Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease increasingly viewed as systemic. Irritable bowel syndrome (IBS) has been proposed as a comorbidity, yet longitudinal data remain limited. A retrospective cohort study was conducted using the U.S. Collaborative Network of the TriNetX platform, including adults diagnosed with HS from 2005–2023 and matched controls without HS. Patients with prior IBS or cancer were excluded. Propensity score matching (1:1) accounted for demographic, socioeconomic, and clinical variables. Incident IBS, defined by ICD-10-CM codes, was assessed over 15 years. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated. Sensitivity analyses varied washout periods, follow-up times, and HS definitions; subgroups were stratified by age and sex. The matched cohort comprised 119,848 HS patients and equal controls. HS was associated with greater IBS risk (HR 1.422, 95% CI 1.308–1.547), consistent across sensitivity analyses. Compared with psoriasis, HS conferred higher IBS risk (HR 1.268, 95% CI 1.157–1.390). Age-stratified analyses showed increased risk in both 18–64 years (HR 1.538, 95% CI 1.397–1.694) and ≥ 65 years (HR 2.443, 95% CI 1.619–3.686). Risk was also elevated in males (HR 1.556, 95% CI 1.221–1.983) and females (HR 1.489, 95% CI 1.354–1.638). HS independently predicts higher long-term IBS risk, supporting shared inflammatory and barrier dysfunction pathways.
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Data availability
Data in this study were retrieved from TriNetX Research Network. All data available in the database were administrated by the TriNetX platform. Detailed information can be retrieved at the official website of the research network (https://trinetx.com).
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Funding
This study was partially funded by Chung Shan Medical University Hospital (CSH-2025-C-007) and the Research Foundation of Taichung Veterans General Hospital.
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All the authors involved in drafting or revising the article and approved of the submitted version. Study conception and design: Chang HC, Hsu YH, Wu MC, Chen SJ Gau SY Data acquisition: Chang HC, Gau SY Data analysis and demonstration: Chang HC, Gau SY Original draft preparation: Chang HC, Hsu YH, Wu MC, Chen SJ, Gau SY.
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This study was approved by the Institutional Review Board of Chung Shan Medical University Hospital (CS1-25002) and Ditmanson Medical Foundation Chia-Yi Christian Hospital (IRB No. IRB2025121).
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Due to the deidentification process of TriNetX research network, the need of informed consent was waived by the Institutional Review Board of Chung Shan Medical University Hospital (CS1-25002).
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Chang, HC., Hsu, YH., Chen, SJ. et al. Risk of irritable bowel syndrome in patients with hidradenitis suppurativa: a global-federated, multicenter cohort study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-38442-6
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DOI: https://doi.org/10.1038/s41598-026-38442-6
