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Adjusted hazard ratio (aHR) assessed ulcerative colitis (UC) or Crohn\u2019s disease (CD) hazard &lt;3 or \u22653 years from surgery or severe obesity. IBD severity was assessed using healthcare utilization\u2013based proxies including medication exposure, IBD-related hospitalizations, and surgical interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort included 100,832 adults with MBS versus 376,855 controls (76.0% females, median age of 44 years). The incidence of IBD was higher in MBS cohort versus controls (61.2 vs. 44.4 per 100,000 adults\/year). Within 3 years, patients with MBS had a 24% lower risk of de novo IBD versus controls (aHR: 0.76, 95% CI: 0.60-0.95). When stratified by surgery and IBD type, VSG had reduction in CD risk (aHR=0.46, 95% CI:0.22-0.96), while RYGB had reduction in UC risk (aHR=0.22, 95% CI:0.06-0.75). After 3 years, patients with MBS, particularly VSG, had greater than 2-fold increased risk of IBD (aHR=2.28, 95%CI: 1.02-5.06). Markers of treatment intensity and healthcare utilization did not significantly differ between groups overall; however, a higher proportion of UC patients in the MBS cohort underwent colectomy, though absolute event numbers were small. (8.70% vs 1.57%, p=0.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While MBS may lower IBD risk initially, IBD risk increases after 3 years, especially UC after VSG, and may be more severe as indicated by the higher proportion of colectomies for patients in the MBS cohort versus controls. Findings regarding treatment intensity should be interpreted cautiously, as objective measures of disease activity were not available in claims data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08714-1","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T02:55:25Z","timestamp":1777949725000},"page":"3078-3090","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Metabolic Bariatric Surgery on Inflammatory Bowel Disease Risk and Outcomes in Adults With Obesity: a Propensity-matched, Nationwide, Analysis"],"prefix":"10.1007","volume":"36","author":[{"given":"Antoinette","family":"Pusateri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yevgeniya","family":"Gokun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Allen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ChienWei","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeeti","family":"Chiplunker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalina","family":"Butnariu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisham","family":"Hussan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"issue":"25","key":"8714_CR1","doi-asserted-by":"publisher","first-page":"2440","DOI":"10.1056\/NEJMsa1909301","volume":"381","author":"ZJ Ward","year":"2019","unstructured":"Ward ZJ, Bleich SN, Cradock AL, Barrett JL, Giles CM, Flax C, et al. 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