Post deployment illness Gulf War

The ground war lasted four days and resulted in 147 battlefield deaths, but almost 199,000 of the 698,000 people who were deployed have since qualified for some degree of service-related disability. Of those, 13,317 people are disabled by "undiagnosed conditions"; Medically Unexplained Symptoms; Medically Unexplained Physical Symptoms (MUPS) or Unexplained Symptoms

Friday, September 25, 2009

Chronic Gastrointestinal Illness in Persian Gulf Veterans

The survey concluded in 1996 and VA is just now talking about this in 2009.
The phrase "Approximately 25 percent of military troops who were deployed in the first Persian Gulf War returned with persistent gastrointestinal symptoms" is quite a statement.
I am one of them, you are to.
Why didn't the VA recommend a Study of our GI disorders/sympthoms?
Why didn't our VA Secertary demand VA- office of Research Development
create an Investigation on this health issue?
Venus-val

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Publication Date:
Friday, July 24, 2009
Federal Register Document Number:
E9-17658 ( html text pdf )
Publishing Agency:
Department of Veterans Affairs
Dates: Comments must be submitted on or before August 24, 2009.
Comments Close: 08/24/2009
Action: Notice.
Genre: Article
Part Name: Notices
Granule Class: Notice

SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Health Administration (VHA), Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden and includes the actual data collection instrument.
DATES: Comments must be submitted on or before August 24, 2009.

ADDRESSES: Submit written comments on the collection of information through http://www.Regulations.gov; or to VA's OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503, (202) 395-7316. Please refer to ``OMB Control No. 2900-New (10-21092a-c)'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 461-7485, fax (202) 273-0443 or e-mail denise.mclamb@mail.va.gov. Please refer to ``OMB Control No. 2900-New (10-21092a-c).''

SUPPLEMENTARY INFORMATION: Titles:
a. Survey of Chronic Gastrointestinal Illness in Persian Gulf Veterans, VA Form 10-21092a.
b. VA Research Consent Form (Cases), VA Form 10-2109b.
c. VA Research Consent Form (Control), VA Form 10-2109c.
OMB Control Number: 2900-New (10-21092a-c).
Type of Review: New collection.

Abstract: Approximately 25 percent of military troops who were deployed in the first Persian Gulf War returned with persistent gastrointestinal symptoms, typical of diarrhea-predominant irritable bowl syndrome. The data collected from the survey will assist VA in determining whether chronic gastrointestinal illness in Persian Gulf Veterans was caused by the presence of bacteria in the intestines and whether eradication of these bacteria reduces symptoms of chronic diarrhea.

An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The Federal Register Notice with a 60-day comment period soliciting comments on this collection of information was published on May 11, 2009 at pages 21853-21854.
Affected Public: Individuals or households.

Estimated Total Annual Burden:
a. Survey of Chronic Gastrointestinal Illness in Persian Gulf Veterans, VA Form 10-21092a--3,000 hours.
b. VA Research Consent Form (Cases), VA Form 10-21092b--41 hours.
c. VA Research Consent Form (Control), VA Form 10-21092c--31 hours.
Estimated Average Burden Per Respondent:
a. Survey of Chronic Gastrointestinal Illness in Persian Gulf Veterans, VA Form 10-21092a--45 minutes. b. VA Research Consent Form (Cases), VA Form 10-21092b--15 minutes.
c. VA Research Consent Form (Control), VA Form 10-21092c--10 minutes.
Frequency of Response: One time.
Estimated Number of Respondents:
a. Survey of Chronic Gastrointestinal Illness in Persian Gulf Veterans, VA Form 10-21092a--4,000.
b. VA Research Consent Form (Cases), VA Form 10-21092b--165.
c. VA Research Consent Form (Control), VA Form 10-21092c--189.
Dated: July 21, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9-17658 Filed 7-23-09; 8:45 am]
BILLING CODE 8320-01-P
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Title: Chronic Gastrointestinal Illness in Persian Gulf Veterans
Synopsis: This study surveyed a sample of Gulf War veterans from a National Guard unit and found these veterans were more likely to report a variety of digestive problems than non-deployed members from the same unit.

