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CME

Melatonin May Reduce the Pain of Irritable Bowel Syndrome

  • Authors: News Author: Laurie Barclay, MD
    CME Author:
    Désirée Lie, MD, MSEd
  • CME Released: 10/14/2005
  • THIS ACTIVITY HAS EXPIRED
  • Valid for credit through: 10/14/2006
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Target Audience and Goal Statement

This article is intended for primary care physicians, gastroenterologists, and other specialists who care for patients with IBS.

The goal of this activity is to provide the latest medical news to physicians and other healthcare professionals in order to enhance patient care.

Upon completion of this activity, participants will be able to:

  • Describe the effect of two weeks of melatonin on abdominal pain and rectal pain sensitivity in IBS.
  • Describe the effect of two weeks of melatonin on sleep disturbances in IBS.


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Author(s)

  • Laurie Barclay, MD

    Laurie Barclay is a freelance reviewer and writer for Medscape.

    Disclosures

    Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

Reviewer(s)

  • Gary Vogin, MD

    Senior Medical Editor, Medscape

    Disclosures

    Disclosure: Gary Vogin, MD, has disclosed no relevant financial relationships.

CME Authors

  • Désirée Lie,MD,MSEd

    Clinical Professor, Family Medicine, University of California, Orange; Director, Division of Faculty Development, UCI Medical Center, Orange, California

    Disclosures

    Disclosure: Désirée Lie, MD, MSEd, has disclosed no relevant financial relationships.


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    For Physicians

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CME

Melatonin May Reduce the Pain of Irritable Bowel Syndrome

Authors: News Author: Laurie Barclay, MD CME Author: Désirée Lie, MD, MSEdFaculty and Disclosures
THIS ACTIVITY HAS EXPIRED

CME Released: 10/14/2005

Valid for credit through: 10/14/2006

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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.”

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.”

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