Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 12;5(5):e814.
doi: 10.1002/hsr2.814. eCollection 2022 Sep.

Efficacy and safety of fecal microbiota transplant in irritable bowel syndrome: An update based on meta-analysis of randomized control trials

Yomna Ali Abdelghafar  1 , Yossef Hassan AbdelQadir  1 , Karam R Motawea  1 , Sara Amr Nasr  1 , Hoda Aly Mohamed Omran  1 , Mohamed Mohamed Belal  1 , Mohamed Mahdy Elhashash  1 , Ahmed Alaa AbdelAzim  2 , Jaffer Shah  3
Affiliations

Efficacy and safety of fecal microbiota transplant in irritable bowel syndrome: An update based on meta-analysis of randomized control trials

Yomna Ali Abdelghafar et al. Health Sci Rep. .

Abstract

Background and aims: Fecal microbiota transfer (FMT) is a potential treatment for irritable bowel syndrome (IBS). Several randomized trials have tested FMT effects using different routes of administration, doses, and sample sizes. We aim to assess the overall efficacy of FMT for IBS patients and the safety of the intervention.

Methods: We systematically searched four databases for randomized control trials that studied the efficacy and safety of FMT in IBS patients.

Results: We included 8 randomized trials (472 patients) that compared FMT with placebo in IBS patients. Pooled results showed no statistically significant difference between FMT and control groups in the overall change in IBS symptom severity (IBS-SSS) at 1 month (p = 0.94), 3/4 months (p = 0.82), and at the end of trials (p = 0.67). No significant difference in the total number of respondents between the FMT and control groups (risk ratios = 1.84, [95% confidence interval (CI) = 0.82-2.65], p = 0.19). Although the oral route of administration showed a significant difference in the number of respondents (p = 0.004), there was no statistically significant difference in the IBS-SSS when subgrouping the oral route of administration (mean difference = 47.57, [95% CI = -8.74-103.87], p = 0.10).

Conclusion: FMT is not an effective treatment to relieve all the symptoms of IBS. Even in the groups that showed relatively significant improvement after FMT, the effect was proven to wear off over time and the re-administration carries a low success rate. Future research should consider different bacterial-based interventions such as probiotics or specific antibiotics.

Keywords: constipation; fecal microbiota transfer; irritable bowel syndrome; quality of life.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart
Figure 2
Figure 2
Risk of bias assessment
Figure 3
Figure 3
The results of IBS symptoms severity score (IBS‐SSS) outcomes
Figure 4
Figure 4
The results of quality of life (QOL) score outcomes
Figure 5
Figure 5
Forest plots of number of patients who achieved more than or equal to 50 points decrease in (IBS‐SSS) score and diarrhea
Figure 6
Figure 6
The difference in adverse events: nausea (abdominal pain, cramping, or tenderness), constipation, and bloating
See this image and copyright information in PMC

References

    1. Mizuno S, Masaoka T, Naganuma M, et al. Bifidobacterium ‐rich fecal donor may be a positive predictor for successful fecal microbiota transplantation in patients with irritable bowel syndrome. Digestion. 2017;96(1):29‐38. 10.1159/000471919 - DOI - PMC - PubMed
    1. El‐Salhy M, Hatlebakk JG, Gilja OH, Bråthen Kristoffersen A, Hausken T. Efficacy of faecal microbiota transplantation for patients with irritable bowel syndrome in a randomised, double‐blind, placebo‐controlled study. Gut. 2020;69(5):859‐867. 10.1136/GUTJNL-2019-319630 - DOI - PMC - PubMed
    1. Patel N, Shackelford KS. Irritable Bowel Syndrome. StatPearls; 2021. Accessed November 30, 2021. https://www.ncbi.nlm.nih.gov/books/NBK534810/
    1. Simrén M, Barbara G, Flint HJ, et al. Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut. 2013;62(1):159‐176. 10.1136/gutjnl-2012-302167 - DOI - PMC - PubMed
    1. Oka P, Parr H, Barberio B, Black CJ, Savarino EV, Ford AC. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta‐analysis. Lancet Gastroenterol Hepatol. 2020;5(10):908‐917. 10.1016/S2468-1253(20)30217-X - DOI - PubMed

LinkOut - more resources