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Serotonin

Irritable Bowel Syndrome (IBS) is a long-term digestive condition that impacts bowel movements, digestion, and sensitivity of the gut. Serotonin (5-HT) is crucial in IBS management as it influences:

• Intestinal motility (the pace of digestion)

• Bowel movements (whether experiencing diarrhea or constipation)

• Gut sensitivity (including pain, bloating, and cramping)

• Brain-gut communication (affecting mood, anxiety, and stress responses)

Given that you have IBS-D (diarrhea-predominant IBS), along with food intolerances and gut problems, it’s vital to comprehend how serotonin influences IBS and how to achieve a natural balance.

How Does Serotonin Influence IBS Symptoms?

• Approximately 95% of serotonin is generated in the gut, where it regulates digestion. An imbalance in serotonin levels, whether excessive or insufficient, can result in various forms of IBS:

Serotonin Level	IBS Type	Symptoms
High Serotonin	IBS-D (Diarrhea-predominant IBS)	Frequent diarrhea, urgency, cramping
Low Serotonin	IBS-C (Constipation-predominant IBS)	Hard stools, bloating, slow digestion
Fluctuating Serotonin	IBS-M (Mixed IBS - Alternating D & C)	Alternating diarrhea & constipation

Individuals suffering from IBS frequently experience imbalances in serotonin, leading to erratic gut symptoms.

Elevated Serotonin and IBS-D (Diarrhea)

• Urgent, frequent diarrhea

• Loose, watery stools

• Post-meal diarrhea (Dumping Syndrome)

• Abdominal discomfort and bloating

Factors Contributing to High Serotonin in IBS-D

• Gut Inflammation: Causes an overproduction of serotonin.

• Stress & Anxiety: Heighten gut serotonin levels, resulting in diarrhea.

• Certain Foods (high-FODMAP, spicy foods): Induce spikes in serotonin.

• SSRI Medications: Some antidepressants elevate serotonin, exacerbating IBS-D.

• Serotonin-Secreting Tumors (Rare): Carcinoid tumors lead to chronic diarrhea.

Reduced Serotonin and IBS-C (Constipation)

• Hard, dry stools

• Infrequent bowel movements

• Bloating and gas

• Straining during bowel movements

Factors Leading to Low Serotonin in IBS-C

• Poor gut microbiome: Diminishes serotonin production.

• Low fiber diet: Results in sluggish digestion.

• Chronic stress gradually depletes serotonin levels.

• Vitamin deficiencies (B6, D, Magnesium): Impact serotonin synthesis.

Fluctuating Serotonin and IBS-M (Mixed IBS)

• Some individuals with IBS face alternating episodes of diarrhea and constipation due to unpredictable serotonin levels.

Serotonin Cycle in IBS-M:

• High serotonin → Rapid digestion → Diarrhea

• The body adjusts by reducing serotonin → Slower digestion → Constipation

• Serotonin increases again. → Diarrhea reappears

Noradrenaline

Irritable Bowel Syndrome (IBS) is linked to noradrenaline dysregulation, particularly through the gut-brain axis. Also referred to as norepinephrine, noradrenaline is a neurotransmitter associated with stress that significantly influences gut function, especially in individuals with IBS.

How Noradrenaline Influences IBS:

Stress and Sympathetic Activation

During stressful situations, noradrenaline is released due to the activation of the sympathetic nervous system, commonly known as the "fight or flight" response. When stress becomes chronic, it results in consistently elevated levels of noradrenaline, which can disturb normal gastrointestinal processes.

Altered Gut Motility

Depending on receptor sensitivity, noradrenaline can either enhance or disrupt gut motility. In cases of IBS-D (diarrhea-dominant), it generally accelerates intestinal contractions, whereas in IBS-C (constipation-dominant), it may hinder peristalsis, leading to discomfort and bloating.

Visceral Hypersensitivity

Noradrenaline heightens the sensitivity of gut nerve endings, causing IBS patients to experience increased sensitivity to typical gut movements, resulting in pain, cramping, and urgency even in the absence of obvious physical triggers.

Microbiome Disruption

Chronic stress and noradrenaline have a significant impact on the gut microbiome, diminishing beneficial bacteria and fostering dysbiosis, which is closely linked to IBS flare-ups.

Inflammation & Gut Barrier Integrity

Noradrenaline may contribute to increased intestinal permeability, often referred to as "leaky gut," and low-grade inflammation, both of which are commonly observed in many IBS patients.

IBS transcends being merely a digestive issue—it represents a breakdown in gut-brain communication, frequently driven by hormonal imbalances.

Adrenaline

Adrenaline acts as your body's immediate response to stress. In times of heightened stress or anxiety, it triggers the gut, resulting in cramping, urgency, or diarrhea. Over time, persistent adrenaline spikes can lead to gut hypersensitivity, causing your digestive system to react excessively to even minor triggers.

GABA (Gamma-aminobutyric acid)

GABA serves as the natural calming neurotransmitter in the body. It plays a crucial role in regulating nerve signals within both the brain and the gut. When GABA levels are low, this calming effect diminishes, leading to overstimulation of the gut, spasms, and exacerbation of IBS symptoms such as bloating and urgency—particularly during emotionally overwhelming situations.

DHEA (Dehydroepiandrosterone)

DHEA is essential for enhancing stress resilience and protecting the gut barrier. A deficiency in DHEA makes the body more susceptible to gut inflammation, leaky gut, and immune dysfunction. This can heighten the sensitivity of the gut lining, increasing reactivity to foods, stress, and environmental factors.

Cortisol

Cortisol is responsible for managing long-term stress, but when levels are chronically high, it can interfere with digestion. Elevated cortisol slows down stomach emptying and leads to errors in gut-brain signaling, which is frequently observed in IBS. Over time, this can result in both constipation-predominant and diarrhea-predominant IBS by disrupting gut motility and microbial balance.

Glutamate

Glutamate is the main excitatory neurotransmitter found in both the central nervous system (CNS) and the enteric nervous system (ENS), often referred to as “the second brain” in your gut.

It plays a significant role in:

• Neurotransmission

• Sensory signaling

• Gut motility and secretion

• Pain perception

Glutamate Dysregulation in IBS

IBS is frequently influenced by visceral hypersensitivity, dysmotility, and stress-related signaling, all of which are affected by glutamate.

Elevated Glutamate in Gut Mucosa

Research indicates that individuals with IBS, particularly those with IBS-D and IBS-M, often exhibit increased levels of glutamate receptors, especially NMDA receptors, in their gut tissues.

This leads to:

• Increased gut sensitivity to normal stimuli

• Heightened pain perception.

• Faster or irregular motility, depending on subtype

Gut-Brain Axis Hyperexcitability

Chronic stress, trauma, and anxiety elevate glutamate levels in the brain, which subsequently affects gut function through the vagus nerve.

This bidirectional loop exacerbates symptoms such as:

• Cramping

• Loose stools or constipation

• IBS flare-ups triggered by emotional or physical stress

Neuroinflammation and Glial Dysregulation

Excess glutamate also contributes to enteric neuroinflammation, further sensitizing the gastrointestinal tract.

Glial cells (the support cells in both the gut and brain) may become impaired, unable to effectively clear glutamate → resulting in overstimulation of the nerves.

Clinical Evidence:

IBS patients frequently exhibit:

• Elevated glutamate levels in mucosal biopsies

• Increased expression of NMDA receptors