Su1092: POST-TRAUMATIC STRESS DISORDER-BASED SUBTYPES OF GULF WAR ILLNESS AND SELF-REPORTED GASTROINTESTINAL DISORDERS

Malhotra, Deeksha; Boyle, Stephen; Gifford, Elizabeth J.; Sullivan, Brian; Nguyen, Theresa H.; Nono-Djotsa, Alice B.; Ahmed, Sarah T.; Helmer, Drew A.; Sims, Kellie J.; Williams, Christina D.

doi:10.1016/s0016-5085(22)61181-8

Cited by 2 publications

(3 citation statements)

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“…As noted previously, higher levels of CRP have been shown to be associated with more severe GWI symptoms (James et al., 2019); thus, the combined effects of psychological trauma and military exposures on inflammatory activity would be expected to result in a more severe presentation of GWI. The finding from a previous study that severe GWI was more frequent in veterans who were GWI+/PTSD+ compared to veterans who were GWI+/PTSD‐ is consistent with this line of thinking (Malhotra et al., 2023). This account of GWI is similar to a recent theory of GWI that posits that the condition, especially its more severe manifestation, is the result of “multiple hits” of neurotoxicant exposures and traumatic brain injury (Ferguson et al., 2022) and the reason many murine models of GWI combine stress and neurotoxicant exposures to recapitulate GWI (Ashbrook et al., 2018; Macht et al., 2019; Michalovicz et al., 2020).…”

Section: Discussionsupporting

confidence: 77%

“…This approach retains the variance of underlying mechanisms that may be shared by military exposures, GWI, and PTSD. Three recent studies of GWI adopted this methodology and found that veterans with GWI and PTSD reported more severe GWI symptoms, including higher levels of pain, fatigue, and depressive symptoms than those with GWI but without PTSD (Jeffrey et al., 2021; Malhotra et al., 2023; Shastry et al., 2022). In keeping with this stratified approach, the present study examined the association between self‐reported military exposures and GWI, stratified by PTSD status, in veterans who were deployed to the Persian Gulf during the Gulf War.…”

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confidence: 99%

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Military exposures and Gulf War illness in veterans with and without posttraumatic stress disorder

Boyle,

Upchurch,

Gifford

et al. 2023

Journal of Traumatic Stress

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Gulf War illness (GWI) is a chronic multisymptom disorder of unknown etiology that is believed to be caused by neurotoxicant exposure experienced during deployment to the Gulf War. Posttraumatic stress disorder (PTSD) covaries with GWI and is believed to play a role in GWI symptoms. The present study examined the association between self‐reported military exposures and GWI, stratified by PTSD status, in veterans from the Gulf War Era Cohort and Biorepository who were deployed to the Persian Gulf during the war. Participants self‐reported current GWI and PTSD symptoms as well as military exposures (e.g., pyridostigmine [PB] pills, pesticides/insecticides, combat, chemical attacks, and oil well fires) experienced during the Gulf War. Deployed veterans’ (N = 921) GWI status was ascertained using the Centers for Disease Control and Prevention definition. Individuals who met the GWI criteria were stratified by PTSD status, yielding three groups: GWI‐, GWI+/PTSD‐, and GWI+/PTSD+. Multivariable logistic regression, adjusted for covariates, was used to examine associations between GWI/PTSD groups and military exposures. Apart from insect bait use, the GWI+/PTSD+ group had higher odds of reporting military exposures than the GWI+/PTSD‐ group, adjusted odds ratio (aOR) = 2.15, 95% CI [1.30, 3.56]–aOR = 6.91, 95% CI [3.39, 14.08]. Except for PB pills, the GWI+/PTSD‐ group had a higher likelihood of reporting military exposures than the GWI‐ group, aOR = 2.03, 95% CI [1.26, 3.26]–aOR = 4.01, 95% CI [1.57, 10.25]. These findings are consistent with roles for both PTSD and military exposures in the etiology of GWI.

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Section: Discussionsupporting

confidence: 77%

mentioning

confidence: 99%

Military exposures and Gulf War illness in veterans with and without posttraumatic stress disorder

Boyle,

Upchurch,

Gifford

et al. 2023

Journal of Traumatic Stress

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“… 8 – 10 A study of Gulf War Veterans found that those with PTSD had higher odds of also being diagnosed with IBS, gastroesophageal reflux disease (GERD), and colonic polyps. 11 A national study of over 60,000 Veterans with IBD found the rate of co-occurring IBD and PTSD to be rising in this population, whereas incidence of co-occurring IBD and depression was declining. 12 Finally, in one systematic review that included both civilian and Veteran studies, the overall prevalence of PTSD in patients with GI disease was 36%, but when the Veteran studies were removed this prevalence rate dropped to 18%.…”

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confidence: 96%

The relationship between post-traumatic stress disorder and gastrointestinal disease in United States Military Veterans

Kent

2024

SAGE Open Medicine

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Background: This study examined the relationship between gastrointestinal disease and post-traumatic stress disorder in U.S. military Veterans. Based on literature and clinical practice data sources from the U.S. Veterans Administration, gastrointestinal disease and post-traumatic stress disorder were hypothesized to be positively correlated in Veterans. Objectives: This study aimed to determine the frequency with which gastrointestinal disease and post-traumatic stress disorder are diagnosed comorbidities, a diagnosis of gastrointestinal disease accompanies a diagnosis of post-traumatic stress disorder, and a diagnosis of post-traumatic stress disorder accompanies a diagnosis of a gastrointestinal disease. Methods: The methodology was a retrospective, correlational design using data collected from the U.S. Department of Veterans Affairs patient database. Results: The results were that post-traumatic stress disorder is bi-directionally correlated with the gastrointestinal diseases of gastroesophageal reflux disease, peptic ulcer disease, functional dyspepsia, Crohn’s disease, diverticular disease, irritable bowel syndrome, and the symptoms of constipation and nausea/vomiting within Veterans who served during wartime periods. The study also found that post-traumatic stress disorder is not correlated with ulcerative colitis in Veterans. Conclusions: The conclusions are that clinicians who see a presentation of post-traumatic stress disorder should be screening for gastrointestinal disease, while primary care and gastroenterology providers treating gastrointestinal disease should be screening for a history of trauma, as improved diagnosis rates may lead to improved treatment.

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Su1092: POST-TRAUMATIC STRESS DISORDER-BASED SUBTYPES OF GULF WAR ILLNESS AND SELF-REPORTED GASTROINTESTINAL DISORDERS

Cited by 2 publications

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Military exposures and Gulf War illness in veterans with and without posttraumatic stress disorder

Military exposures and Gulf War illness in veterans with and without posttraumatic stress disorder

The relationship between post-traumatic stress disorder and gastrointestinal disease in United States Military Veterans

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