Language
English
Publication Date
9-5-2025
Journal
BMJ Open Gastroenterology
DOI
10.1136/bmjgast-2025-001859
PMID
40912694
PMCID
PMC12414160
PubMedCentral® Posted Date
9-5-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Objective: 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.
Methods: 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.
Results: 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).
Conclusion: 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.
Keywords
Humans, Cross-Sectional Studies, Male, Middle Aged, Female, Veterans, Retrospective Studies, United States, Persian Gulf Syndrome, Adult, Gastrointestinal Diseases, Fatigue, Gulf War, Abdominal Pain, Oesophageal Reflux, Dysphagia, Duodenal Ulcer
Published Open-Access
yes
Recommended Citation
Yousef, Abdelrahman; Ahmed, Sarah T; H Nguyen Wenker, Theresa; et al., "Upper Gastrointestinal Symptoms and Gulf War Illness in a Clinical Cohort of Us Veterans: A Retrospective, Cross-Sectional Study" (2025). Faculty and Staff Publications. 4490.
https://digitalcommons.library.tmc.edu/baylor_docs/4490