hydroxyindole-O-methyltransferase (HIOMT), the main components of MEL homeostasis, were determined in gastric mucosa with real time PCR. The fasting serum level of MEL (at 09:00 a.m.) and circadian urine excretion of 6-sulfatoxymelatonin (6-HMS) were determined with ELISA. AANAT expression in antral mucosa of control subjects was 1.76 ± 0.41, in the gastric body 1.35 ± 0.38, and in the dyspeptic group 1.42 ± 0.38 (p < 0.05) and 0.92 ± 0.55 (p < 0.05), respectively. HIOMT expression in the control was 2.05 ± 0.70 in the antrum and 1.57 ± 0.69 in the body and in the CEPS group, it was: 1.51 ± 0.57 (p < 0.05) and 0.74 ± 0.31 (p < 0.001), respectively. MEL concentration (pg/mL) was 9.41 ± 3.09 in the control group and 5.62 ± 1.34 (p < 0.01) in the CEPS group. Urinary 6-HMS excretion (μg/24 h) was 11.40 ± 4.46 in the controls and 7.68 ± 2.88 (p < 0.05) in the CEPS. Moreover, a negative correlation was found between the tested parameters and severity of epigastric pain. These results indicate that patients with CEPS may display low level of AANAT and HIOMT expression in gastric mucosa, resulting in decreased MEL synthesis.

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“…[69] Further supports come from other systematic reviews indicating benefit of anti oxidative herbs in management of inflammatory bowel disease. [70]…”

Section: Discussionmentioning

confidence: 99%

Effects of Hypericum perforatum extract on rat irritable bowel syndrome

et al. 2011

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Context:In irritable bowel syndrome (IBS), disturbance of bowel motility is associated with infiltration of inflammatory mediators and cytokines into the intestine, such as neutrophils, myeloperoxidase (MPO), tumor necrosis factor alfa (TNF-α), and lipid peroxide.Aims:Regarding promising anti-inflammatory and anti-oxidative effects of Hypericum perforatum (HP) extract, besides its anti-depressant effect, this study was designed to evaluate the effects of HP in an experimental model of IBS.Settings and Design:IBS was induced by a 5-day restraint stress in rats. The HP extract was administered by gavage in doses of 150, 300, and 450 mg/kg for 26 days. Fluoxetine and loperamide were used as positive controls. Gastric emptying and small bowel and colon transit, besides the levels of TNF-α, MPO, lipid peroxidation, and antioxidant power, were determined in colon homogenates.Statistical Analysis Used:Data were analyzed by one-way ANOVA followed by Tukey's post hoc test for multiple comparisons.Results:A significant reduction in small bowel and colonic transit (450 mg/kg), TNF-α, MPO, and lipid peroxidation and an increase in antioxidant power in all HP-treated groups (150, 300, and 450 mg/kg) were seen as compared with the control group. Gastric emptying did not alter significantly when compared with the control group. Treatment with loperamide (10 mg/kg) significantly inhibited gastric emptying and small bowel and colonic transit, while flouxetine (10 mg/kg) decreased gastric emptying, TNF-α, MPO, and lipid peroxidation and increased the antioxidant power of the samples in comparison with the control group.Conclusions:HP diminished the recruitment of inflammatory cells and TNF-α following restraint stress not in a dose-dependent manner, possibly via inhibition of MPO activity and increasing colon antioxidant power, without any difference with fluoxetine. The HP extract inhibits small bowel and colonic transit acceleration like loperamide but has minimal effect on gastric emptying.

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Implications of Melatonin Therapy in Irritable Bowel Syndrome: A Systematic Review

Cited by 57 publications

References 0 publications

Therapeutic effect of melatonin on pediatric functional dyspepsia: A pilot study

Therapeutic effect of melatonin on pediatric functional dyspepsia: A pilot study

Does Melatonin Homeostasis Play a Role in Continuous Epigastric Pain Syndrome?

Effects of Hypericum perforatum extract on rat irritable bowel syndrome

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