George E. Whalen Veterans Affairs Medical Center, Salt Lake City, Utah.
Division of Gastroenterology, University of Utah, Salt Lake City, Utah.
Neurogastroenterol Motil. 2019 Mar;31(3):e13533. doi: 10.1111/nmo.13533. Epub 2019 Jan 29.
Gastroenteritis is a risk factor for irritable bowel syndrome (IBS), but its role in other functional gastrointestinal disorders (FGIDs) is less clear. The aim of this study was to determine the prevalence of FGIDs in Gulf War (GW) Veterans before, during, and after deployment and to determine whether gastroenteritis was a risk factor for upper and lower FGIDs.
The Veterans who served during the Persian GW were mailed validated questionnaires inquiring about their bowel habits, psychological and extra-intestinal symptoms, and quality of life (QOL). The lactulose hydrogen breath test (LBT) was performed for small intestinal bacterial overgrowth.
Data were analyzed from 468 GW Veterans. The prevalence of FGID before, during, and 16 years after deployment was 15.7%, 49.9%, and 64.2%, respectively. New FGIDs during deployment was reported by 41.2%, and during 16 years after deployment, 43.7% acquired new FGIDs. FGIDs were associated with psychological disorders, extra-intestinal symptoms, and lower QOL. Gastroenteritis was reported by 44.3% of deployed Veterans and was a risk factor for IBS, dyspepsia, and functional diarrhea post-deployment. The cases and controls did not differ significantly in the frequency of positive LBT.
There is an increase in the prevalence of FGIDs during deployment, and it persists after deployment. There is a further increase in the prevalence of FGIDs after deployment. In addition to IBS, gastroenteritis during deployment is a risk factor for dyspepsia and functional diarrhea post-deployment. Therefore, prevention of gastroenteritis during deployment and screening of Veterans for FGIDs post-deployment would be of value for Veterans' long-term health.
胃肠炎是肠易激综合征（IBS）的一个危险因素，但它在其他功能性胃肠疾病（FGIDs）中的作用尚不清楚。本研究的目的是确定海湾战争（GW）退伍军人在部署前后和部署期间 FGIDs 的患病率，并确定胃肠炎是否是上、下 FGIDs 的危险因素。
GW 期间服役的退伍军人收到了询问他们的肠道习惯、心理和肠道外症状以及生活质量（QOL）的经过验证的问卷。进行乳果糖氢呼气试验（LBT）以检测小肠细菌过度生长。
对 468 名 GW 退伍军人的数据进行了分析。部署前、部署中和部署后 16 年的 FGID 患病率分别为 15.7%、49.9%和 64.2%。41.2%的退伍军人在部署期间报告出现新的 FGIDs，而在部署后 16 年期间，43.7%的退伍军人出现了新的 FGIDs。FGIDs 与心理障碍、肠道外症状和较低的 QOL 相关。44.3%的部署退伍军人报告患有胃肠炎，并且是部署后 IBS、消化不良和功能性腹泻的危险因素。病例组和对照组在 LBT 阳性频率上无显著差异。
在部署期间 FGIDs 的患病率增加，并且在部署后持续存在。在部署后，FGIDs 的患病率进一步增加。除 IBS 外，部署期间的胃肠炎也是部署后消化不良和功能性腹泻的危险因素。因此，预防部署期间的胃肠炎和对退伍军人进行部署后 FGIDs 的筛查对退伍军人的长期健康将具有重要意义。
