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; Chung-Yao Hsu

Journal of the Formosan Medical Association (Mar 2023)

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,
Chung-Yao Hsu

Affiliations

Keng-Hsu Chen: Department of Medical Education, E-Da Hospital, E-Da Healthcare Group, Kaohsiung, Taiwan
Bing-Yan Zeng: Department of Internal Medicine, E-Da Dachang Hospital, Kaohsiung, Taiwan; Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
Bing-Syuan Zeng: Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan; Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
Cheuk-Kwan Sun: Department of Emergency Medicine, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
Yu-Shian Cheng: Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Taiwan; Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
Kuan-Pin Su: Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan; An-Nan Hospital, China Medical University, Tainan, Taiwan
Yi-Cheng Wu: Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
Tien-Yu Chen: Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
Pao-Yen Lin: Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Chih-Sung Liang: Department of Psychiatry, Beitou Branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
Chih-Wei Hsu: Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Che-Sheng Chu: Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Yen-Wen Chen: Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan
Pin-Yang Yeh: Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
Ming-Kung Wu: Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Corresponding author. Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Road, Niaosong District, Kaohsiung City 833, Taiwan.
Ping-Tao Tseng: Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan; Corresponding author. Prospect Clinic for Otorhinolaryngology & Neurology, No. 252, Nanzixin Road, Nanzi District, Kaohsiung City 81166, Taiwan.
Chung-Yao Hsu: Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Corresponding author. Department of Neurology, Kaohsiung Medical University Hospital; College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung city 80754, Taiwan.

Journal volume & issue: Vol. 122, no. 3
pp. 276 – 285

Abstract

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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.

Published in Journal of the Formosan Medical Association

ISSN: 0929-6646 (Print)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General)
Website: http://www.journals.elsevier.com/journal-of-the-formosan-medical-association/

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