<![CDATA[Gastrointestinal disorders, particularly peptic ulcer and gastritis associated with Helicobacter pylori infection, remain a pressing global health burden that is compounded by rising antimicrobial resistance to standard eradication therapies. The genus Sterculia (Malvaceae) has long been used in traditional medicine to treat these conditions, yet no systematic synthesis of its efficacy and underlying phytochemical mechanisms has previously been available. This systematic review followed the PRISMA 2020 guidelines and a PICO framework, searching PubMed, ScienceDirect, Scopus, and Google Scholar, with study quality appraised using the Young and Solomon instrument. Ten eligible articles were narratively synthesized. Findings showed that a methanolic seed extract of Sterculia nobilis inhibited reserpine-induced gastric ulceration by up to 65.1% at 400 mg/kg, approaching the efficacy of ranitidine, through reduced gastric acid secretion, modulation of serum neuropeptides, and enhanced superoxide dismutase activity. Sterculia urens gum functioned dually as a gastroretentive drug-delivery matrix and an intrinsic antioxidant agent. Antimicrobial activity was consistently observed across species: fraxetin from Sterculia quadrifida significantly inhibited gastrointestinal bacterial pathogens, while Sterculia foetida exhibited notable antifungal potential against Candida spp. Three convergent mechanisms free-radical scavenging, neuropeptide modulation, and polysaccharide-mediated mucosal protection appear to underlie the gastroprotective effects of this genus. However, the absence of clinical trials and direct evaluation against Helicobacter pylori represent major evidence gaps. These findings provide a scientific basis for developing Sterculia-based gastrointestinal therapeutic agents, although further preclinical and clinical research is warranted to confirm their efficacy and safety.]]>
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