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We have previously shown that 5-HT may play a role in the post-prandial exacerbation of symptoms seen in female patients with d-lBS. As both progesterone (P) and oestrogen (O) can influence the 5-HT system, the aim of th s study was to compare plasma 5-HT concentrations in female patients with d-lBS (Rome II) with high and ow levels of P/O. Platelet depleted plasma (PDP) 5-HT concentration was therefore assessed for 2 h (60 min intervals) under fasting conditions and 4 h (30 min intervals) after a standard carbohydrate meal (457 kcal) in 39 patients (aged 19-52 yrs) with high P/O (studied either during the luteal phase of the menstrual cycle or while taking combined P/O oral contraception) and in 11 aged matched patients (aged 22-45 years) with Iow P/O levels (menses). 5-HT concentration was measured by reverse-phase high performance liquid chromatography with fluorimetric detection. In addition, symptomatology (0-4; 4 = severe) was assessed throughout the study. Results: Under fasting conditions there was no difference in PDP 5-HT concentration between patients with a high (5.41 ng/ml, (mean)) and Iow (4.98 ng/ml; difference high Iow (95%CI), 0.43 ng/ml (-0.69,1.55) ng/ml; p = 0.443) P/O status. Following meal ingestion, however, patients with high P/O levels have a significantly higher PDP 5-HT peak (13.99 ng/ml; (geometric mean) than those with Iow P/O levels (8.57 ng/ml; ratio high:low, 1.63 (1.02,2.62); p = 0.043). This difference was particularly evident in patients reporting post-prandial symptoms (patients with high P/O levels (n = 31): 15.60 ng/ml v patients with Iow P/O levels (n = 11): 8.57 ng/ml; ratio high:low, 1.82 (1.12, 2.96); p = 0.017) and was not related to a difference in symptom severity between the two groups (patients with high P/O levels: 0.70 (mean) v Iow P/E levels: 0.58; difference highIow, 0.12 (-0.28, 0.53); p = 0.547. Conclusions: Female sex hormones may play a role in the gastrointestinal tract 5-HT response to a meal in female... [ABSTRACT FROM AUTHOR]

Recent studies suggest that patients with irritable bowel syndrome lBS have elevated levels of plasma 5-HT following meal ingestion compared with healthy controls. Moreover, patients who exhibit postprandial symptoms have higher plasma 5-HT levels compared with those who do not, suggesting a possible relationship between Dost-prandial symptoms and abnormalities in 5-HT release. Given functional dyspepsia (FD) belongs to the same family of disorders as lBS, the aims of this study were to assess platelet depleted plasma (PDP) 5-HT concentrations under fasting and fed (760 kcal meal) conditions in 11 patients with FD (aged 30-61 years; 6 males) and 12 healthy volunteers (aged 20-48 years; 5 males) and assess any relationship to gender and epigastric pain/discomfort (p/d). Results: Under fasting conditions FD patients had similar levels of PDP 5-HT to controls (FD (n = 11): 4.65 ng/ml (geometric mean) vs controls (n = 12): 4.57ng/ml; ratio FD:controls (95%CI), 1.02 (0.14, 1.26)). However, under fed conditions, although the peak PDP 5-HT concentration for the whole group of FD patients was not significantly different from controls (11.19 ng/ml vs 8.43 ng/ml; 1.33(0.69, 2.54); p = 0.37, patients who reported post-prandial p/d had a higher PDP 5-HT peak (n = 8:14.74 ng/ml) than both patients who did not report p/d (5.36ng/ml; ratio with:without p/d 2.75(1.24, 6.10); p = 0.02) and controls (8.43 ng/ml; ratio FD with p/d:controls, 1.75 (0.79, 3.87); p = 0.14). This was as a consequence of a higher PDP 5-HT peak in the female FD patients with p/d (36.56 ng/ml), as all other females (FD and controls (n = 9): 7.71 ng/ml; ratio FD with p/d:FD and controls 4.74 (2.5, 9.0 p < 0.001) and all males (FD and contro s (n = 11): 8.07 ng/ml; ratio female FD with p/d: all males, 4.53 (2.19,9.35); p < 0.001) had lower PDP 5-HT peaks. Lastly, symptom severity tended to correlate with peak PDP 5-HT concentration (rho = 0.37; p = 0.08). Conclusions: These data provide evidence for a role... [ABSTRACT FROM AUTHOR]