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Acute tryptophan depletion alters gastrointestinal and anxiety symptoms in irritable bowel syndrome.

OBJECTIVES: To assess the effect of acute changes in serotonin (5-HT) synthesis using the acute tryptophan depletion (ATD) paradigm on gastrointestinal (GI) and mood symptoms in irritable bowel syndrome (IBS).

METHODS: In a randomized double-blind crossover study, 29 subjects (18 patients with ROME II defined IBS and 11 age-matched controls) were studied under ATD and acute tryptophan increase (ATI) conditions. GI symptoms, mood and anxiety ratings, as well as plasma tryptophan concentrations were measured.

RESULTS: Total (and free) plasma tryptophan concentrations decreased on the ATD day in patients (73%[82%]) and controls (73%[80%]), and increased on the ATI day in patients (59%[143%]) and controls (61%[381%]).

Compared with the ATD day, IBS patients reported more GI symptoms on the ATI day at +210 (p < 0.001) and at +270 (p < 0.05) min post drink. IBS patients also reported less anxiety on the ATI day compared with the ATD day at +270 min (p < 0.001). ATD and ATI did not affect these ratings in control participants. IBS patients had a lower mood compared with controls (p < 0.05), but this did not differ between the ATI and ATD days in either group.

CONCLUSIONS: IBS patients' GI and anxiety responses to changes in tryptophan load differ from controls. This suggests a difference in serotonergic functioning between these two groups and provides evidence to support the hypothesis that 5-HT dysfunction is involved in IBS.

About the Authors

Shufflebotham J, Hood S, Hendry J, Hince DA, Morris K, Nutt D, Probert C, Potokar J. (2006) Acute tryptophan depletion alters gastrointestinal and anxiety symptoms in irritable bowel syndrome. Am J Gastroenterol. 2006 Nov;101(11):2582-7. Epub 2006 Oct 4. Clinical Science at South Bristol, University of Bristol, Bristol, United Kingdom.

Comments

Dr_Abram_Hoffer

  • Posted on 05/16/2010 06:46 pm
This new work with NAD Therapy is very exciting and I think is right on target. It is indeed an energy-metabolic-deficiency (EMD) because in the absence of this coenzyme cycle almost all the reactions in the body run down... I congratulate Theo Verwey and his colleagues for this remarkable advance in using this concept and in using a simple test, the ratio of pyruvate to lactate as a diagnostic measure, to indicate the dose, duration of treatment etc.

NAD_Blood_Tests

  • Posted on 05/09/2010 05:45 pm
It is known that dietary tryptophan can be converted to nicotinamide nucleotides in the body. Both the level of tryptophan and the energy content of the diet have been shown to influence the efficiency of conversion. The rate at which tryptophan is converted to nicotinamide nucleotides in the body may be expected to be influenced by the activities of the enzymes concerned with the tryptophan-NAD pathway.

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