Digestive Diseases: The Facts

Introduction

Digestive diseases encompass more than 40 acute and chronic conditions of the gastrointestinal tract ranging from common digestive disorders to serious, life-threatening diseases. More than 34 million Americans are afflicted with diseases of the digestive system, 20 million of whom have chronic disorders. It is estimated that 8% of the U.S. population have chronic digestive diseases, 6% have acute episodes of digestive diseases and 43% have intermittent digestive disorders, leaving 43% unaffected. As a group, the digestive diseases account for 8%-9% of total U.S. mortality. 60% of digestive disease mortality is due to malignant neoplasms and 40% to nonmaligant causes, chief of which is cirrhosis of the liver. Digestive diseases are the second leading cause of disability due to illness in The U.S., with more than 2 million Americans impaired to some degree. It is estimated that 400,000 persons are completely disabled by digestive diseases and 1.2 million people are limited in the work they perform due to digestive diseases. Digestive diseases are the leading cause of time lost from work for male employees, and account for 15% of all absences from work among workers ages 17-64 years. The total economic cost associated with digestive diseases has been estimated at more than $50 billion annually.

Incidence and Prevalence

Digestive System Cancer

Of the 2,047,000 deaths from all causes in the U.S. in 1984, 22% or 452,470 deaths were due to cancer. 25% of all cancer deaths, or 115,240 deaths, were due to cancers of the digestive organs and peritoneum.

Colorectal cancer is the most common cancer of the digestive organs, accounting for over 60% of all digestive organ cancers. The American Cancer Society estimates there to be 140,000 new cases of colorectal cancer in the U.S. in 1986.

Causing an estimated 60,000 deaths in 1986, colorectal cancer is the second leading cause of cancer mortality in the U.S. (behind lung cancer).

Ulcer Disease

About 20 million Americans, or almost 10% of the population, have or have ever had an ulcer of the stomach or duodenum.

Approximately 4 million Americans currently have ulcers of the stomach or duodenum.

In 1984, there were 6,780 deaths in the U.S. from ulcers of the stomach and duodenum, a 7% increase over 1983.

Although duodenal ulcer is 3-4 times more common than gastric ulcer clinically, autopsy studies indicate the incidence of duodenal and gastric ulcers to be nearly equal.

Liver Disease

In 1984, 26,750 people died from cirrhosis and chronic liver disease in the U.S. Chronic liver disease and cirrhosis ranked 9th in age-adjusted death rates in the U.S. in 1984, with a rate of 9.8 deaths per 100,000 population.

Among those ages 45-54 years, cirrhosis and chronic liver disease is the 5th leading cause of death behind cancer, heart disease, accidents and strokes, according to provisional 1984 figures.

There are more than 10 million alcoholics in the U.S. 75% of all deaths attributable to alcohol are due to cirrhosis of the liver.

The American Liver Foundation estimates that 8,000 deaths from cancer of the liver occur each year, including 900 that are related to hepatitis B.

According to the American Liver Foundation, there are 200,000 new cases of hepatitis B annually in the U.S. and 250 deaths from the acute infection. It is estimated that there are 1 million chronic hepatitis B carriers in the U.S.

Biliary atresia is an uncommon congenital defect in the development of the biliary tract that may result in obstruction of the bile ducts and subsequent liver disease. The incidence of biliary atresia is approximately 1 in 20,000 live births.

Primary biliary cirrhosis is a slow progressive liver disease of unknown etiology that affects 1 in 10,000 individuals, most commonly middle-aged women.

Gallbladder Disease

It is estimated that 25 million persons in the U.S. have gallstones. Among those 55-65 years of age, 10% of men and 20% of women have gallstones.

Each year in the U.S., about 1 million new cases of gallstones are discovered and about 500,000 gallbladders removed.

In 1984, 3,260 deaths were attributed to gallstones and other diseases of the gallbladder.

Inflammatory Bowel Disease

An estimated 2 million Americans suffer from the inflammatory bowel diseases, Crohn's disease or ulcerative colitis.

The average annual incidence of ulcerative colitis in the U.S. has been estimated at 5.7 per 100,000, while the incidence of Crohn's disease has been estimated at 4.8 per 100,000.

The worldwide prevalence of ulcerative colitis ranged from 40-100 per 100,000 in 1980, while the worldwide prevalence of Crohn's ranged from 10-100 per 100,000.

An estimated 200,000 children under the age of 16 may suffer from Crohn's disease and ulcerative colitis.