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We included studies reporting the status of <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> infection in patients with and without EoE or oesophageal eosinophilia (EE). We used a random\u2010effects model to pool estimates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analysed 19 studies including 1.704.821 subjects. <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> infection was associated with a 46% lower risk of EoE\/EE (OR: 0.54, 95% CI 0.43 to 0.67). Comparable findings were observed when subgrouping studies by location or design. There was a nonsignificant decrease in odds for EoE in paediatric patients exposed to <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> (OR 0.57, 95% CI 0.26 to 1.24), and in studies using serology to diagnose <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> (OR: 0.41, 95% CI 0.16 to 1.04). We found lower odds of EoE compared with the overall findings in studies that diagnosed <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> only by gastric biopsy (OR 0.43, 95% CI 0.25 to 0.74) and in those published after 2019 (OR 0.44, 95% CI 0.28 to 0.68).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Exposure to <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> was significantly associated with decreased odds of EoE\/EE. As a stronger protective effect was found in more recent studies, the epidemiology of this association may evolve and deserve to be further monitored.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.70042","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T08:59:32Z","timestamp":1741683572000},"page":"1096-1109","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Meta\u2010Analysis: Inverse Association Between <scp><i>Helicobacter pylori<\/i><\/scp> Infection and Eosinophilic Oesophagitis"],"prefix":"10.1111","volume":"61","author":[{"given":"Irene","family":"Spinelli","sequence":"first","affiliation":[{"name":"Department of Translational Medicine and Surgery Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Department of Medical and Surgical Sciences, UOC CEMAD Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia Fondazione Policlinico 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