Digestive diseases affected an estimated 60 to 70 million people in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Digestive Diseases Statistics for the United States. The figures below combine prevalence, healthcare utilization, procedures, prescriptions, deaths, and costs from different measurement years, so each date and geography matters.
Contents
- Digestive disease burden in the United States
- Healthcare visits, hospitalizations, and procedures
- Common digestive conditions
- Inflammatory and functional bowel conditions
- Liver, pancreas, and ulcer disease
- Digestive infections and viral hepatitis
Digestive disease burden in the United States
The NIDDK estimate of 60 to 70 million people affected by all digestive diseases describes the scale of digestive health conditions nationally. It is an estimate, not a count from a single measurement year. Other figures in the same NIDDK source are historical snapshots and should not be read as current prevalence estimates.
The financial burden was measured at $141.8 billion in 2004. Direct medical costs accounted for $97.8 billion, while indirect costs accounted for $44 billion. These categories describe different components of the reported total; they are not later-year projections.
Several measures show how digestive disease reached healthcare settings:
| Measure | Reported figure | Measurement year |
|---|---|---|
| Ambulatory care visits | 48.3 million | 2010 |
| Primary-diagnosis office visits | 36.6 million | 2010 |
| Primary-diagnosis emergency department visits | 7.9 million | 2010 |
| Primary-diagnosis outpatient department visits | 3.8 million | 2010 |
| Hospitalizations | 21.7 million | 2010 |
| Deaths | 245,921 | 2009 |
Together, these figures describe healthcare use and mortality associated with all digestive diseases. They should not be added together because they measure different events and may involve overlapping people.
Healthcare visits, hospitalizations, and procedures
Digestive diseases also accounted for 5.4 million diagnostic and therapeutic inpatient procedures in 2007. The NIDDK source reported that this represented 12 percent of all inpatient procedures. In 2010, digestive diseases accounted for 20.4 million ambulatory surgical procedures, or 20 percent of all write-in surgical procedures.
The condition-specific figures show that healthcare use varies widely. Gastroesophageal reflux disease (GERD) accounted for 8.9 million ambulatory care visits in 2009 and 4.7 million hospitalizations in 2010. Chronic constipation accounted for 4.0 million ambulatory care visits in 2009 and 1.1 million hospitalizations in 2010. Diverticular disease accounted for 2.7 million ambulatory care visits in 2009 and 814,000 hospitalizations in 2010.
Other reported ambulatory care totals were 3.6 million visits for abdominal wall hernia in 2009, 2.2 million visits for gallstones in 2006 to 2007, 1.1 million visits for hemorrhoids in 2009, and 1.6 million visits for irritable bowel syndrome in 2009. The NIDDK source reported 2.3 million ambulatory care visits for gastrointestinal infections in 2004, 1.1 million for Crohn’s disease in 2004, 716,000 for ulcerative colitis in 2004, and 881,000 for pancreatitis in 2004.
Selected procedure figures also illustrate the burden of individual conditions. Abdominal wall hernia accounted for 526,000 surgical procedures in 2006 for inguinal hernia only. Gallstones accounted for 503,000 surgical procedures in 2006 for laparoscopic cholecystectomies only.
Common digestive conditions
The NIDDK statistics included prevalence estimates for several common conditions. Chronic constipation affected 63 million people in 2000. Gallstones affected 20 million people in 2004. Diverticular disease affected 2.2 million people in 1998. GERD affected 20 percent of the population who experienced reflux symptoms at least weekly in 2004. Hemorrhoids affected 75 percent of people older than 45 in 2006.
These prevalence measures use different definitions and populations. The GERD statistic refers specifically to symptoms at least weekly, while the hemorrhoid statistic refers to people older than 45. The dates also range from 1998 through 2006, so they are historical measures rather than a single contemporaneous comparison.
Hospitalization and mortality figures for these conditions were reported for 2010. Abdominal wall hernia accounted for 380,000 hospitalizations and caused 1,322 deaths. Chronic constipation accounted for 1.1 million hospitalizations and caused 132 deaths. Diverticular disease accounted for 814,000 hospitalizations and caused 2,889 deaths. Gallstones accounted for 675,000 hospitalizations and caused 994 deaths. GERD accounted for 4.7 million hospitalizations and caused 1,653 deaths.
