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America's gut check

What Amino's analysis of 4.7M people reveals about chronic gastrointestinal conditions

Comorbidity gif Jump to our tool that shows how gut conditions are related to other health issues

If you're one of the 70 million Americans who live with a chronic gastrointestinal (gut) condition, you know that just getting through the day can often be a challenge. In fact, according to one study, 72% of Americans experience one or more bouts of gut "discomfort," like pain, bloating, gas, and diarrhea, every month.

But what can't be quantified is the emotional toll these conditions can take on your life. It's common to feel anxious, depressed, fearful, and even embarrassed.

We believe that knowledge is power, and we want you to know that if you're living with a chronic gut condition, you're not alone. Our team mined our database to learn more about these illnesses in an effort to get a clear picture of who's getting diagnosed, what it's like to live with a long-term gut condition, and what, if any, other health issues it might trigger.

We looked at 2 years' worth of data (2014-2015) and studied the experiences of people who were diagnosed with acid reflux; inflammatory bowel diseases like ulcerative colitis and Crohn’s disease; irritable bowel syndrome (IBS); gallstones; celiac disease; and colon cancer. We also reviewed data about colonoscopies, a common screening procedure for many gut issues. Click here for the full methodology behind this analysis or find a gastroenterologist if you're one of the millions who suffer from a chronic gut condition.

Here's what we found.

Jump to navigate to one of the sections below:

The most common gut conditions

Gut conditions, ranked

Research shows—and Amino's data confirms—that more people are diagnosed with acid reflux than any other gastrointestinal condition.

Around 326,000 people were diagnosed with colon cancer, the second-leading cause of cancer-related deaths, between 2014 and 2015.

Celiac disease was diagnosed less often than any other gut condition in the 2 year-span we investigated. In comparison, 9x as many people were diagnosed with ulcerative colitis, and 6x as many people were diagnosed with colon cancer. But just because celiac disease is rarely diagnosed, doesn't mean it's a rare condition. Research suggests that between 1-3 million Americans are living with it, but 97% of them go undiagnosed.

Gut conditions are often related to other health problems

As we mentioned earlier, if you have a chronic gut condition, it's common to feel worried and anxious. And if you develop other medical issues on top of it, you might even wonder, "Is what I'm experiencing normal? Do other people who have this condition have other health issues, too?"

To find out, we looked at all the people in our database who were diagnosed with acid reflux, ulcerative colitis, Crohn’s disease, IBS, and celiac disease in 2014 and 2015. Then, we analyzed the other conditions—or "comorbidities"—that doctors diagnosed them with at the same time.

Next, we examined patients who don't have chronic gut illnesses to see how often they're diagnosed with these other conditions. We compared the data and compiled the results in the interactive chart below.

In a nutshell, this chart shows if patients with gut conditions experience other health issues at a higher rate than the general population of patients.

Crohn’s disease
Ulcerative colitis
Acid reflux
Celiac disease
Lactose intolerance
20.2x 10.7x
2.7x 2.8x 2.8x 7.4x 9.3x
1.5x 1.8x 3.6x 3.5x 6.2x
Celiac disease
5.8x 5.6x 5.6x
Delayed stomach emptying
2.5x 2.7x 4.9x 5.0x
1.2x 1.2x 1.9x 2.3x 4.2x
Rectal hemorrhage
5.0x 9.2x 1.6x 2.3x 3.7x
2.1x 2.4x 3.4x
Acid reflux
1.6x 1.6x 1.9x 3.3x
4.5x 4.7x 3.0x 3.2x
2.2x 3.6x 1.3x 1.2x 3.1x
Ulc. colitis Ulcerative colitis
3.5x 1.3x 5.1x 2.9x
1.4x 1.4x 1.6x 2.2x 2.9x
1.7x 2.7x 1.4x 1.1x 2.8x
Crohn’s disease
5.2x 2.8x
1.6x 1.5x 2.0x 1.6x 2.6x
9.6x 9.5x 2.4x 2.6x
Blood in stool
4.7x 7.1x 1.5x 2.4x 2.5x
H. pylori
3.1x 5.0x 2.5x
Generalized anxiety disorder
1.3x 1.1x 2.3x
1.7x 1.8x 2.9x 5.2x 2.2x
5.4x 5.9x 3.6x 2.1x
1.1x 1.2x 1.8x 1.2x 2.0x
Restless leg syndrome
2.1x 1.4x 2.0x
Hiatal hernia
1.3x 1.4x 4.4x 3.2x 1.9x
Weight loss
3.0x 2.9x 1.3x 3.7x 1.8x
1.4x 1.3x 1.6x 1.1x 1.6x
Colon polyps
1.6x 2.8x 1.2x 1.3x 1.5x
1.7x 1.7x 1.6x 2.9x 1.4x
Difficulty swallowing
1.0x 1.0x 2.9x 1.7x 1.3x
B12 deficiency
4.1x 3.0x 1.0x 3.9x 1.1x
1.6x 2.3x 2.1x 2.2x 1.1x
Hashimoto’s thyroiditis
4.7x 3.9x 11.4x
Short stature
Down’s Syndrome
4.2x 4.5x 4.1x 7.7x
Food allergy
Raynaud’s syndrome
Sicca syndrome
Adrenal insufficiency
Addison’s disease
Type 1 diabetes
Megaloblastic anemia
3.2x 2.5x 3.6x
Iron deficiency anemia
2.8x 2.8x 3.1x
Intestinal hemorrhage
3.4x 4.6x 1.4x
Bowel obstruction
8.9x 6.6x 1.2x
Runny nose
Sleep apnea
OSA Obstructive sleep apnea
Chronic obstructive asthma
Digestive tract abscess
12.8x 9.3x
Rectal pain
7.2x 7.1x
C. diff
4.6x 6.4x
6.4x 5.4x
Anal polyp
Rectal narrowing
Ankylosing spondylitis
Anal fissure
If you have one of these
How much more likely
are you to have…

