Data and Statistics
Inflammatory Bowel Disease (IBD) in the United States
In 2015, an estimated 1.3% of US adults (3 million) reported being diagnosed with IBD (either Crohn’s disease or ulcerative colitis).1 This was a large increase from 1999 (0.9% or 2 million adults).2 A recent study found that the prevalence of IBD increased from 2001 to 2018 among Medicare beneficiaries of all race and ethnicity groups, with a higher increase rate among non-Hispanic Black adults.3
In 2015, some people were more likely to report having IBD1, including those:
- Aged 45 years or older
- Hispanic or non-Hispanic White
- With less than a high school level of education
- Not currently employed
- Born in the United States (compared with adults born outside of the United States)
- Living in poverty
- Living in suburban areas
These estimates do not include children younger than 18 years, who may also have IBD. Most people with IBD are diagnosed in their 20s and 30s.
Adults with IBD have higher health care use than those without IBD, including doctors’ visits, medication prescriptions, emergency department visits, hospitalizations, and surgeries.4 On the basis of the National Inpatient Sample data, there was no significant change in the hospitalization rate when Crohn’s disease was the primary diagnosis from 2003 to 2013.5 The hospitalization rate, however, increased significantly during this period from 44.2 to 59.7 per 100,000 population when it was listed as any secondary diagnosis.5 The mean hospitalization costs in 2014 were $11,345 for Crohn’s disease and $13,412 for ulcerative colitis.6 From 2003 to 2008, total hospitalization costs increased annually by 3% for Crohn’s disease and 4% for ulcerative colitis but remained unchanged for both diseases from 2008 to 2014.6
Compared with adults without IBD, those with IBD are more likely to have certain chronic health conditions7 that include:
- Cardiovascular disease
- Respiratory disease
- Kidney disease
- Liver disease
- Migraine or severe headache8
A study based on Medicare beneficiaries aged 66 years or older found that older adults with IBD were more likely to be hospitalized for hip fractures and have 30-day readmissions and longer hospital stays.9 Therefore, the following are important for this population:
- Exercise interventions to prevent fallsexternal icon
- Comprehensive inpatient care are important for this population
In addition, clinicians should be aware of potential health-risk behaviors that are more prevalent among adults with IBD than those without,7 such as:
- Not getting enough sleep
- Not meeting aerobic nor muscle-strengthening physical activity guidelinesexternal icon
Since IBD is associated with various chronic and infectious conditions, preventive care is an essential aspect of lifelong disease management. The American College of Gastroenterology published clinical guidelines for disease prevention among people with IBD.10 The first U.S. population-based study using 2015 and 2016 National Health Interview Survey results reported that adults with IBD were more likely than adults without IBD to receive preventive care services, which included:
- Receiving medical advice about smoking cessation
- Having colon cancer screening in the past 12 months
- Having ever had an HIV test
- Having ever had a pneumococcal vaccine
- Having received a flu vaccine in the past 12 months
- Having received a tetanus vaccine in the past 10 years.11
During the current COVID-19 pandemic, it is important to receive a COVID-19 vaccine and be fully vaccinated. A study found that Medicare beneficiaries with ulcerative colitis were more likely to be hospitalized for COVID-19 compared with those without IBD.12 The International Organization for the Study of Inflammatory Bowel Disease recommends that patients with IBD get a COVID-19 vaccine.13
Besides receiving recommended preventive care, it is important to have a healthy and balanced diet. A study assessing dietary patterns among adults with IBD from the 2015 National Health Interview Survey14 found that adults with IBD were more likely to have low dietary fiber intake compared with adults without IBD; and women with IBD were more likely to have more sugar-sweetened beverages and total added sugar compared with women without IBD.
- Dahlhamer JM, Zammitti EP, Ward BW, Wheaton AG, Croft JB. Prevalence of inflammatory bowel disease among adults aged ≥18 years — United States, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(42):1166–1169. https://www.cdc.gov/mmwr/volumes/65/wr/mm6542a3.htm.
- Nguyen GC, Chong CA, Chong RY. National estimates of the burden of inflammatory bowel disease among racial and ethnic groups in the United States. J Crohns Colitis. 2014;8:288–295. DOI: https://academic.oup.com/ecco-jcc/article/8/4/288/386357external icon.
