Background: Previous studies on the association between inflammatory bowel disease (IBD) and stroke showed conflicting results.

Methods: Articles published before July 2020 were searched in databases (PubMed, Web of Science, Medline, EMBASE, and Google Scholar). We computed all multivariate odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CI) by using STATA 12.0 software.

Results: The meta-analysis indicated that IBD was associated with an elevated risk of stroke (OR/RR = 1.21, 95% CI 1.08 to 1.34, I2  = 83.6%, p < .001). In addition, both Crohn's disease (CD) and ulcerative colitis (UC) were associated with a higher risk of stroke (CD: OR/RR = 1.25, 95% CI 1.03 to 1.52, I2  = 86.1%, p < .001; UC: OR/RR = 1.09, 95% CI 1.04 to 1.15, I2  = 54.7%, p = .051). Subgroup study showed that IBD was associated with a higher risk of stroke in cohort studies (RR = 1.21, 95% CI 1.08 to 1.36, I2  = 85.0%, p < .001). Subgroup study showed that IBD was related to an elevated risk of stroke in both Caucasian and Asian groups (Caucasian group: OR/RR = 1.13, 95% CI 1.05 to 1.23, I2  = 44.6%, p = .094; Asian group: OR/RR =1.36, 95% CI 1.07 to 1.74, I2  = 92.5%, p < .001).

Conclusion: IBD is a risk factor for stroke. More high-quality large-sample epidemiologic studies about the relationship between IBD and stroke should be further conducted.