Nausea, abdominal pain and diarrhoea of uncertain cause responding to ondansetron

To assess the value of ondansetron in a patient with intractable nausea, abdominal pain and diarrhoea unrelated to cancer chemotherapy or radiotherapy.

A 33-year-old teacher presented with a three-and-a-half-year history of nausea, abdominal pain and diarrhoea. She attended a consulting room in private practice for a second opinion as her symptoms had not responded to routine management of "irritable bowel syndrome".

A prospective, non-placebo-controlled study was undertaken whereby she received ondansetron 8 mg three times daily for five days. Before ingestion of ondansetron it was planned that the efficacy of this new drug would be assessed by the clinical response and measured by the values obtained in a three-day faecal fat collection.

There was clinical benefit during the period of ingestion of ondansetron. In this time faecal weight and faecal fat excretion were reduced when compared with the results of similar collections (baseline study, and following the ingestion of pancreatic supplements) performed before the administration of ondansetron.

The benefit obtained warrants further assessment. If confirmed, the results may suggest a role for ondansetron in the management of nausea and vomiting unrelated to cancer chemotherapy and radiotherapy.