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Meta-Analysis
. 2019 Oct;7(8):1033-1041.
doi: 10.1177/2050640619866990. Epub 2019 Jul 30.

Fecal microbiota transplantation in irritable bowel syndrome: A systematic review and meta-analysis

Kanchana Myneedu  1 , Abhizith Deoker  1 , Max J Schmulson  2 , Mohammad Bashashati  1
Affiliations
Meta-Analysis

Fecal microbiota transplantation in irritable bowel syndrome: A systematic review and meta-analysis

Kanchana Myneedu et al. United European Gastroenterol J. 2019 Oct.

Abstract

Background: Modulating gut microbiota is a potential treatment for irritable bowel syndrome (IBS). This meta-analysis explored whether fecal microbiota transplantation (FMT) is successful in treating IBS.

Methods: A systematic review was performed to find trials on FMT in IBS. Ratios and relative ratios (RR) of improvement for single-arm trials (SATs) and randomized controlled trials (RCTs) were calculated, respectively. Changes in IBS Severity Scoring System (IBS-SSS) and IBS Quality of Life (IBS-QOL) instrument compared to baseline in FMT versus placebo groups were pooled.

Results: In SATs, 59.5% (95% confidence interval (CI) 49.1-69.3) of IBS patients showed significant improvement. In RCTs, there were no differences between FMT and control in improvement (RR=0.93 (95% CI 0.50-1.75)) or changes in the IBS-SSS and IBS-QOL.

Conclusions: FMT was not effective in IBS. Variations in FMT methods and patient factors may contribute to the heterogeneous results of the trials.

Keywords: Fecal microbiota transplantation; IBS Quality of Life; IBS Symptom Severity Scale; irritable bowel syndrome; meta-analysis.

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Figures

Figure 1.
Figure 1.
Flow diagram of study selection for the meta-analysis of fecal microbiota transplant (FMT) in irritable bowel syndrome (IBS).
Figure 2.
Figure 2.
Meta-analysis of single-arm clinical trials (SATs) on the role of FMT in IBS. Data represent proportion (ratio), which is defined as the number of cases with improvement divided by the total studied cases.
Figure 3.
Figure 3.
Meta-analysis of randomized clinical trials (RCTs) on the role of FMT in IBS. (a) Risk ratio or relative ratio: events indicate number of cases with improvement of symptoms. (b) Changes in IBS Severity Scoring System (IBS-SSS) after treatment at 12 weeks; negative values indicate decrease in IBS-SSS after treatment or improvement. (c) Crude changes in IBS Quality of Life (IBS-QOL) after treatment.
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