![]() The search terms used to identify potentially related publications included “irritable bowel syndrome,” “IBS,” “short chain fatty acid,” “SCFA,” “volatile fatty acid,” etc., and these were applied to all fields to identify the maximum number of studies and increase the hit rate. Controlled vocabulary and keyword searching were both used in each database to identify relevant studies. Studies to be included in the meta-analysis were searched for using PubMed (January 1946 to May 2018), EMBASE, Web of Science, China National Knowledge Infrastructure, and Wanfang database in May 2018. We aimed to identify the characteristics of fecal SCFAs in patients with IBS and compare them to those in healthy controls (HCs), to determine whether SCFAs can be utilized as biomarkers of disordered gut microbiota in patients with IBS. Therefore, a systematic review and meta-analysis on the alteration in fecal SCFAs in patients with IBS is desirable for clarifying this issue. However, these studies reported varying or even contradictory results neither the concentrations of SCFAs nor the relative proportions of different SCFAs have shown consistent associations with IBS. Hence, many studies have examined the association between IBS and SCFAs. Fecal SCFAs abnormalities have been reported in patients with IBS, implying that alterations in SCFAs might be related to IBS. The cause of IBS remains unknown, and no single treatment is found to be universally applicable to all patients with IBS. The fact that SCFAs are the main end-products of colonic bacterial fermentation, they play a role in preserving gut barrier functions, and have immunomodulatory and anti-inflammatory properties, provides a rationale and representative target to measure intestinal health. Short-chain fatty acids (SCFAs), the primary metabolite for colonocytes, are produced in the intestinal lumen by commensal anaerobic bacteria via carbohydrate fermentation, which are principle nutrient substrates of the colonic epithelium. Researchers also discovered that disorders of gut microbiota potentially contribute to the pathogenesis of IBS. ![]() IBS is a chronic condition that requires long-term management. Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, with signs and symptoms including cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. Propionate and butyrate could be used as biomarkers for IBS diagnosis. In IBS-C patients, propionate and butyrate were reduced, whereas butyrate was increased in IBS-D patients in comparison to HCs. Finally, we found that restricted diets correlated with fecal butyrate reduction in IBS (SMD = -0.26, 95% CI = -0.51, -0.01).ConclusionsIn terms of fecal SCFAs, there were differences between patients with IBS and HCs. A subgroup analysis showed that the concentration of fecal propionate (SMD = -0.91, 95% CI = -1.41, -0.41) and butyrate (SMD = -0.53, 95% CI = -1.01, -0.04) in patients with constipation-predominant IBS (IBS-C) was significantly lower than that in HCs, and the concentration of fecal butyrate in patients with diarrhea-predominant IBS (IBS-D) was higher than that in HCs (SMD = 0.34, 95% CI = 0.00, 0.67). The standardized mean difference (SMD) with 95% confidence interval (CI) in fecal SCFA levels between different groups was calculated.ResultsThe proportion of fecal propionate in patients with IBS was significantly higher than in healthy controls (HCs) (SMD = 0.44, 95% CI = 0.12, 0.76). No prior systematic review has been conducted on the alterations in fecal SCFAs in IBS patients.AimsWe performed a meta-analysis to explore and clarify alterations in fecal SCFAs in IBS patients.MethodsCase-control studies, randomized controlled trials (RCTs), and self-controlled studies were identified through electronic database searches. Previous studies on SCFA alterations in patients with IBS have yielded conflicting results. BackgroundRecent studies indicate that gut microbiota disorders potentially contribute to the pathogenesis of irritable bowel syndrome (IBS), which can be partly reflected by fecal short-chain fatty acids (SCFAs) generated from gut microbiota.
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