Burden of Gastrointestinal, Liver, and Pancreatic Diseases in the United States

Peery AF1, Crockett SD2, Barritt AS2, Dellon ES2, Eluri S2, Gangarosa LM2, Jensen ET2, Lund JL3, Pasricha S2, Runge T2, Schmidt M2, Shaheen NJ2, Sandler RS2. Gastroenterology. 2015 Aug 28. pii: S0016-5085(15)01242-1. doi: 10.1053/j.gastro.2015.08.045. [Epub ahead of print]
Author information

1University of North Carolina School of Medicine, Chapel Hill, NC. Electronic address: Anne_Peery@med.unc.edu. 2University of North Carolina School of Medicine, Chapel Hill, NC. 3Gillings School of Global Public Health, Chapel Hill, NC.


BACKGROUND & AIMS: Gastrointestinal (GI), liver, and pancreatic diseases are a source of substantial morbidity, mortality, and cost in the United States (US). 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 US.

METHODS: We collected statistics on healthcare 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 more than 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 over the last 20 years. In 2011, there were more than 1 million people in the US living with colorectal cancer. The leading GI cause of death was colorectal cancer, followed by pancreatic and hepatobiliary neoplasms.

CONCLUSIONS: GI and liver diseases are a source of substantial burden and cost in the US.

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