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Disproportionality screening using both the reporting odds ratio (ROR) and Bayesian information component (IC) showed that signal magnitudes varied widely across the Top 50 set (ROR 0.62\u20135.08; IC \u22120.69\u20132.33), with 28\/50 drugs meeting prespecified signal criteria by both metrics. Bevacizumab demonstrated the strongest disproportionality (ROR 5.08; IC 2.33), while adalimumab contributed the largest number of DIO reports. Time-to-onset analyses conducted at the report\u2013drug pair level indicated that DIO frequently occurred after weeks to months of exposure (median 100\u00a0days; IQR 19\u2013469), with substantial drug-level heterogeneity and a predominance of delayed-onset events (&amp;gt;30\u00a0days) for most agents. Cross-database benchmarking in JADER for 20 overlapping drugs showed moderate concordance, supporting partial transportability of leading signals while underscoring setting-specific heterogeneity. Comparison with current product information using a three-level framework (Yes\/No\/Unclear) suggested incomplete alignment between disproportionality signals and explicit obstruction terminology (12\/50 Yes, 28\/50 No, 10\/50 Unclear). These findings are hypothesis-generating and support sustained clinical vigilance for high-signal therapies, particularly in patients with elevated baseline bowel risk, and confirmation in longitudinal pharmacoepidemiological studies with validated exposure windows and rigorous confounder control.<\/jats:p>","DOI":"10.3389\/fphar.2026.1760208","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T06:36:38Z","timestamp":1773988598000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Cross-national pharmacovigilance of drug-induced intestinal obstruction: disproportionality signals in FAERS and external validation in JADER"],"prefix":"10.3389","volume":"17","author":[{"given":"Yang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Urology, Children\u2019s Hospital of Chongqing Medical University, National Clinical Research Center for Children and Adolescents\u2019 Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders","place":["Chongqing, China"]},{"name":"Chongqing Key Laboratory of Structural Birth Defect and Reconstruction","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengde","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology, Children\u2019s Hospital of Chongqing Medical University, National Clinical Research Center for Children and Adolescents\u2019 Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders","place":["Chongqing, China"]},{"name":"Chongqing Key Laboratory of Structural Birth Defect and Reconstruction","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s13017-021-00379-8","article-title":"Diagnosis and management of small bowel obstruction in virgin abdomen: a WSES position paper","volume":"16","author":"Amara","year":"2021","journal-title":"World J. 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