Deployment-Associated Functional Gastrointestinal Disorders: Do We Know the Etiology?

Abstract

Functional gastrointestinal disorders (FGD) are a collection of symptoms with no known anatomical or biochemical abnormality [1]. Irritable bowel syndrome (IBS) and dyspepsia are two of the most common types of FGD. The etiology of these disorders is unknown, but speculated mechanisms include altered gastrointestinal motility, visceral hypersensitivity, aberrant brain-gut interaction, food intake, and psychological factors, perhaps with a genetic predisposition [2]. Acute gastrointestinal infection can precipitate or exacerbate the clinical expression of IBS and dyspepsia [3,4]. Various studies in non-military populations have demonstrated the onset of IBS after gastroenteritis. This type of IBS is known as post-infectious IBS (PI-IBS). The current study makes an association between infective gastroenteritis and subsequent development of FGD in military personnel.Porter and colleagues conducted a retrospective casecontrol study to determine whether self-reported diarrhea and/or vomiting and psychological stress during deployment were associated with increased risk of FGD in active-duty military personnel during their first deployment to Iraq and Afghanistan from 2008 to 2009 [5]. Using active-duty military medical encounter data from the Defense Medical Surveillance System, they identified 129 cases (constipation = 67, dyspepsia = 15, IBS = 22, overlapping syndrome = 25) and 396 controls of FGD using ICD-9 codes.

Randomized, Double-Blind Placebo-Controlled Trial to Assess the Effect of Probiotics on Irritable Bowel Syndrome in Veterans With Gulf War Illness

“…Furthermore, there are demographic differences between Gulf War veterans and patients enrolled in other studies: Gulf War veterans are predominantly male, many were deployed abroad and had a history of gastroenteritis during deployment, and were exposed to stressful situations. 46 These factors may be involved in triggering or maintaining IBS in Gulf War veterans. A further limitation of our randomized trial is the relatively small sample size.…”