Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug;53(7):e298-e302.
doi: 10.1097/MCG.0000000000001135.

Intestinal Hyperpermeability in Gulf War Veterans With Chronic Gastrointestinal Symptoms

Buyi Zhang  1 , Meghan L Verne  2 , Jeremy Z Fields  1 , G Nicholas Verne  1 , QiQi Zhou  1   3
Affiliations

Intestinal Hyperpermeability in Gulf War Veterans With Chronic Gastrointestinal Symptoms

Buyi Zhang et al. J Clin Gastroenterol. 2019 Aug.

Abstract

Background: Well over 700,000 United States military personnel participated in the Persian Gulf War in which they developed chronic health disorders of undetermined etiology. Up to 25% of Veterans had persistent and chronic gastrointestinal (GI) symptoms, which they suspected were related to their military service in the Gulf.

Aim: The overall aim of the current study was to evaluate intestinal permeability in previously deployed Gulf War Veterans who developed chronic GI symptoms during their tour in the Persian Gulf.

Methods: To accomplish this, we evaluated intestinal permeability (IP) using the urinary lactulose/mannitol test. Measurements of intestinal permeability were then correlated with mean ratings of daily abdominal pain, frequency of bowel movements, and consistency of bowel movements on the Bristol Stool Scale in all Veterans.

Results: A total of 73 veterans had documented chronic GI symptoms (diarrhea, abdominal pain) and were included in the study. A total of 29/73 (39%) of veterans has increased IP and had a higher average daily stool frequency (P<0.05); increased liquid stools as indicated by a higher Bristol Stool Scale (P<0.01); and a higher mean M-VAS abdominal pain rating (P<0.01). Pearson correlation coefficients revealed that there was a positive correlation between increased IP and stool frequency, Bristol Stool Scale, and M-VAS abdominal pain rating.

Conclusions: Our study demonstrates that deployed Gulf War Veterans with persistent GI symptoms commonly have increased intestinal permeability that potentiates the severity of abdominal pain, diarrhea, and stool consistency. These new findings in our study are important as they may lead to novel diagnostic biomarkers for returning Gulf War Veterans who suffer from chronic functional gastrointestinal disorders. These advances are also important for an increasing number of veterans who are now serving in the Persian Gulf and are at a high risk of developing these chronic pain disorders.

PubMed Disclaimer

Conflict of interest statement

The authors have no financial or other relationship to report that might lead to a conflict of interest.

Figures

Figure 1.
Figure 1.
Average Daily Stool Frequency, Gulf War Veteran with normal permeability (N-IP), Gulf War Veterans with increased permeability (I-IP), *p<0.05. Error bars =SD
Figure 2.
Figure 2.
Average Daily Bristol Stool Scale, Gulf War Veteran with normal permeability (N-IP), Gulf War Veterans with increased permeability (I-IP), **p<0.01. Error bars=SD.
Figure 3.
Figure 3.
Average Daily M-VAS Abdominal Pain Rating, Gulf War Veteran with normal permeability (N-IP), Gulf War Veterans with increased permeability (I-IP), **p<0.01. Error bars=SD.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Baker DG, Mendenhall CL, Simbartl LA, Magan LK, Steinberg JL. Relationship between posttraumatic stress disorder and self-reported physical symptoms in Persian Gulf War veterans. Arch Intern Med 1997;157:2076–8. - PubMed
    1. Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev 1988;8:77–100.
    1. Camilleri M, Madsen K, Spiller R, Van Meerveld BG, Verne GN. Intestinal barrier function in health and gastrointestinal disease. Neurogastroenterol Motil 2012;24:503–12. - PMC - PubMed
    1. Chaloner A, Rao A, Al-Chaer ED, Greenwood-Van Meerveld B. Importance of neural mechanisms in colonic mucosal and muscular dysfunction in adult rats following neonatal colonic irritation. Int J Dev Neurosci 2010;28:99–103. - PMC - PubMed
    1. Chronic Multisymptom Illness in Gulf War Veterans: Case Definitions Reexamined Institute of Medicine, National Academy of Sciences, National Academies Press; 2014:10.17226/18623 - DOI - PubMed