Overall Summary: See project objective. Overall Project Objective: Clearly define the most prevalent chronic gastrointestinal symptoms in a unit of Persian Gulf veterans. Results to Date: Survey completed. Have identified most prevalent symptoms. Note: Following is quoted from poster accepted for Poster Presentation at Digestive Disease week in San Diego, May 1995, Chronic Gastrointestinal Symptoms In Persian Gulf Veterans; MB Sostek, S Jackson, JK Linevsky, EM Schimmel, BG Fincke; Departments of Medicine and Social Services, Boston Veterans Affairs Medical Center and Boston University School of Medicine, Boston, MA.

Background: Persian Gulf Syndrome is characterized by a constellation of chronic symptoms postdating deployment to the Gulf Region in 1991. Intermittent diarrhea is one of the eight most commonly reported symptoms. The prevalence of non-diarrheal gastrointestinal (GI) symptoms is not well documented. Over the past year, we have received increasing referrals for evaluation of Persian Gulf veterans (PGV) with various GI complaints. The aims of this study were I) to determine the prevalence and spectrum of GI complaints in a representative sample from this population and II) to compare this data to a control group of soldiers not deployed to the gulf region.

Methods: A 4-page questionnaire was mailed to the 92 members of a National Guard Unit deployed to the Persian Gulf Region in 1991 and distributed to 44 members (controls) of the same unit who were not deployed to the Gulf Region in 1991. The questionnaire asked the veterans to grade current severity of 26 GI and 10 non-GI symptoms. The survey also asked veterans to recall occurrence of 5 GI symptoms either during or before the Dessert Storm mission. Results: 57/92 Persian Gulf veterans (62%) responded to the survey. All 44 of the controls returned the survey.

The table below summarized the reported frequency of several GI symptoms in this population: GI Symptom Before ODS After ODS Controls (Current) Loose Stool 2/57 (3%) 39/57 (68%)* 4/44 (9%) Abdominal Pain 2/57 (3%) 32/57 (56)* 3/44 (7%) Excessive Gas 5/57 (9%) 42/57 (74%)* 10/44 (23%) Nausea/Vomiting 2/57 (3%) 13/57 (23%) 1/44 (2%) Hematochezia no data 4/57 (7%) 0/44 (0%) *p<.0001 compared to symptom frequency before desert storm. Additional frequently reported GI symptoms among PGV's in this survey include: sensation of incomplete rectal evacuation post defecation 34/57 (60%), and watery bowel movements following episodes of abdominal pain 30/57 (53%). The most frequent non-GI symptoms were: fatigue 46/57 (81%), joint pains 42/57 (74%) and headache 38/57 (67%).

Conclusion: A significant number of veterans from a single National Guard unit, deployed to the Persian Gulf, developed GI symptoms while in that region. The majority of these veterans currently continue to report persistent loose stools, lower abdominal pain, excessive gas and tenesmus. Veterans in the same unit, who were not deployed to the Gulf region, report significantly fewer chronic GI symptoms at the present time. While these symptoms are suggestive of the development of irritable bowel syndrome following Persian Gulf deployment, further studies are needed to better understand the pathophysiology of this combination of chronic GI symptoms. Project: VA-18 Agency: Department Of Veterans Affairs Location: VAMC Boston P.I. Name: Mark Sostek Status: Complete Study Start Date: October 01, 1994 Estimated Completion Date: October 01, 1996 Specific Aims: 1. Determine and define symptom complex. 2. Look for underlying pathophysiology. Methodology: Survey of a single unit of Persian Gulf veterans. Hydrogen breath tests on affected individuals. Publications: Sostek M . High prevalence of chronic gastrointestinal symptoms in a national guard unit of Persian Gulf veterans.Am J Gastroenterol.1996;91:2494-7.

Why do VA and DOD Health Directors omit details?

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