Melatonin Supplementation in the Management of Irritable Bowel Syndrome: An Updated Systematic Review and Meta-Analysis.
Ghadeer Ahmad Mahdi, Noor Abotaiban, Ahmed Farid Gadelmawla et al.
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In 30 seconds
This updated systematic review and meta-analysis assessed randomized, double-blind, placebo-controlled trials of oral or sublingual melatonin in adults with irritable bowel syndrome (IBS). Seven trials involving 391 participants were included; four contributed to pooled analyses. Compared with placebo, melatonin reduced moderate-to-severe IBS symptoms (RR = 0.52, 95% CI = 0.39-0.71, p < 0.0001) and improved pain frequency and frequency of defecation. Overall quality of life and global sleep quality did not differ significantly. Reported adverse effects were mild and infrequent.
Key findings
- Melatonin reduced moderate-to-severe IBS symptoms versus placebo (RR = 0.52, 95% CI = 0.39-0.71, p < 0.0001).
- Pain frequency improved with melatonin (SMD = 0.59, 95% CI = 0.27-0.92, p = 0.0003).
- Frequency of defecation improved (SMD = 0.42, 95% CI = 0.12-0.72, p = 0.0056).
- No significant differences were found in overall quality of life or global sleep quality; reported adverse effects were mild and infrequent.
Why it matters
The pooled findings suggest melatonin may benefit overall IBS symptom severity and selected pain and bowel-habit outcomes, while not demonstrating improvement in overall quality of life or sleep. This distinction helps frame the potential scope of benefit and the outcomes that remain uncertain when considering evidence for adjunctive approaches to IBS management.
What to keep in mind
Only seven trials involving 391 participants were included, and just four contributed to quantitative synthesis. The authors note that larger, high-quality trials are needed to confirm long-term efficacy.