Tap Click the column headers to focus on each condition and hover over the purple boxes to see the likelihood of having that related health issue.

Grab a GIF of this interactive tool.
Read the methodology to learn more.

We found that yes, chronic gut conditions often coexist with other health issues. For example, our data shows that patients with IBS are 10x more frequently diagnosed with lactose intolerance than patients without IBS. And, if you have Crohn's, you're around 4x more likely to have B12 vitamin deficiency.

Many diagnoses have an age spike

Every time Lia Moore's son texts her during the school day, she gets a sinking feeling in the pit of her stomach.

That's because she's received more than a half-dozen of these texts in three months, and each time, her instinct has been right: her son has diarrhea and stomach pain and needs to be picked up from school.

Lia's 16-year-old son, Matt, has irritable bowel syndrome, or IBS. He was diagnosed with the condition at age 13. Our data shows that Matt is not alone: some gut conditions, like IBS, are often diagnosed in adolescence. For example, ulcerative colitis and Crohn's disease diagnoses more than doubled from age 14 to 20, and IBS diagnoses more than tripled from age 14 to 20.

Doctors aren't 100% sure what's behind the uptick in chronic gut diagnoses during the teen years. Maneesh Singh, M.D., a third-year fellow in gastroenterology at UCSF, says fluctuating hormones at the onset of puberty could play a role in certain gut conditions such as Crohn's disease and ulcerative colitis. He also says it's possible that poor growth, weight loss, and delayed puberty may be red flags for certain gastrointestinal conditions and therefore lead to diagnosis in this age group.

Amino's database reveals that other chronic gut conditions are most often diagnosed in different age groups. For instance:

  • Celiac disease diagnoses tripled from age 2 to 7. Infants 0 to 2 years old account for 7.6% of all acid reflux diagnoses.

  • Colon cancer is more commonly diagnosed in middle-aged adults. In fact, Amino's data shows that colon cancer diagnoses more than triple (3.5x) from age 45 to age 60.

  • Women age 17 to 30 are diagnosed with gallstones 4x more often than men.

And this brings us to an interesting point: women are diagnosed with gastrointestinal conditions more often than men. Consider the infographic below.

Women get IBS more than men

But why is this? Are women simply more prone to gut conditions than men?

Women go to the doctor more than men

A woman's physical makeup may play a role in her developing certain gut conditions, like IBS and gallstones. A study from March 2015 suggests it’s because the intestine’s nerve cells are more "sluggish" in women.

According to the International Foundation for Functional Gastrointestinal Disorders (IFFGD), 60-65% of people who report IBS are women, and they're 3x more likely to see their doctor about their symptoms. In the case of gallstones, women are also diagnosed more than men. This may be due to the female hormone estrogen, which raises cholesterol levels in the bile and slows gallbladder movement. When estrogen rises—like during pregnancy or if a woman takes birth control pills—there’s a higher likelihood of developing gallstones.

For acid reflux or Crohn's disease, there's no clinical evidence to prove women are more likely to develop the condition.

Another, simpler reason why more women are diagnosed with gut conditions? Our data reveals differences in the way men and women seek care: women go to the doctor more than men.

According to a Kaiser Women's Health survey, 91% of women said they've seen a doctor in the past 2 years; only 75% of men said the same. And when women go to the doctor, the survey reveals, they're more likely than men to get the recommended screening services, like colonoscopies.

Time for a gut check

Amino's data finds that nearly 440,000 more women than men received at least one colonoscopy between 2014 and 2015.

The American Cancer Society (ACS) recommends you get a colonoscopy beginning at age 50 and then every 10 years—unless you have a family history of colon cancer. In that case, you should get your first one before age 40, and then every 2 years. New studies recommend the general population (those who have no family history of colon cancer) begin screening closer to age 40.

Colonoscopy analysis

Our data shows that most people stick to the ACS recommendations—colonoscopies for both men and women between age 50 to 52 spike. In fact, in 2014 and 2015, the number of people getting a colonoscopy quadrupled from age 49 to 51.

That's encouraging news, because if you have colon cancer, your chance of survival is higher if the cancer is caught early.

For more of our data on colonoscopies, check out our appendix of charts below.

How to use this data

As we stated earlier, at Amino, we believe knowledge is power. So, we've come up with 4 ways you can use the data in this report to impact your health (or that of someone you love):

Book your colonoscopy


Download all the charts

Research and editing by Hannah Levy; interactive design by Sumul Shah; medical review by Jorge A. Caballero, MD