Department of Medicine, Tulane University School of Medicine, New Orleans, LA.
Texas A&M University, College Station, TX.
J Clin Gastroenterol. 2019 Aug;53(7):e298-e302. doi: 10.1097/MCG.0000000000001135.
Well over 700,000 United States military personnel participated in the Persian Gulf War in which they developed chronic health disorders of undetermined etiology. Up to 25% of Veterans had persistent and chronic gastrointestinal (GI) symptoms, which they suspected were related to their military service in the Gulf.
The overall aim of the current study was to evaluate intestinal permeability in previously deployed Gulf War Veterans who developed chronic GI symptoms during their tour in the Persian Gulf.
To accomplish this, we evaluated intestinal permeability (IP) using the urinary lactulose/mannitol test. Measurements of intestinal permeability were then correlated with mean ratings of daily abdominal pain, frequency of bowel movements, and consistency of bowel movements on the Bristol Stool Scale in all Veterans.
A total of 73 veterans had documented chronic GI symptoms (diarrhea, abdominal pain) and were included in the study. A total of 29/73 (39%) of veterans has increased IP and had a higher average daily stool frequency (P<0.05); increased liquid stools as indicated by a higher Bristol Stool Scale (P<0.01); and a higher mean M-VAS abdominal pain rating (P<0.01). Pearson correlation coefficients revealed that there was a positive correlation between increased IP and stool frequency, Bristol Stool Scale, and M-VAS abdominal pain rating.
Our study demonstrates that deployed Gulf War Veterans with persistent GI symptoms commonly have increased intestinal permeability that potentiates the severity of abdominal pain, diarrhea, and stool consistency. These new findings in our study are important as they may lead to novel diagnostic biomarkers for returning Gulf War Veterans who suffer from chronic functional gastrointestinal disorders. These advances are also important for an increasing number of veterans who are now serving in the Persian Gulf and are at a high risk of developing these chronic pain disorders.
超过 700,000 名美国军事人员参加了波斯湾战争，他们患上了病因不明的慢性健康障碍。多达 25%的退伍军人有持续和慢性的胃肠道（GI）症状，他们怀疑这些症状与他们在海湾的兵役有关。
本研究的总体目的是评估在波斯湾服役期间出现慢性胃肠道症状的先前部署的海湾战争退伍军人的肠通透性。
为了实现这一目标，我们使用尿乳果糖/甘露醇试验评估肠通透性（IP）。然后，将肠道通透性的测量结果与所有退伍军人的每日腹痛平均评分、排便频率以及布里斯托粪便量表上粪便一致性进行相关性分析。
共有 73 名退伍军人有记录的慢性胃肠道症状（腹泻、腹痛），并纳入研究。共有 29/73（39%）名退伍军人有增加的 IP，并具有更高的平均每日排便频率（P<0.05）；更高的布里斯托粪便量表（P<0.01）表明液体粪便增加；以及更高的平均 M-VAS 腹痛评分（P<0.01）。Pearson 相关系数显示，增加的 IP 与粪便频率、布里斯托粪便量表和 M-VAS 腹痛评分之间存在正相关。
我们的研究表明，持续存在胃肠道症状的部署海湾战争退伍军人通常具有增加的肠通透性，这会加剧腹痛、腹泻和粪便一致性的严重程度。我们研究中的这些新发现很重要，因为它们可能为患有慢性功能性胃肠道疾病的返回海湾战争退伍军人提供新的诊断生物标志物。这些进展对于现在在波斯湾服役且处于患上这些慢性疼痛障碍高风险的越来越多的退伍军人也很重要。
