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A clinicopathological study of serotonin of sigmoid colon mucosa in association with chronic symptoms in uncomplicated diverticulosis

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Abstract

Introduction

Neurotransmitter imbalance is hypothesised as a pathogenetic mechanism in several bowel conditions. We previously reported increased 5-HT in the sigmoid mucosa of colon resected for complicated diverticular disease (DD). We aimed to identify if abnormal 5-HT expression is associated with symptoms of uncomplicated DD.

Methods

This was a prospective, comparative study and follow-up survey of symptoms. We examined the differences in 5-HT between DD patients and controls, as well as the presence of bowel symptoms at time of endoscopy and also 2 years later. Sigmoid biopsies were collected at colonoscopy. Immunohistochemical staining for 5-HT cells was performed.

Results

Eighty-seven patients were recruited, 37 (42.5 %) DD and 50 (57.5 %) controls. No patients underwent surgery. There was no significant difference in total mean number of 5-HT-positive cells in DD compared to controls or between patients and controls with abdominal symptoms. Forty-one patients (47.1 %) responded to questionnaires at median 57.8 months from biopsy. Eighteen (43.9 %) were DD and 23(56.1 %) controls. 5-HT counts showed no significant association to symptom persistence.

Discussion

Although 5-HT expression has previously been found to be increased in complicated DD in whole bowel-resected specimens, the same is not confirmed on colonic mucosal biopsies. This raises the suggestion that 5-HT may be involved in the development of acute complications but may not be involved in the pathogenesis of chronic symptoms.

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Conflict of interest

All authors declare no competing interests.

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Kings College Hospital, London, UK

    S. Jeyarajah, A. Haji, S. Banerjee & S. Papagrigoriadis

  2. Department of Histopathology, Kings College Hospital, London, UK

    N. Akbar & J. Moorhead

Authors
  1. S. Jeyarajah
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  2. N. Akbar
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  3. J. Moorhead
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  4. A. Haji
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  5. S. Banerjee
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  6. S. Papagrigoriadis
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Corresponding author

Correspondence to S. Jeyarajah.

Appendix

Appendix

Post procedure symptom questionnaire

figure a

Date:

Type of bowel condition (if any):

Date and type of surgery (if any):

Number of admissions to hospital with this problem before Endoscopy?

Number of admissions to hospital with this problem since endoscopy?

Number of visits to A&E/GP with this problem before Endoscopy?

Number of visits to A&E/GP with this problem since endoscopy?

  1. 1.

    Do you regularly suffer with constipation? If YES, how often?

  2. 2.

    Do you regularly suffer with diarrhoea? If YES, how often?

  3. 3.

    Do you regularly suffer with abdominal pain? If YES, how often?

  4. 4.

    Do you regularly suffer with flatulence (passing large amounts of gas)? If YES, how often?

  5. 5.

    Do you regularly suffer with abdominal bloating? If YES, how often?

  6. 6.

    Do you regularly suffer with rectal bleeding? If YES, how often?

  7. 7.

    Do you take any regular medications? Please could you list them here:

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Jeyarajah, S., Akbar, N., Moorhead, J. et al. A clinicopathological study of serotonin of sigmoid colon mucosa in association with chronic symptoms in uncomplicated diverticulosis. Int J Colorectal Dis 27, 1597–1605 (2012). https://doi.org/10.1007/s00384-012-1515-6

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  • DOI: https://doi.org/10.1007/s00384-012-1515-6

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