When employers think about
Gastrointestinal (GI) issues are defined as any condition that affects the digestive tract, including irritable bowel syndrome (IBS), acid reflux and hemorrhoids. Given the nature of GI conditions, it's often under-discussed in the workplace and even the doctor's office, making the road to diagnosis and treatment a long one.
"I'm a privileged white guy — I have been able to access a great gastroenterologist, and I've been able to afford it," says Jactel. "I have taken the drugs I was told to take and followed guidelines, and I've still been sick. I am not alone."
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Jactel suffered from an inflammatory bowel disease for 10 years before realizing medication wasn't enough to manage his symptoms. Ayble, which offers nutrition and mental health support, was his response to the gap in care in the GI space. Up to 70 million Americans live with a chronic gastrointestinal issue, with nearly 40% of Americans with GI conditions admitting they have had to stop routine activities like exercise, running errands and socializing due to their symptoms, according to the American Gastroenterological Association. On top of that, a report from the NEJM Journal Watch estimates that GI issues cost the U.S. healthcare system $136 billion annually, which is more than heart disease and mental health conditions. Unsurprisingly, UnitedHealth Group usually ranks GI among the top five drivers of healthcare costs for employers.
"Over the last five years, Ayble has done a lot of work to understand how expensive we really are," says Jactel. "Even lower acuity GI conditions like IBS are generating more cost than the average diabetic. Not only are people with GI [conditions] really expensive, but they can't make it to work, or when they do, they're kind of partially there. If you've got a stomachache, you're not a very productive employee, are you?"
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Jactel underlines how vital management is for a chronic condition, noting that even if an employee has the right specialist in-network, it still won't solve the array of symptoms they're likely dealing with on a day-to-day basis. For GI health management, patients need help choosing the right foods and ingredients their bodies can digest, as well as help understanding the role their mental health and moods play in digestion. Accordingly, Ayble helps its members identify trigger foods to create a personalized diet plan, even providing a national grocery store database that employees can use to check if their would-be purchase is safe. The platform's mind-gut program provides techniques to ease stress and hopefully make digestion easier.
"You're not just a sack of guts," says Jactel. "Your mind and your gut are connected by a kind of information superhighway. We help people retrain how their mind and their guts communicate through auditory guided exercises."
Jactel also warns employers that gut health does not impact workers equally, making it a healthcare and inclusivity issue. According to the American College of Gastroenterology, women experience IBS two to six times more than men do and tend to have worse symptoms. Notably, postmenopausal women report even more GI symptoms than other women, pointing to the impact hormonal changes can have on their digestive system.
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While GI may go unspoken in the workplace, that doesn't mean employers should ignore it when it comes to their healthcare benefits, stresses Jactel. If GI is driving costs for your plan, it may be worth considering whether employees have the resources to manage their condition or if their health is just getting worse.
"You can't fix GI just by throwing doctors at the problem," says Jactel. "To manage a condition, you need to utilize tools that employ technology and humans together to manage a patient holistically. We're here to really enhance and be the connective tissue in the 99% of the time that patients are out of the clinic."
