• J Formos Med Assoc · Mar 2023

    Meta Analysis

    The efficacy of exogenous melatonin supplement in ameliorating irritable bowel syndrome severity: A meta-analysis of randomized controlled trials.

    • Keng-Hsu Chen, Bing-Yan Zeng, Bing-Syuan Zeng, Cheuk-Kwan Sun, Yu-Shian Cheng, Kuan-Pin Su, Yi-Cheng Wu, Tien-Yu Chen, Pao-Yen Lin, Chih-Sung Liang, Chih-Wei Hsu, Che-Sheng Chu, Yen-Wen Chen, Pin-Yang Yeh, Ming-Kung Wu, Ping-Tao Tseng, and Chung-Yao Hsu.
    • Department of Medical Education, E-Da Hospital, E-Da Healthcare Group, Kaohsiung, Taiwan.
    • J Formos Med Assoc. 2023 Mar 1; 122 (3): 276285276-285.

    BackgroundIrritable bowel syndrome (IBS) was found in 11% of the general population worldwide. The current pharmacologic management of IBS was unsatisfactory, and it was accompanied by a number of adverse events. Melatonin was found to play an important role in gastrointestinal smooth muscle motility. Dysregulation of endogenous melatonin secretion has been found in IBS patients. Exogenous melatonin supplement has become one alternative treatment for IBS, but the evidence is inconclusive. The current meta-analysis sought to determine the efficacy of exogenous melatonin supplement in improving IBS severity in IBS patients.MethodsWe included randomized controlled trials (RCTs) that investigated the efficacy of exogenous melatonin supplement in ameliorating IBS severity in IBS patients. This meta-analysis was conducted using a random effects model. The primary target outcomes were changes in IBS severity associated with melatonin or placebo.ResultsThis meta-analysis of 4 RCTs and 115 participants revealed that exogenous melatonin supplement was associated with significantly better improvement in overall IBS severity than placebo (k = 4, Hedges' g = 0.746, 95% confidence intervals = 0.401-1.091, p < 0.001). The subgroup without concurrent medication had the same result (p < 0.001). In addition, exogenous melatonin supplement was also associated with significantly better improvement in IBS pain severity (p < 0.001) and quality of life (p = 0.007) than placebo, but not in abdominal distension (p = 0.111) or sleep quality (p = 0.142). Finally, melatonin was associated with similar safety profiles with placebo.ConclusionThis meta-analysis provides evidence for the use of exogenous melatonin in IBS patients to ameliorate overall IBS severity, IBS pain severity, and quality of life.Trial RegistrationPROSPERO CRD42021269451.Copyright © 2022 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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