Plain language summary
Irritable bowel syndrome (IBS) is characterised by abdominal distension, change in stool consistency, sensation of incomplete evacuation, or pain relieved with defecation. This study's aim was to provide more evidence and directly address the efficacy of exogenous melatonin supplement in improving IBS severity. This study was a meta-analysis of four randomised controlled trials with a total of 115 participants. Results showed that daily melatonin supplement was associated with significantly better improvement in overall IBS severity, IBS pain severity, and quality of life, but not in abdominal distension or sleep quality. Furthermore, melatonin supplement was not associated with a significantly different safety profile compared to placebo. Authors concluded that their findings provided evidence for the potential benefit of exogenous melatonin supplementation in IBS management, including overall IBS severity, IBS pain severity, and quality of life.
Abstract
BACKGROUND Irritable 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. METHODS We 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. RESULTS This 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. CONCLUSION This 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 REGISTRATION PROSPERO CRD42021269451.
Methodological quality
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