Fecal Microbiota Transplantation For Irritable Bowel Syndrome:A Systematic Review And Meta-analysis

OBJECTIVE AND BACKGROUND: Irritable bowel syndrome is an intermittent or persistent episode of gastrointestinal disease.Its clinical features are abdominal pain or discomfort associated with bowel habits.The cause and mechanism of the disease are not well understood.Ecological disorders may be the cause of their disease.The dysbiosis of the gut microbiota involves some gastrointestinal diseases and extraintestinal diseases.Current research indicates that Fecal bacteria transplantation(FMT)has a certain effect in the treatment of diseases such as Clostridium difficile infection(CDI),inflammatory bowel disease(IBD),irritable bowel syndrome(IBS)and hepatic encephalopathy(HE).At present,the therapeutic effect of FMT on IBS is still controversial.To discuss the clinical effect of FMT on IBS,we conducted this meta-analysis.Methods: Search PubMed,Cochrane Library,EMBASE,CNKI,Wanfang database,etc.The search time limit is built until now.Randomized controlled trials(RCTs),non-randomized controlled trials,and non-randomized experimental studies of FMT-treated IBS were performed.The literature was screened according to inclusion criteria and exclusion criteria.The primary outcome was overall symptom improvement,while adverse events and other related outcomes were observed.Data analysis was performed using Review Manager 5.3 software.RESULTS: After literature screening,5 randomized controlled trials were finally included.Meta-analysis using Review Manager 5.3 showed that the overall symptom improvement was 87 in the experimental group and 67 in the control group,P=0.70,(OR = 1.10;95% CI [0.69,1.74]).The study has a significant heterogeneity of I2 = 79%.Subgroup analysis showed that the results of oral FMT capsules in different FMT transplantation methods(OR=0.27;95% CI [0.12,0.61];I2=22%,the comparison between donor and patient feces FMT(OR)=2.41;95% CI [1.20,4.84],I2=0%).Analysis of adverse reactions during FMT treatment and follow-up showed that the overall adverse reaction rate was 29.1% in the experimental group and the overall adverse reaction rate in the control group.36.7%,the results were compared(OR=0.88;95% CI [0.29,2.72],I2=0%),and serious adverse reactions related to FMT were not observed.Conclusion: FMT can not effectively alleviate the overall symptoms of IBS and improve the quality of life.It may also require a large sample of randomized controlled trials to verify the clinical value of FMT in the treatment of IBS.