A randomised trial of ondansetron for the treatment of irritable bowel syndrome with diarrhoea
Open Access
- 12 December 2013
- Vol. 63 (10), 1617-1625
- https://doi.org/10.1136/gutjnl-2013-305989
Abstract
Background Irritable bowel syndrome with diarrhoea (IBS-D) is particularly debilitating due to urgency and episodic incontinence. Some 5-hydroxytryptamine 3 (5-HT3) receptor antagonists (5-HT3RAs) have proven effective but have serious side effects. Ondansetron, also a 5-HT3RA, has been widely used as an antiemetic with an excellent safety record for over two decades. Our aim was to assess its effectiveness in IBS-D. Methods 120 patients meeting Rome III criteria for IBS-D entered a randomised, double-blind, placebo-controlled crossover study of 5 weeks of ondansetron 4 mg versus placebo with dose titration allowed, up to two tablets three times daily in the first 3 weeks. Patients completed daily diaries documenting stool consistency using the Bristol Stool Form score. Gut transit was measured in the last week of each treatment. The primary endpoint was average stool consistency in the last 2 weeks of treatment. Results Ondansetron significantly improved stool consistency (mean difference in stool form between ondansetron and placebo −0.9, 95% CI −1.1 to −0.6, pConclusions Ondansetron relieves some of the most intrusive symptoms of IBS-D, namely loose stools, frequency and urgency.Keywords
This publication has 41 references indexed in Scilit:
- Randomised clinical trial: alosetron improves quality of life and reduces restriction of daily activities in women with severe diarrhoea‐predominant IBSAlimentary Pharmacology & Therapeutics, 2012
- Serotonin Signaling Is Altered in Irritable Bowel Syndrome With Diarrhea but Not in Functional Dyspepsia in Pediatric Age PatientsGastroenterology, 2010
- Postinfectious Irritable Bowel SyndromeGastroenterology, 2009
- Predictors of Patient-Assessed Illness Severity in Irritable Bowel SyndromeThe American Journal of Gastroenterology, 2008
- Afferent hypersensitivity in a mouse model of post‐inflammatory gut dysfunction: role of altered serotonin metabolismThe Journal of Physiology, 2008
- A Phase II Trial of the Novel Serotonin Type 3 Receptor Antagonist Ramosetron in Japanese Male and Female Patients with Diarrhea-Predominant Irritable Bowel SyndromeDigestion, 2008
- Effects of 5-Hydroxytryptamine (Serotonin) Type 3 Antagonists on Symptom Relief and Constipation in Nonconstipated Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsClinical Gastroenterology and Hepatology, 2008
- A randomized, double-blind, placebo-controlled clinical trial of the effectiveness of the novel serotonin type 3 receptor antagonist ramosetron in both male and female Japanese patients with diarrhea-predominant irritable bowel syndromeScandinavian Journal of Gastroenterology, 2008
- The 5-HT3 receptor antagonist alosetron inhibits the colorectal distention induced depressor response and spinal c-fos expression in the anaesthetised ratGut, 2000
- The pharmacological properties of the novel selective 5‐HT3 receptor antagonist, alosetron, and its effects on normal and perturbed small intestinal transit in the fasted ratNeurogastroenterology & Motility, 1999