Studies Explore Stress, Exposure, and GI Disorders

In two new studies, presented at the American College of Gastroenterology’s 74th annual meeting in San Diego, researchers explored the connection between high stress, high exposure occupations, and long-term gastrointestinal disorders. The studies, performed by the United States Navy and the State University of New York, Stonybrook, examine the long term effects of infectious gastroenteritis (IGE) among active duty military and the interaction between gastroesophageal reflux (GERD) and mental health disorders among World Trade Center workers, respectively.

Mark Riddle, DrPH, of the United States Navy, led the study that examined functional gastrointestinal disorders (FGD) within the active military population and their connection to IGE. IGE can be caused by various factors, including exposure to bacterial pathogens, protozoa and/or certain viruses, and active duty military personnel are at high risk during deployments.

Using electronic medical records obtained through the Defense Medical Surveillance System, Riddle and his colleagues identified 31,866 cases of FGD, including irritable bowel syndrome, functional constipation or diarrhea, and dyspepsia, in active duty personnel between 1999 and 2007. Matching each case to four corresponding non-FGD controls, the team calculated FGD incidence rates, as well as performed an assessment of differential risk for FGD associated with the type of IGE exposure.

The researchers found a significant association between IGE and all FGD, with the highest risk of functional diarrhea and irritable bowel syndrome and moderate risk with functional constipation and dyspepsia. They also found that risk of FGD generally increased nearer to IGE exposure and that exposure to bacteria was associated with the highest risk overall.

Importantly, 28.8% of active duty personnel studied still received FGD-related care two years after their initial diagnosis.

The second study looked at the high frequencies of GERD and mental health disorders that were reported among exposed World Trade Center responders. Dr. Douglas Brand and Yvette Lam, MD, were part of a team at the Long Island World Trade Center Responder Center that examined the results of 697 World Trade Center responders who were seen in 2005 to determine whether these conditions persisted over time and whether they were related to one another.

Among these responders, 41% of those examined had GERD, more than twice the 20% incidence rate among the general population. Furthermore, patients with GERD also had a higher prevalence of mental health disorders, including posttraumatic stress disorder and depression. In fact, patients with greater numbers of mental health disorders had progressively higher rates of GERD at their assessment: one mental health disorder 47.27%, two mental health disorders 64.4%, 3 mental health disorders 69.7%, and 4 mental health disorders 72.2%.

“Eight years after 9/11 we are still realizing the after-effects on those who responded and participated in the massive clean-up efforts” said Brand.

Source: American College of Gastroenterology