The burden of selected digestive diseases in the United States
Gastroenterology, Volume 122, Issue 5, Pages 1500-1511 (May 2002)
R. sandler, J. Everhart, M. Donowitz, E. Adams, K. Cronin, C. Goodman, E. Gemmen, S. Shah, A. Avdic, R. Rubin

Background & Aims
Gastrointestinal (GI) and liver diseases inflict a heavy economic burden. Although the burden is considerable, current
and accessible information on the prevalence, morbidity, and cost is sparse. This study was undertaken to estimate the
economic burden of GI and liver disease in the United States for use by policy makers, health care providers, and the

Data were extracted from a number of publicly available and proprietary national databases to determine the
prevalence, direct costs, and indirect costs for 17 selected GI and liver diseases. Indirect cost calculations were
purposefully very conservative. These costs were compared with National Institutes of Health (NIH) research
expenditures for selected GI and liver diseases.

The most prevalent diseases were non-food-borne gastroenteritis (135 million cases/year), food-borne illness (76
million), gastroesophageal reflux disease (GERD; 19 million), and irritable bowel syndrome (IBS; 15 million). The
disease with the highest annual direct costs in the United States was GERD ($9.3 billion), followed by gallbladder
disease ($5.8 billion), colorectal cancer ($4.8 billion), and peptic ulcer disease ($3.1 billion). The estimated direct costs
for these 17 diseases in 1998 dollars were $36.0 billion, with estimated indirect costs of $22.8 billion. The estimated
direct costs for ail digestive diseases were $85.5 billion. Total NIH research expenditures were $676 million in 2000.

GI and liver diseases exact heavy economic and social costs in the United States. Understanding the prevalence and
costs of these diseases is important to help set priorities to reduce the burden of illness.