Self‐reported gastrointestinal disorders among veterans with gulf war illness with and without posttraumatic stress disorder

Background Gulf War Illness (GWI) is a chronic, multi‐symptom disorder affecting 25%–32% of Gulf War veterans. Veterans with GWI disproportionately suffer from gastrointestinal (GI) disorders. Given the increasing evidence supporting a gut‐brain axis, we explore the relationship between post‐traumat...

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Published in:Neurogastroenterology and motility 2023-05, Vol.35 (5), p.e14548-n/a
Main Authors: Malhotra, D., Boyle, S. H., Gifford, E. J., Sullivan, B. A., Nguyen Wenker, T. H., ABS, Nono‐Djotsa, Ahmed, S. T., Upchurch, J., Vahey, J., Stafford, C., Efird, J. T., Hunt, S. C., Bradford, A., Sims, K. J., Hauser, E. R., Helmer, D. A., Williams, C. D.
Format: Article
Language:English
Subjects:
biopsychosocial models
brain‐gut Axis
colonic polyps
Digestive system
Digestive tract
Gastroesophageal Reflux
Gastrointestinal Diseases
Gulf War
Gulf War syndrome
Humans
Irritable Bowel Syndrome
Military personnel
Persian Gulf Syndrome
Persian Gulf War
Polyps
Post traumatic stress disorder
post‐traumatic stress disorders
Self Report
Stress Disorders, Post-Traumatic
Veterans - psychology
War
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Summary:Background Gulf War Illness (GWI) is a chronic, multi‐symptom disorder affecting 25%–32% of Gulf War veterans. Veterans with GWI disproportionately suffer from gastrointestinal (GI) disorders. Given the increasing evidence supporting a gut‐brain axis, we explore the relationship between post‐traumatic stress disorder (PTSD), GWI, and self‐reported GI disorders among GW veterans. Methods Veterans from the Gulf War Era Cohort and Biorepository responded to a mail‐based survey (N = 1058). They were stratified by GWI (Centers for Disease Control definition) and PTSD status. This yielded three groups: GWI−, GWI+/PTSD−, and GWI+/PTSD+. Multivariable logistic regression adjusting for demographic and military characteristics examined associations between GWI/PTSD groups and GI disorders. Results were expressed as adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). Key Results The most frequently reported GI disorders were irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and colon polyps (CP). The GWI+/PTSD+ group had a higher odds of these disorders than the GWI+/PTSD− group (aORIBS = 3.12, 95% CI: 1.93–5.05; aORGERD = 2.04, 95% CI: 1.44–2.90; aORCP = 1.85, 95% CI: 1.23–2.80), which had a higher odds of these disorders than the GWI− group (aORIBS = 4.38, 95% CI: 1.55–12.36; aORGERD = 2.51 95% CI: 1.63–3.87; aORCP = 2.57, 95% CI: 1.53–4.32). Conclusions & Inferences GW veterans with GWI and PTSD have significantly higher odds of specific self‐reported GI disorders than the other groups. Given the known bidirectional influences of the gut and brain, these veterans may benefit from a holistic healthcare approach that considers biopsychosocial contributors to the assessment and management of disease. The most frequent self‐reported GI disorders in this cohort were IBS, GERD, and colon polyps. The GWI+/PTSD+ group had a higher likelihood of IBS, GERD, and colon polyps than the GWI+/PTSD− group, which had a higher likelihood of all three disorders than the GWI− group.
ISSN:1350-1925
1365-2982
DOI:10.1111/nmo.14548