Inflammatory bowel disease (IBD) is a general term for several conditions that cause inflammation of the digestive tract. If the inflammation is chronic, it can affect how foods are digested, nutrients extracted, and waste products discharged. A healthy digestive system is often the key to a person’s overall health. It should be no surprise, then, that inflammatory bowel disease pushes up overall health costs.

The most common types of IBD are ulcerative colitis (UC) and Crohn’s disease. UC usually involves the large intestine, while Crohn’s most commonly affects the tail-end of the small intestine. The cause of IBD is not known, but there are identified risk factors, such as a family history, smoking, and eating fatty foods.

For someone with IBD, use of health services increases substantially. This is in part because it can be a chronic condition that is difficult to treat effectively. A recent study found that adults with IBD, as compared to those who did not have IBD, were

       –Twice as likely to have seen a specialist in a 12-month period.

       –74% more likely to have seen a mental health provider.

       –32% more likely to have been prescribed medication,

       –More likely to have at least four visits to a health professional.

       –More likely to have at least four emergency room visits, overnight hospital stay, or surgeries.

The impact of IBD on use of health care services is complicated because those with the condition are more likely to have co-morbidities, such as cardiovascular disease, arthritis, and liver problems. 

It is estimated that the annual direct and indirect costs of treating IBD in the U.S. ranges from $14.6 to $31.5 billion, but others think the costs are much bigger. 

A question is what actions might be taken to reduce these costs, and this question generates some controversy.

Dr. Michael Kappelman of the University of North Carolina notes that the cost findings correlate with his general experience.  He states that “it comes as no surprise that patients with a significant chronic condition such as IBD utilize more healthcare than those without IBD.” 

Dr. Kappelman, along with others, thinks the emphasis should not be on reducing health care utilization, but rather on how best to provide effective treatment that will reduce hospitalizations and surgeries, which are big drivers of health care costs. The goal is to make people healthier, not simply to reduce the costs of doing that.