Prescription counts were reported for 2004. GERD had 64.6 million prescriptions, chronic constipation had 5.3 million, diverticular disease had 2.8 million, gallstones had 1.65 million, and hemorrhoids had 2 million. A prescription count records prescriptions, not unique patients or treatment success.
Inflammatory and functional bowel conditions
Crohn’s disease affected 359,000 people in 1998. In the reported healthcare measures, it accounted for 1.1 million ambulatory care visits in 2004 and 187,000 hospitalizations in 2010. Crohn’s disease caused 611 deaths in 2010 and had 1.8 million prescriptions in 2004.
Ulcerative colitis affected 619,000 people in 1998. It accounted for 716,000 ambulatory care visits in 2004 and 107,000 hospitalizations in 2010. Ulcerative colitis caused 305 deaths in 2010 and had 2.1 million prescriptions in 2004.
Irritable bowel syndrome affected 15.3 million people in 1998. It accounted for 1.6 million ambulatory care visits in 2009 and 280,000 hospitalizations in 2010. The condition caused 21 deaths in 2010 and had 5.9 million prescriptions in 2004.
The three conditions therefore appear differently across the measures: irritable bowel syndrome had the largest reported affected population among these three historical estimates, while Crohn’s disease had more hospitalizations and deaths than ulcerative colitis in the listed 2010 figures. Those observations compare the supplied historical measures only; they do not establish current rankings.
Liver, pancreas, and ulcer disease
Liver disease affected 3.0 million people in 2011. It accounted for 1.2 million hospitalizations in 2010 and caused 42,923 deaths in 2010. The NIDDK source also reported 635,000 ambulatory care visits in 2009 for cirrhosis only, 6,342 liver transplants in 2011, and 731,000 prescriptions in 2004. The ambulatory-care figure is narrower than the broader liver-disease category.
Pancreatitis affected 1.1 million people in 1998. Reported incidence was 17 acute cases per 100,000 people in 2003 and 8.2 chronic cases per 100,000 people in 1981. Incidence is a rate of new cases in a population, whereas the affected-population figure is a count from a different year. Pancreatitis accounted for 881,000 ambulatory care visits in 2004 and 553,000 hospitalizations in 2010. It caused 3,413 deaths in 2010 and had 766,000 prescriptions in 2004.
Peptic ulcer disease affected 15.5 million people in 2011. It accounted for 669,000 ambulatory care visits in 2006 to 2007 and 358,000 hospitalizations in 2010. Peptic ulcer disease caused 2,981 deaths in 2011 and had 5 million prescriptions in 2004.
Digestive infections and viral hepatitis
In 1998, gastrointestinal infections affected 135 million people with nonfoodborne gastroenteritis and 76 million people with foodborne illness. These are separate categories in the NIDDK statistics. Gastrointestinal infections accounted for 2.3 million ambulatory care visits in 2004 and 487,000 hospitalizations in 2010. They caused 11,022 deaths in 2011 and had 938,000 prescriptions in 2004.
The hepatitis figures distinguish chronic infection, new acute clinical cases, healthcare visits, hospitalizations, and deaths. Hepatitis A had no chronic infection prevalence in 2007, 1,670 new acute clinical cases in 2010, 10,000 hospitalizations in 2004, and 29 deaths in 2010.
Hepatitis B had a chronic infection prevalence of 800,000 to 1.4 million people in 2007. It had 3,350 new acute clinical cases in 2010, 729,000 ambulatory care visits in 2004, 61,000 hospitalizations in 2010, and 588 deaths in 2010.
Hepatitis C had a chronic infection prevalence of 2.7 to 3.9 million people in 2007. It had 850 new acute clinical cases in 2010, 1.2 million ambulatory care visits in 2009, 419,000 hospitalizations in 2010, and 6,844 deaths in 2010.
The different hepatitis measures should be interpreted separately. Chronic infection prevalence is not the same as the number of new acute clinical cases, and healthcare encounters from 2004 or 2009 are not current estimates. Across all of these digestive health statistics, the measurement year, population definition, and type of event determine what each number can—and cannot—show.