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World J Gastroenterol. Jun 14, 2026; 32(22): 116469
Published online Jun 14, 2026. doi: 10.3748/wjg.v32.i22.116469
Published online Jun 14, 2026. doi: 10.3748/wjg.v32.i22.116469
Association between proton pump inhibitor use and the risk of inflammatory bowel disease: A systematic review and meta-analysis
Min Gao, Rui-Rui Yin, Zong-Xin Shao, Yan-Yan Shi, Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
Xin Mao, Peking University Health Science Center, Peking University, Beijing 100191, China
Co-first authors: Min Gao and Rui-Rui Yin.
Author contributions: Gao M and Yin RR contributed to investigation and drafting the manuscript as co-first authors; Mao X and Shao ZX contributed to discussion; Shi YY was responsible for designing and revising this meta-analysis; all authors have read and approved the article.
AI contribution statement: AI tools were used solely for language refinement to improve the clarity and readability of the manuscript. These tools did not contribute to the generation of scientific ideas, research content, data analysis, image creation, or any experimental or computational procedures. The study design, data collection, data interpretation, and scientific conclusions were carried out entirely by the authors.
Supported by Beijing Natural Science Foundation of China, No. J230002.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Yan-Yan Shi, MD, Professor, Research Center of Clinical Epidemio
Received: November 13, 2025
Revised: January 11, 2026
Accepted: February 28, 2026
Published online: June 14, 2026
Processing time: 198 Days and 0.7 Hours
Revised: January 11, 2026
Accepted: February 28, 2026
Published online: June 14, 2026
Processing time: 198 Days and 0.7 Hours
Core Tip
Core Tip: Proton pump inhibitors (PPIs) are among the most commonly prescribed medications worldwide, yet their long-term safety remains under debate. This systematic review and meta-analysis demonstrate a statistically significant association between PPI use and an increased risk of incident inflammatory bowel disease. However, substantial heterogeneity and sensitivity analyses suggest that this association may be influenced by study design, age differences, and protopathic bias, thereby limiting causal inference. Clinicians should interpret this association cautiously, and future prospective studies with rigorous bias control are needed to determine whether PPI use contributes to inflammatory bowel disease pathogenesis.