Gastrointestinal problems costing close to $100 billion annually
(HealthDay News) – Among our commonest and most frequent ailments are conditions and diseases that start in organs leading to the gut.
Heartburn, most often associated with gastroesophageal reflux disease (GERD) and the common bellyache, caused by one of any number of ailments, are digging a big hole in America 's pocketbook. A study five years ago in the journal Gastroenterology estimated these diseases and conditions were costing about $85.5 billion a year.
The most prevalent digestive diseases include: non-food-borne gastroenteritis, 135 million cases per year; food-borne illnesses, 76 million cases; gastro-esophageal reflux disease (GERD), 19 million cases; and irritable bowel syndrome (IBS), 15 million cases.
A high ranking in prevalence, however, doesn't necessarily translate to the highest cost -- the most expensive disease was GERD, which has an estimated $9.3 billion price tag per year. That's followed by gallbladder disease, at $5.8 billion; colorectal cancer, at $4.8 billion; and peptic ulcer disease, at $3.1 billion.
And these estimates are very conservative, because the information used was from 1998 statistics.
The costs attributed to conditions represent a combination of two factors -- direct costs, including drugs, doctors and hospitalizations, and indirect costs, which range from missed work and activities missed because of pain and suffering to premature death.
While some conditions lean heavily on direct costs, others may have exceptionally high indirect costs, explains lead researcher Dr. Robert Sandler, a professor of medicine and epidemiology at the University of North Carolina .
"GERD, for instance, ranked the highest in cost, not because of indirect costs -- most people with the condition can indeed go to work. The expenses fall mostly on the direct costs side because the drugs to treat the condition are terribly expensive," he said.
On the other hand, costs for another highly prevalent condition, IBS, which causes chronic bowel problems and abdominal pain, are attributed almost entirely to indirect costs.
"IBS is a very expensive condition in terms of indirect costs, but not for direct costs because there are no effective therapies that are approved by the [Food and Drug Administration], so there's a real disconnect there," Sandler explained.
Altogether, the 17 most prominent gastrointestinal and liver diseases were estimated to cost $36 billion in direct costs and about $22.8 billion in indirect costs.
Ideally, the payoff of direct costs, such as better treatments, would be a reduction of indirect costs. Finding better treatments for food-borne illnesses, for example, would erase those lost days of work from food-related intestinal ailments, explained Dr. Mark Donowitz, professor of medicine at Johns Hopkins University who is co-author of the study.
"If we could find some kind of magic antibiotic or something that could stop the diarrhea in those cases, we could really reduce time lost from work," he said.
Inflammatory bowel disease (IBD), which also causes diarrhea, bleeding and other symptoms, is another example of a condition whose cost could decrease with more attention, added, Donowitz, who is immediate past president of the American Gastroenterological Association (AGA) Institute.
"IBD is a condition in which patients are heavy in their use of physicians' time and hospital care because we don't quite understand how the disease works and we don't have very good ways of dealing with it yet."
"Once we do, though, we're very hopeful we'll be able to decrease the costs both for the treatment and for time lost for the patients," Donowitz added.
As recently as 2000, the National Institutes of Health spent $676 million on research for digestive diseases, and Sandler said hopes the information in the new study can help officials decide where such funds should go.
"Gall bladder disease, for instance, is tremendously expensive. It's very common, and the treatment is expensive because it involves surgery," he said.
"But there apparently isn't a whole lot of research on gall bladder disease, and we need to know more about why people get gallstones, how to prevent them…," Sandler said.
Sandler added that he hoped the research would increase awareness of just how common -- and expensive -- conditions are that have long been swept under the rug because many people simply don't want to talk about them.
"There was a slogan for a colon cancer campaign a few years back that went something like 'Don't Die from Embarrassment,' and that really captures the general problem with gastrointestinal conditions," Sandler said.
"Lobbying efforts for many of these diseases are hindered because they are frankly embarrassing to people," he added. "You've got, for instance, breast cancer and AIDS lobbyists that have been very effective in getting research funds, but you don't see many diarrhea lobbying groups out there because people are simply embarrassed about diarrhea."
On the Web
The American Gastroenterological Association's Web site on Digestive Health and Nutrition is a good place to start in determining your intestinal health.
SOURCES:
Robert Sandler, M.D., professor, cancer epidemiology, cancer prevention and control , University of North Carolina Cancer Hospital, Chapel Hill; Mark Donowitz, M.D., immediate past president, American Gastroenterological Association (AGA) Institute, professor of medicine, and director, Hopkins Center for Epithelial Disorders, Johns Hopkins University, Baltimore; May 2002 Gastroenterology
Author:
Nancy A. Melville, HealthDay Reporter
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