Journal Article

IDDF2025-ABS-0348 Digestive disease burden in women across 204 countries (1990–2021): rising trends and a projected surge in mortality by 2050 – a global call to action

Rayarakula, Nikhil, Patel, Sagar, Vaghani, Dhwani, Desai, Hardik Dineshbhai, Jaimini Patoliya (Desai), Sandeep Sekar Lakshmisai, Rajpal, Shreyaa, Yuvaraj Bhargav Gowd Sudhakar, Sinha, Neelima

2025

Overview

BackgroundDigestive diseases (DD) disproportionately affect women worldwide, driven by unique biological factors, hormonal influences, and deep-rooted gender disparities in healthcare. From gallbladder disease and autoimmune liver disorders to irritable bowel syndrome, these conditions often go underdiagnosed and undertreated especially in low-resource settings—silently eroding women’s health and quality of life.MethodsWe analyzed the incidence, prevalence, deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) due to DD among women across 204 countries from 1990–2021, stratified by age, sex, year, and location utilizing global burden of disease study. Future mortality was projected to 2050 using ARIMA modelling (IDDF2025-ABS-0348 figure 1. Global annual percentage of change in age-standardized incidence rate per 100–000 due to digestive disease from 1990–2021, IDDF2025-ABS-0348 figure 2. Global annual percentage of change in age-standardized YLDs rate per 100–000 due to digestive disease from 1990–2021, IDDF2025-ABS-0348 figure 3. Global annual percentage of change in age standardized-YLLs rate per 100–000 due to digestive disease from 1990–2021, IDDF2025-ABS-0348 figure 4. Global burden and trend of digestive disease in 204 countries from 1990–2021).Abstract IDDF2025-ABS-0348 Figure 1Global annual percentage of change in age-standardized incidence rate per 100–000 due to digestive disease from 1990–2021[Figure omitted. See PDF]Abstract IDDF2025-ABS-0348 Figure 2Global annual percentage of change in age-standardized YLDs rate per 100–000 due to digestive disease from 1990–2021[Figure omitted. See PDF]Abstract IDDF2025-ABS-0348 Figure 3Global annual percentage of change in age standardized-YLLs rate per 100–000 due to digestive disease from 1990–2021[Figure omitted. See PDF]Abstract IDDF2025-ABS-0348 Figure 4Global burden and trend of digestive disease in 204 countries from 1990–2021[Figure omitted. See PDF]Abstract IDDF2025-ABS-0348 Figure 5Age-wise distribution of digestive disease burden in women in 204 countries in 2021[Figure omitted. See PDF]Abstract IDDF2025-ABS-0348 Figure 6DALYs rank by digestive disease burden age-standardized DALYs rate in 2021[Figure omitted. See PDF]ResultsFrom 1990–2021, the total percentage change (TPC) in prevalence increased by 72% (95% UI: 70%–75%), deaths by 35% (15%–62%), DALYs by 22% (8%–39%), and YLDs by 62% (58%–67%). The highest TPC incidence was observed in low-SDI regions, rising by 155%. Regionally, deaths increased most in Latin America and the Caribbean (93%), followed by Sub-Saharan Africa (76%) and Central Europe, Eastern Europe, and Central Asia (62%). By age, the greatest increase in incidence rate occurred among women aged 20–54 years (20%), followed by those aged 55+ (11%) and under 20 (4%). In 2021, cirrhosis and other chronic liver diseases accounted for 47.3% of all DD-related deaths, followed by upper DD (12.2%) and paralytic ileus/intestinal obstruction (11.1%). By 2050, DD-related deaths are projected to rise to 1.8 million (95% UI: 1.5–2.1 million) (IDDF2025-ABS-0348 figure 5. Age-wise distribution of digestive disease burden in women in 204 countries in 2021, IDDF2025-ABS-0348 figure 6. DALYs rank by digestive disease burden age-standardized DALYs rate in 2021).ConclusionsDD represents a rapidly escalating and often overlooked threat to women’s health worldwide, with the burden rising sharply over the past three decades—notably in low-SDI regions and among women in their prime working years. If this trajectory continues unchecked, deaths are expected to surge by 2050, deepening existing global health disparities. This silent epidemic is already claiming millions of lives and disproportionately impacting vulnerable populations. Urgent, gender-responsive global action is no longer optional—it is essential to halt this trend, advance health equity, and protect the well-being and future of women across the world.

• Publisher: BMJ Publishing Group LTD
• Subject: Age / Age composition / Cirrhosis / Digestive system diseases / Disease / Gender / Health disparities / Irritable bowel syndrome / Liver diseases / Mortality / Public health / Quality of life / Trends / Womens health