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Gastrointestinal dysfunction has been implicated in the prodromal phase of Parkinson\u2019s disease (PD), but long-term population-based evidence remains limited. Methods: Using the Korean National Health Insurance Service database (2012\u20132023), we conducted a nationwide matched cohort study including 142,668 patients with IBS and 285,336 matched individssuals without IBS. IBS was defined by at least two ICD-10 diagnoses with a three-year washout period to reduce reverse causation. Participants were followed for up to nine years for incident PD. Incidence rate ratios (IRRs), Kaplan\u2013Meier analyses, and multivariable Cox models were applied. Results: IBS was associated with a higher incidence of PD (IRR, 1.24; 95% CI, 1.14\u20131.36). The magnitude and statistical significance of the association varied across age- and sex-stratified analyses, with the highest crude relative risk observed among women younger than 60 years. In fully adjusted Cox models, IBS remained significantly associated with PD in the overall population (hazard ratio, 1.38; 95% CI, 1.18\u20131.62), with statistical significance retained particularly among women in subgroup analyses. Sensitivity analyses using alternative definitions yielded consistent results. Conclusions: In this nationwide cohort, IBS was associated with an increased long-term risk of PD after adjustment for measured covariates. Given the observational claims-based design, these findings should be interpreted cautiously as hypothesis-generating epidemiological evidence requiring further validation.<\/jats:p>","DOI":"10.3390\/healthcare14101329","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T12:46:55Z","timestamp":1778676415000},"page":"1329","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Risk of Parkinson\u2019s Disease Following Irritable Bowel Syndrome: A Nationwide Population-Based Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Youngoh","family":"Bae","sequence":"first","affiliation":[{"name":"Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea"},{"name":"Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seondeok","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Artificial Intelligence, Sungkyunkwan University, Suwon 16419, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Ryong","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae June","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5632-5208","authenticated-orcid":false,"given":"Seung Won","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea"},{"name":"Department of Artificial Intelligence, Sungkyunkwan University, Suwon 16419, Republic of Korea"},{"name":"Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8460-5933","authenticated-orcid":false,"given":"Hohyun","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Statistics, Sungshin Women\u2019s University, Seoul 02844, Republic of Korea"},{"name":"Center for Data Science, Sungshin Women\u2019s University, Seoul 02844, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lacy, B.E., and Patel, N.K. 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