Yousef Abdelrahman, Ahmed Sarah T, H Nguyen Wenker Theresa, Nono-Djotsa Alice B S, Boyle Stephen H, Gifford Elizabeth J, Malhotra Deeksha, Chandler Helena, Bandi Sandhya, Helmer Drew A
Gastrointestinal Medical Oncology Department, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Internal Medicine Department, University of New Mexico Hospital, Albuquerque, New Mexico, USA.
BMJ Open Gastroenterol. 2025 Sep 5;12(1):e001859. doi: 10.1136/bmjgast-2025-001859.
Approximately 30% of the 700 000 US Gulf War Veterans (GWVs) report symptoms collectively termed Gulf War Illness (GWI), a multisymptom illness of uncertain pathophysiology. Prior studies in GWI focus on overlap with irritable bowel syndrome. This study examines the associations between upper gastrointestinal (UGI) symptoms, GWI and specialty GI care.
This cross-sectional study analysed GWVs referred to a Veterans Health Administration clinical War-Related Illness and Injury Study Center (2008-2020). Symptoms, demographics, military service and clinical history were obtained from self-reported intake packets. GWI was defined by the Centers for Disease Control and Prevention criteria requiring moderate-to-severe symptoms in at least two of three domains: fatigue, musculoskeletal and mood cognition. UGI symptoms were analysed individually as a composite variable and additively (0-5). Logistic regression models estimated ORs for associations between UGI symptoms, GWI and GI specialty care.
The cohort included 596 GWVs (mean age 49.3 years, 88% men). Most (93.5%) reported at least one UGI symptom, with a mean of 2.8 symptoms. GWI was identified in 413 (69%). Veterans with GWI were more likely to report UGI symptoms (98.3% vs 82.5%) and had a higher mean symptom count (3.1 vs 2.1). Adjusted ORs for UGI symptoms in GWI ranged from 1.79 (dysphagia) to 3.57 (nausea/vomiting).
UGI symptoms are common among GWVs and strongly associated with GWI. Clinicians should screen for UGI symptoms and follow standard protocols for treatment and referral.
在美国70万海湾战争退伍军人（GWVs）中，约30%报告有统称为海湾战争病（GWI）的症状，这是一种病理生理学不明的多症状疾病。先前关于GWI的研究集中在与肠易激综合征的重叠方面。本研究探讨上消化道（UGI）症状、GWI与专科胃肠护理之间的关联。
这项横断面研究分析了被转诊至退伍军人健康管理局临床战争相关疾病和损伤研究中心的GWVs（2008 - 2020年）。症状、人口统计学特征、军事服役情况和临床病史通过自我报告的入院资料获取。GWI根据疾病控制与预防中心的标准定义，要求在三个领域（疲劳、肌肉骨骼和情绪认知）中至少两个领域出现中度至重度症状。UGI症状分别作为一个复合变量和累加变量（0 - 5）进行分析。逻辑回归模型估计UGI症状、GWI与胃肠专科护理之间关联的比值比（ORs）。
该队列包括596名GWVs（平均年龄49.3岁，88%为男性）。大多数（93.5%）报告至少有一种UGI症状，平均症状数为2.8种。413人（69%）被确诊为GWI。患有GWI的退伍军人更有可能报告UGI症状（98.3%对82.5%），且平均症状数更高（3.1对2.1）。GWI中UGI症状的校正ORs范围为1.79（吞咽困难）至3.57（恶心/呕吐）。
UGI症状在GWVs中很常见，且与GWI密切相关。临床医生应筛查UGI症状，并遵循标准的治疗和转诊方案。
