US Pharm. 2008;33(12):10.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), digestive diseases have affected more than 70 million Americans. More than six million diagnostic and therapeutic procedures have been performed in the more than 14 million people who have been hospitalized for digestive diseases (14% of all inpatient procedures). Digestive diseases have cost in excess of $120 billion, with $100 billion of this being direct medical costs. Digestive diseases have disabled two million people and have led at least 45 million to seek ambulatory care.

Lactose intolerance, which has the greatest prevalence of digestive diseases (about 50 million people), is closely followed by gastroesophageal reflux disease (GERD), which affects about 20% of the U.S. population. GERD has necessitated hospitalization in more than 700,000 people, with an equal number of people seeking ambulatory care, and it has caused disability in more than 45,000.

More than 20 million people have gallstones, resulting in about 640,000 hospitalizations, roughly two million ambulatory-care visits, more than one-half million surgical procedures (cholecystectomy), and about 200,000 prescriptions.

Peptic ulcers are common; one in 10 Americans develops one during his or her lifetime. Peptic ulcer has affected about 15 million people, causing more than 400,000 to be hospitalized and more than 875,000 million to seek ambulatory care. More than two million prescriptions have been written for peptic ulcers.

Hemorrhoids are common in both men and women; about half of the population develops them by age 50. Hemorrhoids constitute the fifth most prevalent type of digestive disease (8.5 million people affected), with about two million ambulatory-care visits and more than 1.5 million prescriptions written. About 170,000 people have been hospitalized for hemorrhoids, which have a very low mortality rate (18 deaths in 2002).

Abdominal-wall hernia has affected more than 4.5 million people, necessitating ambulatory-care visits in about 3.5 million and hospitalization in about 325,000. The condition has caused disability in approximately 470,000 people, and at least 185,000 prescriptions have been written for it.

Gastritis is not a single disease, but rather several different conditions involving inflammation of the stomach lining. More than four million people suffer from gastritis, and in excess of three million have had ambulatory care. Of the more than 6.5 million people suffering from persistent indigestion or nonulcer dyspepsia (NUD), only about 800,000 have had ambulatory care. According to the NIDDK, disability caused by NUD is more than double that of gastritis (30,000), but the number of prescriptions (two million) written for gastritis is three times that for NUD.

One in five adults in the United States has symptoms of irritable bowel syndrome (IBS), making it one of the most commonly diagnosed disorders. IBS occurs more often in women than in men, and it begins before age 35 in about 50% of people. According to the NIDDK, the number of prescriptions written for constipation is half (one million) the number written for IBS, even though more than three million and two million people, respectively, suffer from constipation and IBS. The number of ambulatory-care visits for the treatment of constipation is more than three million, versus more than two million for IBS.

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