Discussion
bloating, chronic pelvic pain, sleep disorders, abdominal pain, IBS, abdominal bloating, daytime dysfunction, extracolonic, chronic disease
DISEASE, FIBROMYALGIA, CHRONIC FATIGUE SYNDROME, PATHOGENESIS, CHRONIC DISEASE
IBS is a concerning and common disease worldwide that significantly burdens the health system as a chronic situation. Clinical manifestations vary among individuals, and current treatments do not meet patients’ demands [Melatonin is a hormone secreted by the pineal gland with a photoperiodic pattern that regulates the circadian rhythm. Furthermore, melatonin is also found in the GI tract, 400 times more than the secreted amount of the pineal gland, which is mostly synthesized in enterochromaffin cells [Furthermore, sleep disorders are discussed as another possible influencing factor in the pathogenesis of IBS. Wang et al. [IBS affects not only patients' physical health but also various aspects of daily life, including psychological health, work productivity, and social functioning. It is associated with life-disrupting symptoms such as abdominal pain, changes in bowel habits, bloating, fibromyalgia, chronic pelvic pain, and chronic fatigue syndrome. Since IBS is a chronic disease with a relatively long diagnostic and therapeutic course, patients are prone to poor quality of life [We included 136 IBS patients, which was more than similar trials [Chen et al. [The results of our trial showed that in both groups of patients with and without sleep disorders, receiving melatonin leads to a significant improvement in IBS score and GI symptoms, including the severity and the frequency of abdominal pain, the severity of abdominal bloating, satisfaction with bowel habits, disease's impact on patient's life, and stool consistency; however, there was no significant improvement in the frequency of defecations per week. In patients with sleep disorders, significant improvement in sleep parameters, including subjective sleep quality, sleep latency, sleep duration, sleep efficiency, and daytime dysfunction, was observed, while in patients without sleep disorders, there was no significant improvement in sleep parameters. In addition, quality-of-life improvement was observed in a significant number of melatonin recipients compared to placebo in both groups of patients.The differences between the results of our trial and other trials may be due to the difference in the trial duration, melatonin dosage, and scales used for evaluating the IBS symptoms, sleep parameters, and quality of life. In addition, they evaluated some parameters that we did not, such as psychological profile, colonic transit times, polysomnographic parameters, extracolonic parameters, and rectal sensory thresholds. In the following, we will discuss the studied parameters and results of each trial.Lu et al. [Song et al. [Saha et al. [Chojnacki et al. [