Melatonin May Reduce the Pain of Irritable Bowel Syndrome CME

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Melatonin May Reduce the Pain of Irritable Bowel Syndrome CME

News Author: Laurie Barclay, MD

CME Author: Désirée Lie, MD, MSEd

 

_Disclosures_ (http://www.medscape.com/viewarticle/514515_author)

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Release October 14, 2005

 

; Valid for credit through October 14, 2006

 

 

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Oct. 14, 2005 — Melatonin may reduce the pain associated with irritable bowel

syndrome (IBS), according to the results of a small, double-blind study

reported in the October issue of Gut.

“Melatonin, a sleep promoting agent, is involved in the regulation of

gastrointestinal [GI] motility and sensation,†write G. H. Song, MD, from the

National University of Singapore, and colleagues. “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.â€

In this study, 40 patients with IBS and sleep disturbances were randomized to

receive either melatonin (3 mg) or matching placebo at bedtime for two

weeks. There were 24 women and 16 men; age range was 20 to 64 years.

Assessments

immediately before and after treatment included patient-completed bowel,

sleep, and psychological questionnaires; rectal manometry; and overnight

polysomnography (PSG).

Compared with the placebo group, the melatonin group had a decreased mean

abdominal pain score (2.35 vs 0.70; P < .001) and increased mean rectal pain

threshold (8.9 vs -1.2 mm Hg; P < .01). Neither group had significant changes

after treatment in bloating, stool type, stool frequency, or anxiety and

depression scores nor in sleep parameters, including total sleep time, sleep

latency, sleep efficiency, sleep onset latency, arousals, duration of stages 1

to

4, rapid eye movement (REM) sleep, and REM onset latency.

“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 authors

write. “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.â€

Study limitations include small sample size, short treatment period, use of

only one dose of melatonin, and limited sensitivity of the hospital anxiety

and depression scale.

“Future studies should focus on therapy with different doses of melatonin,

prolonging the treatment period, and using a larger sample size to provide a

clearer view of the role of melatonin in IBS and sleep disturbance,†the

authors conclude.

The authors have disclosed no financial relationships.

Gut. 2005;54:1402-1407