{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:43:54Z","timestamp":1785300234972,"version":"3.55.0"},"reference-count":81,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>\n                      The management of\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      (\n                      <jats:italic>H. pylori<\/jats:italic>\n                      ) in patients with inflammatory bowel disease (IBD) presents a common clinical dilemma. While standard guidelines recommend\n                      <jats:italic>H. pylori<\/jats:italic>\n                      eradication to prevent gastric pathology, emerging evidence suggests a potential complex relationship with IBD. This study aims to critically evaluate this relationship through an updated systematic review and meta-analysis to inform clinical decision-making.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search on four major databases, PubMed, Embase, Medline, and Web of Science, was conducted, and all records before July 10th, 2025, were retrieved for screening. Pooled odds ratios (OR) with 95% confidence intervals (CIs) were calculated using STATA 18 software and a random-effects model (Restricted Maximum Likelihood, REML). Subgroup analyses, meta-regression, heterogeneity, sensitivity, and publication bias analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Analysis of 44 studies involving 14,100 IBD patients and 291,352 controls revealed a significantly lower prevalence of\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection in IBD patients compared to controls (13.48% vs. 10.87%; OR: 0.43, 95% CI: 0.35\u20130.53,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01). This negative association was particularly strong for Crohn\u2019s disease (OR: 0.36, 95%CI: 0.28\u20130.45) and in Eastern populations (OR: 0.34, 95%CI: 0.26\u20130.40). Heterogeneity was high (I\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f84.93%), but sensitivity analysis confirmed the robustness of the findings. No significant publication bias was detected.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This meta-analysis demonstrates a significant negative association between\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection and IBD, particularly in patients with Crohn\u2019s disease and those of Eastern population. Furthermore,\n                      <jats:italic>H. pylori<\/jats:italic>\n                      may exert a potential immunomodulatory role in IBD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024567688<\/jats:ext-link>\n                      , CRD42024567688.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1757356","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T14:49:29Z","timestamp":1770130169000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["To eradicate or not? Helicobacter pylori in patients with inflammatory bowel disease: an updated systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Yuzhen","family":"Bi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Chun\u2019an County First People\u2019s Hospital (Zhejiang Provincial People\u2019s Hospital, Chun\u2019an branch)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Chun\u2019an County First People\u2019s Hospital (Zhejiang Provincial People\u2019s Hospital, Chun\u2019an branch)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunhai","family":"Zhou","sequence":"additional","affiliation":[{"name":"Second School of Clinical Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Sun","sequence":"additional","affiliation":[{"name":"Key Laboratory of Gastroenterology of Zhejiang Province, Zhejiang Provincial People\u2019s Hospital (Affiliated People's Hospital, Hangzhou Medical College)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"7247238","DOI":"10.1155\/2019\/7247238","article-title":"A comprehensive review and update on the pathogenesis of inflammatory bowel disease","volume":"2019","author":"Guan","year":"2019","journal-title":"J Immunol Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e065186","DOI":"10.1136\/bmjopen-2022-065186","article-title":"Global, regional and national burden of inflammatory bowel disease in 204 countries and territories from 1990 to 2019: a systematic analysis based on the global burden of disease study 2019","volume":"13","author":"Wang","year":"2023","journal-title":"BMJ Open"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1053\/j.gastro.2023.07.003","article-title":"Incidence, prevalence, and racial and ethnic distribution of inflammatory bowel disease in the United States","volume":"165","author":"Lewis","year":"2023","journal-title":"Gastroenterology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1128\/CMR.00054-05","article-title":"Pathogenesis of Helicobacter pylori infection","volume":"19","author":"Kusters","year":"2006","journal-title":"Clin Microbiol Rev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1136\/gutjnl-2015-309252","article-title":"Kyoto global consensus report on Helicobacter pylori gastritis","volume":"64","author":"Sugano","year":"2015","journal-title":"Gut"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1007\/BF01300747","article-title":"Prevalence of Helicobacter pylori in specific forms of gastritis. 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