- Xu F, Carlson SA, Liu Y, Greenlund KJ. Prevalence of inflammatory bowel disease among Medicare fee-for-service beneficiaries — United States, 2001−2018. MMWR Morb Mortal Wkly Rep. 2021;70(19):698–701. https://www.cdc.gov/mmwr/volumes/70/wr/mm7019a2.htm?s_cid=mm7019a2_w
- Terlizzi EP, Dahlhammer JM, Xu F, Wheaton AG, Greenlund KJ. Health care utilization among U.S. adults with inflammatory bowel disease, 2015-2016. Natl Health Stat Report. 2021;152:1–7. https://stacks.cdc.gov/view/cdc/100471.
- Malarcher CA, Wheaton AG, Liu Y, et al. Hospitalization for Crohn’s disease — United States, 2003–2013. MMWR Morb Mortal Wkly Rep. 2017;66(14):377–381. https://www.cdc.gov/mmwr/volumes/66/wr/mm6614a1.htm. Accessed May 2, 2018.
- Xu F, Liu Y, Wheaton AG, Rabarison KM, Croft JB. Trends and factors associated with hospitalization costs for inflammatory bowel disease in the United States. Appl Health Econ Health Policy. 2019;17(1):77–91. DOI: 10.1007/s40258-018-0432-4. https://pubmed.ncbi.nlm.nih.gov/30259396/external icon
- Xu F, Dahlhamer JM, Zammitti EP, Wheaton AG, Croft JB. Health-risk behaviors and chronic conditions among adults with inflammatory bowel disease — United States, 2015 and 2016. MMWR Morb Mortal Wkly Rep. 2018;67(6):190–195. https://www.cdc.gov/mmwr/volumes/67/wr/mm6706a4.htm.
- Liu Y, Xu F, Wheaton AG, Greenlund KJ, Thomas CW. The association between inflammatory bowel disease and migraine or severe headache among US adults: Findings from the National Health Interview Survey, 2015‐2016. Headache. 2021;61(4):612–619. DOI: 10.1111/head.14087external icon.
- Xu F, Wheaton AG, Barbour KE, Liu Y, Greenlund KJ. Trends and outcomes of hip fracture among Medicare beneficiaries with inflammatory bowel disease, 2000–2017. Dig Dis Sci. 2021;66(6):1818–1828. DOI: 10.1007/s10620-020-06476-z. https://link.springer.com/article/10.1007/s10620-020-06476-zexternal icon.
- Farraye FA, Melmed GY, Lichtenstein GR, Kane SV. ACG clinical guideline: preventive care in inflammatory bowel disease. Am J Gastroenterol. 2017;112(2):241-258. DOI: 10.1038/ajg.2016.537. https://journals.lww.com/ajg/Fulltext/2017/02000/ACG_Clinical_Guideline__Preventive_Care_in.15.aspxexternal icon.
- Xu F, Dahlhamer JM, Terlizzi EP, Wheaton AG, Croft JB. Receipt of preventive care services among US adults with inflammatory bowel disease, 2015—2016. Dig Dis Sci. 2019; DOI: 10.1007/s10620-019-05494-w. https://link.springer.com/article/10.1007%2Fs10620-019-05494-wexternal icon.
- Xu F, Carlson SA, Wheaton AG, Greenlund KJ. COVID-19 hospitalizations among U.S. Medicare beneficiaries with inflammatory bowel disease, April 1 to July 31, 2020. Inflamm Bowel Dis. 2021; izab041. DOI: 10.1093/ibd/izab041. https://academic.oup.com/ibdjournal/article/27/7/1166/6255240external icon.
- Siegal CA, Melmed GY, McGovern DP, et al. SARS-CoV-2 vaccination for patients with inflammatory bowel diseases: recommendations from an international consensus meeting. Gut. 2021;70(4):635–640. DOI: 10.1136/gutjnl-2020-324000. https://gut.bmj.com/content/70/4/635.longexternal icon.
- Xu F, Park S, Liu Y, Greenlund KJ. Dietary intake patterns among adults with inflammatory bowel disease in the United States, 2015. PLoS One. 2021;16(4):e0250441. DOI: 10.1371/journal.pone.0250441. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0250441external icon.