The Burden of IBD in Canada

In the fall of 2008, the Crohn’s and Colitis Foundation of Canada (CCFC) released its report, “The Burden of Inflammatory Bowel Disease in Canada.” This landmark document revealed that over 200,000 Canadians suffer from inflammatory bowel disease. IBD affects more people than multiple sclerosis or HIV and is almost as prevalent as epilepsy and Type 1 diabetes. In spite of that, IBD remains a closet disease, shrouded in silence and relatively unknown.

Why is that? Perhaps it is because people with Crohn’s disease (CD) and ulcerative colitis (UC) are reluctant to speak out about health issues that have been taboo in polite conversation. It’s time for that to stop. We need to bring this conversation out into the open and talk about a disease that strikes more than 9,000 new patients every year.

Canada has one of the highest incidences of IBD in the world. With an annual cost of $1.8 billion to individuals, their families and society at large, the burden of IBD is significant. In 2008, costs covered by the health care system were estimated at $753 million; including expenses such as hospitalization, surgery, medication and physician visits. Not included in these estimates, but having as real a system impact, are things like emergency visits, lab costs and other consultations with other health professionals such as nurse practitioners, dietitians and social workers.

In addition to the direct expenses to the health care system, it is estimated that IBD incurs more than a $1 billion dollars every year in indirect costs. These include short and long-term work absences, productivity losses, caregiver work absences and patient out-of-pocket expenses related to care, nutritional products, medication and complementary therapies. 

Beyond the economic impact, the emotional suffering inflicted by these chronic diseases is incalculable. Quality of life, career choices, sense of self-worth, intimacy and personal freedoms are all affected when someone develops IBD. Over and above those concerns, the risk of premature death for IBD sufferers is 47 per cent higher than the general public, and the risk of developing colorectal cancer is also elevated. Read more

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Elderly IBD patients are less likely to present with symptoms of abdominal pain, diarrhea, and anemia.8-10 More frequent symptoms include weight loss, bleeding, fever, and paradoxical constipation (with distal UC, which is more common than pancolitis).11 Colonic CD is more common than small-bowel or ileocolonic disease and has a lower incidence of fever and strictures than small-bowel disease.9,12,13 Elderly patients have a lower incidence of IBD family history and, as expected, a greater incidence of osteoporosis, but their incidence of extraintestinal IBD manifestations is similar to that of younger patients.8,10,12,14 However, a disparity exists in the literature, with some reports claiming that there is no difference in disease location. Read more

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