In 2012, 117 million Americans had at least one chronic health condition and most of these involved the gastrointestinal tract, as estimated by the CDC. About 86% of spending on health care that year was allocated toward these chronic diseases. Since gastrointestinal disorders can affect 60 million to 70 million Americans, reducing cases needs to be a top priority for professionals in health care.
Symptoms of gastronomical diseases can range from being mild to life threatening. Many of these symptoms including gas, bloating, vomiting, diarrhea and constipation and can affect quality of life. Patients will miss work and have to deal with multiple doctor visitors to get relief of their symptoms. More serious diseases like Chron’s disease, celiac disease, intestinal cancer and pancreatitis can cause enough tissue damage to kill a patient if left untreated.
Figure 1. Age-specific prevalence of Crohn’s disease per 100,000 persons in a commercially insured U.S. population, 2008-2009. Crohn’s disease is a particular concern, affecting roughly 200 per 100,000 adults, with the incidence rising worldwide.
For a patient with Crohn’s disease, the average hospital stay is 5.5 days and costs $10,639. Due to the nature of the disease, there is a 30-day readmission rate that is as high as 19%, which can cost more than $12,000. Since these numbers are so high, gastroenterologists need to come up with strategies to help reduce hospitalization and readmissions for those with flares from the diseases. There has been some success. A new study was presented at the 2016 annual meeting of the American College of Gastroenterology Sigmon and colleagues developed a template to reduce readmission rates by 21%.
Figure 2. Readmissions for patients with Crohn’s disease dropped after an intervention.
While this is promising, diet should not be overlooked in terms of prevention. Meeting with a registered dietitian (RD) usually costs less than $200 a session and costs can be covered by insurance. Due to their training, RDs can help translate scientific nutrition research into suggestions for patients and help them develop custom menus that will accommodate their preferences. RDs can also help debunk myths that are spread about nutrition.
Since RDs can play such a vital role in helping those with chronic diseases, gastrologists should team up with RDs. Dietitians can help give the patient a full nutrition assessment and optimize the patient’s nutrition with the right treatment, whether that’s restricting foods or using parenteral nutrition in extreme cases, while the GI can focus on treating the patient and not worry about the nutrition side. Dietary treatment has been underused so far in the treatment of these chronic diseases and a GI should consider teaming up to give the best patient care.