Procedures in Fecal Microbiota Transplantation for Treating Irritable Bowel Syndrome: Systematic Review and Meta-Analysis
Background: Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disease with no effective treatment. Altered microbiota composition seems implicated in disease etiology and therefore fecal microbial transplantation (FMT) has emerged as a possible treatment therapy. To clarify the clinical...
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MDPI AG
2023-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/5/1725 |
| _version_ | 1797615086653669376 |
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| author | Tânia Rodrigues Sofia Rodrigues Fialho João Ricardo Araújo Rita Rocha André Moreira-Rosário |
| author_facet | Tânia Rodrigues Sofia Rodrigues Fialho João Ricardo Araújo Rita Rocha André Moreira-Rosário |
| author_sort | Tânia Rodrigues |
| collection | DOAJ |
| description | Background: Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disease with no effective treatment. Altered microbiota composition seems implicated in disease etiology and therefore fecal microbial transplantation (FMT) has emerged as a possible treatment therapy. To clarify the clinical parameters impacting FMT efficacy, we conducted a systematic review with subgroup analysis. Methods: A literature search was performed identifying randomized controlled trials (RCTs) comparing FMT with placebo in IBS adult patients (8-week follow-up) with a reported improvement in global IBS symptoms. Results: Seven RCTs (489 participants) met the eligibility requirements. Although FMT seems not to be effective in global improvement of IBS symptoms, subgroup analysis shows that FMT through gastroscopy or nasojejunal tube are effective IBS treatments (RR 3.03; 95% CI 1.94–4.73; I<sup>2</sup> = 10%, <i>p</i> < 0.00001). When considering non-oral ingestion routes, IBS patients with constipation symptoms are more likely to benefit from FMT administration (<i>p</i> = 0.003 for the difference between IBS subtypes regarding constipation). Fresh fecal transplant and bowel preparation seem also to have impact on FMT efficacy (<i>p</i> = 0.03 and <i>p</i> = 0.01, respectively). Conclusion: Our meta-analysis revealed a set of critical steps that could affect the efficacy of FMT as clinical procedure to treat IBS, nevertheless more RCTs are needed. |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T07:20:33Z |
| publishDate | 2023-02-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-5f5bdfc694ac4b9cbbbd38d9299892b82023-11-17T07:57:30ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01125172510.3390/jcm12051725Procedures in Fecal Microbiota Transplantation for Treating Irritable Bowel Syndrome: Systematic Review and Meta-AnalysisTânia Rodrigues0Sofia Rodrigues Fialho1João Ricardo Araújo2Rita Rocha3André Moreira-Rosário4NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, 1169-056 Lisboa, PortugalNOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, 1169-056 Lisboa, PortugalNOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugali3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, PortugalNOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, 1169-056 Lisboa, PortugalBackground: Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disease with no effective treatment. Altered microbiota composition seems implicated in disease etiology and therefore fecal microbial transplantation (FMT) has emerged as a possible treatment therapy. To clarify the clinical parameters impacting FMT efficacy, we conducted a systematic review with subgroup analysis. Methods: A literature search was performed identifying randomized controlled trials (RCTs) comparing FMT with placebo in IBS adult patients (8-week follow-up) with a reported improvement in global IBS symptoms. Results: Seven RCTs (489 participants) met the eligibility requirements. Although FMT seems not to be effective in global improvement of IBS symptoms, subgroup analysis shows that FMT through gastroscopy or nasojejunal tube are effective IBS treatments (RR 3.03; 95% CI 1.94–4.73; I<sup>2</sup> = 10%, <i>p</i> < 0.00001). When considering non-oral ingestion routes, IBS patients with constipation symptoms are more likely to benefit from FMT administration (<i>p</i> = 0.003 for the difference between IBS subtypes regarding constipation). Fresh fecal transplant and bowel preparation seem also to have impact on FMT efficacy (<i>p</i> = 0.03 and <i>p</i> = 0.01, respectively). Conclusion: Our meta-analysis revealed a set of critical steps that could affect the efficacy of FMT as clinical procedure to treat IBS, nevertheless more RCTs are needed.https://www.mdpi.com/2077-0383/12/5/1725irritable bowel syndromefecal microbiota transplantationmicrobiome therapymeta-analysisrandomized controlled trials |
| spellingShingle | Tânia Rodrigues Sofia Rodrigues Fialho João Ricardo Araújo Rita Rocha André Moreira-Rosário Procedures in Fecal Microbiota Transplantation for Treating Irritable Bowel Syndrome: Systematic Review and Meta-Analysis Journal of Clinical Medicine irritable bowel syndrome fecal microbiota transplantation microbiome therapy meta-analysis randomized controlled trials |
| title | Procedures in Fecal Microbiota Transplantation for Treating Irritable Bowel Syndrome: Systematic Review and Meta-Analysis |
| title_full | Procedures in Fecal Microbiota Transplantation for Treating Irritable Bowel Syndrome: Systematic Review and Meta-Analysis |
| title_fullStr | Procedures in Fecal Microbiota Transplantation for Treating Irritable Bowel Syndrome: Systematic Review and Meta-Analysis |
| title_full_unstemmed | Procedures in Fecal Microbiota Transplantation for Treating Irritable Bowel Syndrome: Systematic Review and Meta-Analysis |
| title_short | Procedures in Fecal Microbiota Transplantation for Treating Irritable Bowel Syndrome: Systematic Review and Meta-Analysis |
| title_sort | procedures in fecal microbiota transplantation for treating irritable bowel syndrome systematic review and meta analysis |
| topic | irritable bowel syndrome fecal microbiota transplantation microbiome therapy meta-analysis randomized controlled trials |
| url | https://www.mdpi.com/2077-0383/12/5/1725 |
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