Key points
- U.S. prevalence of inflammatory bowel disease (IBD) is estimated between 2.4 and 3.1 million, with differing burden across groups.
- IBD prevalence and health care costs are rising.
- In 2018, the total annual U.S. health care costs for IBD were about $8.5 billion.
- Biologic prescription drugs have shifted the patterns of cost and service use.

The basics

Inflammatory bowel disease (IBD) refers to a group of life-long diseases affecting the intestines. The main types of IBD are ulcerative colitis and Crohn’s disease.
Prevalence in the United States
Depending on the data source, current estimates of IBD in the United States vary considerably:
- Ranging from 2.4–2.8 million IBD patients based on administrative claims data.1
- Up to 3.1 million adults with the disease based on national survey data.23
The prevalence of IBD is rising in the United States.41
IBD prevalence differs across groups.23
Understanding the burden of IBD on different U.S. populations allows us to identify inequities in care and develop or improve care for those most in need.
Differences across groups
Racial and ethnic groups
Prevalence rates for IBD are consistently highest in non-Hispanic White populations.1256
Recent estimates of the racial and ethnic distribution of IBD prevalence among U.S. adults and children were:1
- Non-Hispanic White patients—0.8%.
- Black patients—0.5%.
- Hispanic patients—0.5%.
- Asian American patients—0.4%.
The difference between racial and ethnic groups may be narrowing, as some studies find prevalence increasing among minority groups.567
Older age groups
IBD prevalence increases with increasing age.412 Highest prevalence was found among adults aged 45 years and above.2
Prevalence across health behaviors
Compared to adults without IBD, adults with IBD are more likely to:2
- Have formerly smoked (21% vs. 26%).
- Sleep less than 7 hours a day (32% vs. 38%).
- Fall short of aerobic and muscle- strengthening physical activity guidelines (45% vs. 50%).
- Have experienced serious psychological distress (3% vs. 7%).
Adults with IBD were also more likely to have other (comorbid) chronic conditions.2
IBD health care costs
The cost of IBD care is rising in the United States.8910
A recent study estimated the 2018 total overall costs for IBD-related care were $8.5 billion, with the largest distributions by type of service:11
- Prescribed medicine: 71%.
- Inpatient visits: 18%.
- Office-based visits: 9%
- Emergency visits: 2%.
Effective but highly priced biologic medication have improved outcomes and rates of remission. They have also affected health care costs and changed the frequency different types of services are used.8910121314