Burden of Gastrointestinal, Liver, and Pancreatic Diseases in the United States.
OBJECTIVE
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.
University of North Carolina School of Medicine, Chapel Hill, North Carolina. Electronic address: Anne_Peery@med.unc.edu.
Anne F
AF
Peery
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Seth D
SD
Crockett
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Alfred S
AS
Barritt
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Evan S
ES
Dellon
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Swathi
S
Eluri
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Lisa M
LM
Gangarosa
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Elizabeth T
ET
Jensen
Gillings School of Global Public Health, Chapel Hill, North Carolina.
Jennifer L
JL
Lund
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Sarina
S
Pasricha
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Thomas
T
Runge
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Monica
M
Schmidt
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Nicholas J
NJ
Shaheen
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Robert S
RS
Sandler
D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005249:Fees and Charges; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data*; D017721:Hospital Costs; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D010343:Patient Admission / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
Abdominal Pain; GERD; Gastrointestinal Hemorrhage; IBS