Verne Zachary Thomas, Fields Jeremy Z, Zhang Benjamin Buyi, Zhou QiQi
Biology, Texas A&M University System, College Station, Texas, USA.
Department of Medicine, The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA.
J Investig Med. 2023 Jan;71(1):7-10. doi: 10.1136/jim-2021-002291.
Over 25% of veterans with Gulf War illness developed chronic gastrointestinal (GI) symptoms of unknown etiology after they returned from deployment to the Persian Gulf. To determine the prevalence of delayed gastric emptying and its association with autonomic dysfunction in returning Gulf War (GW) veterans with chronic GI symptoms, we prospectively studied 35 veterans who were deployed to the Persian Gulf and developed chronic nausea, vomiting, postprandial abdominal pain, and bloating during their tour of duty and 15 asymptomatic controls. All veterans underwent 5 standardized cardiovascular tests to assess autonomic function. Each test was scored from 0 (normal) to 5 (severe disease) and the mean was calculated. A composite score >1.5 was considered abnormal, with 5 representing severe autonomic dysfunction. A standardized gastric emptying test with a solid phase was performed in each veteran. A gastric retention of >50% at 100 minutes was considered abnormal. The composite autonomic score was 3.7 in veterans with GI symptoms (vs 1.3 in controls) (p<0.01). The mean solid phase retention at 100 minutes was 72.6% in the symptomatic veterans versus 24.6% in controls (p<0.001). Our results suggest that autonomic dysfunction and delayed gastric emptying are common in returning GW veterans with GI symptoms. Autonomic dysfunction was positively correlated with the severity of delayed gastric emptying and may account for the GI symptoms of nausea, vomiting, postprandial abdominal pain, and bloating. These new findings are important for an increasing number of veterans who are serving in the Persian Gulf and are at a high risk of developing GI disorders while deployed.
超过25%的海湾战争病退伍军人在从波斯湾部署地返回后出现了病因不明的慢性胃肠道（GI）症状。为了确定患有慢性GI症状的海湾战争（GW）退伍军人中胃排空延迟的患病率及其与自主神经功能障碍的关联，我们前瞻性地研究了35名曾部署到波斯湾且在服役期间出现慢性恶心、呕吐、餐后腹痛和腹胀的退伍军人以及15名无症状对照者。所有退伍军人都接受了5项标准化心血管测试以评估自主神经功能。每项测试的评分从0（正常）到5（严重疾病），并计算平均值。综合评分>1.5被认为异常，5表示严重自主神经功能障碍。对每位退伍军人进行了一项固相标准化胃排空测试。100分钟时胃潴留>50%被认为异常。有GI症状的退伍军人的自主神经综合评分为3.7（对照组为1.3）（p<0.01）。有症状的退伍军人在100分钟时固相平均潴留率为72.6%，而对照组为24.6%（p<0.001）。我们的结果表明，自主神经功能障碍和胃排空延迟在有GI症状的返回GW退伍军人中很常见。自主神经功能障碍与胃排空延迟的严重程度呈正相关，可能是恶心、呕吐、餐后腹痛和腹胀等GI症状的原因。这些新发现对于越来越多在波斯湾服役且在部署期间患GI疾病风险较高的退伍军人来说很重要。
