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Melatonin's role in IBS

A study using a commonly prescribed probiotic called VSL#3 showed that male IBS sufferers using VSL#3 had less abdominal pain and an improved satisfaction with bowel habits. (Wong.2015)
It is interesting that patients in the study that used the probiotic had increased morning salivary melatonin. This study is very useful in helping explain another reason why taking a probiotic is regulatory for the digestive system. My overly simplistic surmise of what is happening is that this probiotic is favorably shifting the gut biome so that the enterochromaffin cells are secreting melatonin more efficiently.

Melatonin (a hormone) has been studies in the digestive tract as it is known to be produced by enterochromaffin cells and small amounts stimulate motility and large amounts seem to slow motility.

As we know Melatonin is also produced in the body by the pineal gland and is responsible for helping with sleep/wake cycles of the body’s biorhythm. It also boosts natural killer cell activity in the immune system.

 Melatonin was used in a 2007 study of 18 IBS subjects (Saha.et.al,2007) where 3 mg of Melatonin was given at bedtime for 8 weeks leading to overall better IBS scores.

Melatonin in the gut likely balances visceral sensitivity of the gut. Also melatonin in the central nervous system helps us sleep better which we know is very important for the mind/gut aspect of IBS management. Siah,et.al in a 2014 review proposed why melatonin helps IBS sufferers because it promotes gastrointestinal motility, reduces visceral pain, and promotes restful sleep.

Supplementing probiotics or melatonin in the treatment protocol is critical. If an IBS patient has significant Dysbiosis or SIBO and they try supplementing with melatonin or VSL#3 it's likely not going to help without addressing the bigger task at hand. The first step would be to treat the Dysbiosis or SIBO and then follow afterwards with melatonin and/or VSL#3. I like to clear the terrain of dysfunction prior to doing these specific targeted treatments. Seems to work better. Melatonin is not tolerated by everyone. I have seen morning grogginess, nightmares, and even insomnia when using melatonin with patients. There are some new forms of melatonin out that are liposomal and are worth trying for a more profound effect.

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