Gastroenterology

Gastroenterology

Volume 149, Issue 7, December 2015, Pages 1731-1741.e3
Gastroenterology

Original Research
Full Report: Clinical—Alimentary Tract
Burden of Gastrointestinal, Liver, and Pancreatic Diseases in the United States

https://doi.org/10.1053/j.gastro.2015.08.045Get rights and content

Background & Aims

Gastrointestinal (GI), liver, and pancreatic diseases are a source of substantial morbidity, mortality, and cost in the United States. Quantification and statistical analyses of the burden of these diseases are important for researchers, clinicians, policy makers, and public health professionals. We gathered data from national databases to estimate the burden and cost of GI and liver disease in the United States.

Methods

We collected statistics on health care utilization in the ambulatory and inpatient setting along with data on cancers and mortality from 2007 through 2012. We included trends in utilization and charges. The most recent data were obtained from the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, and the National Cancer Institute.

Results

There were 7 million diagnoses of gastroesophageal reflux and almost 4 million diagnoses of hemorrhoids in the ambulatory setting in a year. Functional and motility disorders resulted in nearly 1 million emergency department visits in 2012; most of these visits were for constipation. GI hemorrhage was the most common diagnosis leading to hospitalization, with >500,000 discharges in 2012, at a cost of nearly $5 billion dollars. Hospitalizations and associated charges for inflammatory bowel disease, Clostridium difficile infection, and chronic liver disease have increased during the last 20 years. In 2011, there were >1 million people in the United States living with colorectal cancer. The leading GI cause of death was colorectal cancer, followed by pancreatic and hepatobiliary neoplasms.

Conclusions

GI, liver and pancreatic diseases are a source of substantial burden and cost in the United States.

Section snippets

Methods

We compiled the most recently available statistics from several publicly available databases. We used material available in the public domain or limited datasets with no direct patient identifiers. The methods used to collect the data from the source databases are detailed here.

Symptoms and Diagnoses Across Ambulatory Settings

The leading GI symptoms prompting a visit in 2010 are shown in Table 1. Abdominal pain was responsible for >27 million total visits, followed by diarrhea, vomiting, nausea, and bleeding. Constipation and anorectal symptoms accounted for 3.0 million and 2.6 million visits, respectively.

Abdominal pain is also the most frequent diagnosis (Table 2) with nearly 17 million annual visits. There were >7 million visits with gastroesophageal reflux disease and reflux esophagitis. Hemorrhoids accounted

Discussion

We have compiled the most recently available statistics from several complementary national databases to create a complete and accurate report detailing the current state of GI, liver, and pancreatic morbidity, mortality, and cost in adults in the United States. These diseases account for substantial utilization of health care resources and costs in the United States. This report demonstrates several trends in the data worthy of highlighting.

The US population is growing older.11 This

References (28)

  • Howlader N, Noone AM, Krapcho M, et al., eds. SEER Cancer Statistics Review, 1975−2011, National Cancer...
  • US Census Bureau. Data tables. Available at: http://www.census.gov/popclock/data_tables.php?component=growth. Accessed...
  • Ortman J, Velkoff V, Hogan H. An aging nation: the older population in the United States population. Published May 1,...
  • B.D.P.N. Smith et al.

    Hepatitis C virus antibody prevalence, correlates and predictors among persons born from 1945 through 1965, United States, 1999−2008

    Hepatology

    (2011)
  • Cited by (702)

    • Diverticular disease

      2024, Medicine (Spain)
    View all citing articles on Scopus

    This article has an accompanying continuing medical education activity on page e13. Learning Objective: Upon completion of this test, successful learners will be able to cite several current gastrointestinal disease statistics.

    Conflicts of interest The authors disclose no conflicts.

    Funding This research was supported in part by the National Center for Advancing Translational Sciences, National Institutes of Health, 1KL2TR001109 and a grant from the National Institutes of Health, T32 DK07634.

    View full text