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World J Gastroenterol. May 7, 2006; 12(17): 2681-2687
Published online May 7, 2006. doi: 10.3748/wjg.v12.i17.2681
Central serotonergic and noradrenergic receptors in functional dyspepsia
S O’Mahony, TG Dinan, PW Keeling, ASB Chua
S O’Mahony, TG Dinan, Department of Psychiatry and Alimentary Pharmabiotic Centre, University College Cork, Ireland
PW Keeling, Department of Medicine, Trinity College Dublin, Ireland
ASB Chua, Ipoh Gastro Centre, Ipoh, Perak, Malaysia
Correspondence to: Professor TG Dinan, Department of Psychiatry, Cork University Hospital, Wilton, Cork, Ireland. t.dinan@ucc.ie
Telephone: +353-21-4922593 Fax: +353-21-4922584
Received: March 3, 2006
Revised: March 12, 2006
Accepted: April 7, 2006
Published online: May 7, 2006
Abstract

Functional dyspepsia is a symptom complex characterised by upper abdominal discomfort or pain, early satiety, motor abnormalities, abdominal bloating and nausea in the absence of organic disease. The central nervous system plays an important role in the conducting and processing of visceral signals. Alterations in brain processing of pain, perception and affective responses may be key factors in the pathogenesis of functional dyspepsia. Central serotonergic and noradrenergic receptor systems are involved in the processing of motor, sensory and secretory activities of the gastrointestinal tract. Visceral hypersensitivity is currently regarded as the mechanism responsible for both motor alterations and abdominal pain in functional dyspepsia. Some studies suggest that there are alterations in central serotonergic and noradrenergic systems which may partially explain some of the symptoms of functional dyspepsia. Alterations in the autonomic nervous system may be implicated in the motor abnormalities and increases in visceral sensitivity in these patients. Noradrenaline is the main neurotransmitter in the sympathetic nervous system and again alterations in the functioning of this system may lead to changes in motor function. Functional dyspepsia causes considerable burden on the patient and society. The pathophysiology of functional dyspepsia is not fully understood but alterations in central processing by the serotonergic and noradrenergic systems may provide plausible explanations for at least some of the symptoms and offer possible treatment targets for the future.

Keywords: Functional dyspepsia; Serotonin; Nor-adrenaline; Gastrointestinal disorders