AUTHOR=Samuthpongtorn Chatpol , Kantagowit Piyawat , Pittayanon Rapat , Patcharatrakul Tanisa , Gonlachanvit Sutep 

TITLE=Fecal microbiota transplantation in irritable bowel syndrome: A meta-analysis of randomized controlled trials

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.1039284

DOI=10.3389/fmed.2022.1039284

ISSN=2296-858X

ABSTRACT=Introduction: Fecal microbiota transplantation (FMT) has been proposed as a potential treatment for irritable bowel syndrome (IBS); however, the consensus regarding its efficacy and safety is limited.

Materials and Methods: We performed a systematic search of the literature using PubMed, EMBASE, Ovid MEDLINE, and Cochrane. Meta-analyses were conducted in relative risk (RR) or standard mean difference (SMD) using 95% confidence intervals (CI). Cochrane risk-of-bias 2 tool (RoB2) was employed to evaluate the study quality.

Result: Of 2589 potential records, 7 studies with 9 cohorts involving 505 participants were included. Meta-analyses showed no significant difference in the short-term (12 weeks) and long-term (12 months) global improvement of IBS symptoms of FMT vs. placebo (RR 0.63, 95% CI 0.39 to 1.00 and RR 0.88, 95% CI 0.53 to 1.45 respectively). There were statistically significant differences of short-term IBS-SSS improvement (SMD -0.58, 95% CI -1.09 to -0.88) and short-term IBS-QoL improvement (SMD 0.67, 95% CI 0.43 to 0.91). Eight from 9 studies (88.9%) had a low risk of bias. The subgroup analysis revealed the short-term global symptoms improvement in studies with low-risk of bias (RR 0.53, 95% CI 0.35 to 0.81), studies with well-defined donors (RR 0.31, 95% CI 0.14 to 0.72), and studies with FMT using colonoscopy (RR 0.66, 95% CI 0.47 to 0.92). Major FMT adverse events are transient and rapidly self-limiting. 

Conclusion: FMT significantly improved IBS-SSS and IBS-QoL in the short-term period in IBS patients. However, global symptom improvement showed no significance. Well-defined donors and appropriate fecal administration routes appear to be important factors for the successful outcomes of FMT in IBS.