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Research Topics
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General
Project Summary

Title: Chronic Gastrointestinal Illness in Persian Gulf Veterans
Synopsis: This study surveyed a sample of Gulf War veterans from a National Guard unit and found that these veterans were more likely to report a variety of chronic gastrointestinal symptoms than were non-deployed members from the same unit.
Overall Project Objective: Clearly define the most prevalent chronic gastrointestinal symptoms in a unit of Persian Gulf veterans.
Status/Results to Date: Survey completed. Have identified most prevalent symptoms. Note: Following is quoted from poster accepted for Poster Presentation at Digestive Disease week in San Diego, May 1995, Chronic Gastrointestinal Symptoms In Persian Gulf Veterans; MB Sostek, S Jackson, JK Linevsky, EM Schimmel, BG Fincke; Departments of Medicine and Social Services, Boston Veterans Affairs Medical Center and Boston University School of Medicine, Boston, MA. Background: Persian Gulf Syndrome is characterized by a constellation of chronic symptoms postdating deployment to the Gulf Region in 1991. Intermittent diarrhea is one of the eight most commonly reported symptoms. The prevalence of non-diarrheal gastrointestinal (GI) symptoms is not well documented. Over the past year, we have received increasing referrals for evaluation of Persian Gulf veterans (PGV) with various GI complaints. The aims of this study were I) to determine the prevalence and spectrum of GI complaints in a representative sample from this population and II) to compare this data to a control group of soldiers not deployed to the gulf region. Methods: A 4-page questionnaire was mailed to the 92 members of a National Guard Unit deployed to the Persian Gulf Region in 1991 and distributed to 44 members (controls) of the same unit who were not deployed to the Gulf Region in 1991. The questionnaire asked the veterans to grade current severity of 26 GI and 10 non-GI symptoms. The survey also asked veterans to recall occurrence of 5 GI symptoms either during or before the Dessert Storm mission. Results: 57/92 Persian Gulf veterans (62%) responded to the survey. All 44 of the controls returned the survey. The table below summarized the reported frequency of several GI symptoms in this population: GI Symptom Before ODS After ODS Controls (Current) Loose Stool 2/57 (3%) 39/57 (68%)* 4/44 (9%) Abdominal Pain 2/57 (3%) 32/57 (56)* 3/44 (7%) Excessive Gas 5/57 (9%) 42/57 (74%)* 10/44 (23%) Nausea/Vomiting 2/57 (3%) 13/57 (23%) 1/44 (2%) Hematochezia no data 4/57 (7%) 0/44 (0%) *p<.0001 compared to symptom frequency before desert storm. Additional frequently reported GI symptoms among PGV's in this survey include: sensation of incomplete rectal evacuation post defecation 34/57 (60%), and watery bowel movements following episodes of abdominal pain 30/57 (53%). The most frequent non-GI symptoms were: fatigue 46/57 (81%), joint pains 42/57 (74%) and headache 38/57 (67%). Conclusion: A significant number of veterans from a single National Guard unit, deployed to the Persian Gulf, developed GI symptoms while in that region. The majority of these veterans currently continue to report persistent loose stools, lower abdominal pain, excessive gas and tenesmus. Veterans in the same unit, who were not deployed to the Gulf region, report significantly fewer chronic GI symptoms at the present time. While these symptoms are suggestive of the development of irritable bowel syndrome following Persian Gulf deployment, further studies are needed to better understand the pathophysiology of this combination of chronic GI symptoms.
Project:VA-18
Agency:Department Of Veterans' Affairs
Location:VAMC Boston
P.I. Name:Mark Sostek, M.D.
Research Type:Clinical
Research Focus:Symptoms & General Health
Focus Category:General Health & Physical Symptoms
Status:Complete
Study Start Date:October 01,1994
Estimated Completion Date:October 01,1996
Specific Aims: 1. Determine and define symptom complex. 2. Look for underlying pathophysiology.
Methodology: Survey of a single unit of Persian Gulf veterans. Hydrogen breath tests on affected individuals.
Most Recent Publications:

Sostek M. High prevalence of chronic gastrointestinal symptoms in a national guard unit of Persian Gulf veterans. American Journal of Gastroent, 91(12):2494-7, Dec 1996. Abstract