Hyperserotoninemia in Functional Gastrointestinal Disease

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Abstract
Of 252 patients with gastrointestinal disease of functional origin, 65 patients with the most severe symptoms were studied. Nine had increased blood serum serotonin and decreased urinary 5-hydroxyindoleacetic acid. Various studies indicated an aberration in serotonin metabolism. The features presented by these patients were similar and consisted of abdominal pain, diarrhea, nausea, vomiting, weight loss, weakness, easy fatiguing, and possible psychiatric disturbances. Two patients had flushes. All had recurrent episodic attacks but most had some or all of their complaints to a lesser intensity between attacks. A provocative test of intramuscular reserpine in 4 patients produced in each a severe typical attack. Treatment with cyproheptadine, an antiserotonin, produced great improvement in those 4 patients able to tolerate the drug. These findings suggest the occurrence of a disorder in indole metabolism in some patients considered to have gastrointestinal symptoms on a functional basis.