title: Burden of gastrointestinal disease in the United States: 2012 update.
abstract: OBJECTIVE
  Gastrointestinal (GI) diseases account for substantial morbidity, mortality, and cost. Statistical analyses of the most recent data are necessary to guide GI research, education, and clinical practice. We estimate the burden of GI disease in the United States.
  
  
  METHODS
  We collected information on the epidemiology of GI diseases (including cancers) and symptoms, along with data on resource utilization, quality of life, impairments to work and activity, morbidity, and mortality. These data were obtained from the National Ambulatory Medical Care Survey; National Health and Wellness Survey; Nationwide Inpatient Sample; Surveillance, Epidemiology, and End Results Program; National Vital Statistics System; Thompson Reuters MarketScan; Medicare; Medicaid; and the Clinical Outcomes Research Initiative's National Endoscopic Database. We estimated endoscopic use and costs and examined trends in endoscopic procedure.
  
  
  RESULTS
  Abdominal pain was the most common GI symptom that prompted a clinic visit (15.9 million visits). Gastroesophageal reflux was the most common GI diagnosis (8.9 million visits). Hospitalizations and mortality from Clostridium difficile infection have doubled in the last 10 years. Acute pancreatitis was the most common reason for hospitalization (274,119 discharges). Colorectal cancer accounted for more than half of all GI cancers and was the leading cause of GI-related mortality (52,394 deaths). There were 6.9 million upper, 11.5 million lower, and 228,000 biliary endoscopies performed in 2009. The total cost for outpatient GI endoscopy examinations was $32.4 billion.
  
  
  CONCLUSIONS
  GI diseases are a source of substantial morbidity, mortality, and cost in the United States.
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Anne F
authors.initials: AF
authors.lastname: Peery
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Evan S
authors.initials: ES
authors.lastname: Dellon
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lund
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Seth D
authors.initials: SD
authors.lastname: Crockett
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Christopher E
authors.initials: CE
authors.lastname: McGowan
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: William J
authors.initials: WJ
authors.lastname: Bulsiewicz
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Gangarosa
authors.affiliation: Quintiles, Research Triangle Park, North Carolina.
authors.forename: Michelle T
authors.initials: MT
authors.lastname: Thiny
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Karyn
authors.initials: K
authors.lastname: Stizenberg
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Morgan
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Ringel
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Hannah P
authors.initials: HP
authors.lastname: Kim
authors.affiliation: Kantar Health, New York, New York.
authors.forename: Marco Dacosta
authors.initials: MD
authors.lastname: DiBonaventura
authors.affiliation: Worldwide Epidemiology, GlaxoSmithKline, Research Triangle Park, North Carolina.
authors.forename: Charlotte F
authors.initials: CF
authors.lastname: Carroll
authors.affiliation: Worldwide Epidemiology, GlaxoSmithKline, Research Triangle Park, North Carolina.
authors.forename: Jeffery K
authors.initials: JK
authors.lastname: Allen
authors.affiliation: Worldwide Epidemiology, GlaxoSmithKline, Research Triangle Park, North Carolina.
authors.forename: Suzanne F
authors.initials: SF
authors.lastname: Cook
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Sandler
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Kappelman
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina. Electronic address: nshaheen@med.unc.edu.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Shaheen
mesh_terms: D016145:Endoscopy, Digestive System / Q000191:economics / Q000706:statistics & numerical data*; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006306:Health Surveys / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008484:Medicaid / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D011788:Quality of Life; D018426:SEER Program / Q000706:statistics & numerical data; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D014798:Vital Statistics