Association between proton pump inhibitor use and the risk of inflammatory bowel disease: A systematic review and meta-analysis
Abstract
BACKGROUND The worldwide prevalence of inflammatory bowel disease (IBD) continues to rise, motivating extensive exploration into possible contributing factors. Proton pump inhibitors (PPIs) are frequently prescribed medications for managing various gastrointestinal disorders. However, uncertainties persist regarding the implications of chronic PPI therapy and its potential association with the onset of IBD. AIM To assess the association between PPI use and incident IBD risk via a systematic review and meta-analysis of observational studies. METHODS A comprehensive literature search was performed in databases including PubMed, EMBASE, and Web of Science, covering the period from inception to February 13, 2025. Search terms included “proton pump inhibitors” and “inflammatory bowel disease”. Eligible were observational studies (cohort, case-control, and cross-sectional studies) reporting adjusted effect estimates for the association between PPI use and incident IBD. Study quality was assessed using the Newcastle-Ottawa Scale. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model, and heterogeneity was quantified with the I 2 statistic. RESULTS A total of five observational studies, encompassing 48058263 participants across diverse age groups, were included in this meta-analysis. Findings revealed that participants with PPI exposure had a significantly higher risk of developing IBD than those without exposure (OR = 1.85; 95%CI:…
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