{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T01:28:31Z","timestamp":1767835711180,"version":"3.49.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"11-12","funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015620","name":"Center for Innovations in Quality, Effectiveness and Safety","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015620","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015620","name":"Center for Innovations in Quality, Effectiveness and Safety","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015620","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Excess rates of Gulf War illness (GWI) and irritable bowel syndrome (IBS), two chronic multisymptom illnesses, have long been documented among nearly 700,000 veterans who served in the 1990-1991 Persian Gulf War. We sought to report the prevalence, characteristics, and association of GWI and IBS decades after the war in a clinical cohort of deployed Gulf War veterans (GWVs) who were evaluated at the Department of Veterans Affairs\u2019 War Related Illness and Injury Study Center (WRIISC) for unexplained chronic symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We analyzed data gathered from clinical intake questionnaires of deployed GWVs who were evaluated at WRIISC clinics between 2008 and 2020. We applied Centers for Disease Control (CDC) criteria to determine the prevalence of severe GWI. IBS was identified using Rome IV diagnostic criteria (current IBS) and veterans\u2019 self-reported \u201chistory of physician-diagnosed IBS.\u201d We examined associations between IBS and GWI using bivariate analyses and multivariable logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the N\u2009=\u2009578 GWVs evaluated by the WRIISC, severe GWI (71.8%), history of physician-diagnosed IBS (50.3%) and current IBS (42.2%) were all highly prevalent. Nearly half of GWVs with severe GWI met Rome criteria for IBS (45.8%), and over half reported a history of physician-diagnosed IBS (56.1%). In multivariable models, severe GWI was significantly associated both with current IBS (adjusted odds ratio (aOR): 1.68, 95% CI: 1.11, 2.54) and with veteran-reported history of physician-diagnosed IBS (aOR: 2.15, 95% CI: 1.43, 2.23). IBS with diarrhea (IBS-D) was the most common subtype among GWVs with current IBS (61.1%). However, IBS-mixed affected a significantly greater proportion of veterans with severe GWI, compared to veterans who did not have severe GWI (P\u2009=\u2009.03).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>More than 20\u2009years after the Persian Gulf War, our findings indicate a high degree of comorbidity between severe GWI and IBS among deployed GWVs seeking care for unexplained illnesses. Our results suggest GWVs with GWI should be screened for IBS for which evidence-based treatments are available and could potentially reduce symptom burden. Conversely, symptoms of IBS should trigger additional evaluation for non-gastrointestinal symptoms in deployed Gulf War veterans to identify possible GWI and ensure a comprehensive approach to care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usae260","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T14:59:37Z","timestamp":1716303577000},"page":"e2644-e2654","source":"Crossref","is-referenced-by-count":4,"title":["Irritable Bowel Syndrome in Veterans With Gulf War Illness Evaluated at VA\u2019s War-Related Illness and Injury Study Center"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9779-9522","authenticated-orcid":false,"given":"Alice B S","family":"Nono Djotsa","sequence":"first","affiliation":[{"name":"VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. 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DeBakey VA Medical Center , Houston, TX 77030,","place":["USA"]},{"name":"Big Data Scientist Training Enhancement Program (BD-STEP), VA Office of Research and Development , Washington, DC 20420,","place":["USA"]},{"name":"Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine , Houston, TX 77030,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5495-545X","authenticated-orcid":false,"given":"Sarah T","family":"Ahmed","sequence":"additional","affiliation":[{"name":"VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center , Houston, TX 77030,","place":["USA"]},{"name":"Section of Health Services Research, Department of Medicine, Baylor College of Medicine , Houston, TX 77030,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saurendro","family":"Ghosh","sequence":"additional","affiliation":[{"name":"VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center , Houston, TX 77030,","place":["USA"]},{"name":"Section of Health Services Research, Department of Medicine, Baylor College of Medicine , Houston, TX 77030,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deeksha","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Cooperative Studies Program Epidemiology Center-Durham, Durham VA Medical Center, Durham VA Health Care System , Durham, NC 27705,","place":["USA"]},{"name":"Department of Medicine, Duke University School of Medicine , Durham, NC 27710,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen H","family":"Boyle","sequence":"additional","affiliation":[{"name":"Cooperative Studies Program Epidemiology Center-Durham, Durham VA Medical Center, Durham VA Health Care System , Durham, NC 27705,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth J","family":"Gifford","sequence":"additional","affiliation":[{"name":"Cooperative Studies Program Epidemiology Center-Durham, Durham VA Medical Center, Durham VA Health Care System , Durham, NC 27705,","place":["USA"]},{"name":"Duke Margolis Center for Health Policy, Duke University Sanford School of Public Policy, Center for Child and Family Policy , Durham, NC 27708,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kellie J","family":"Sims","sequence":"additional","affiliation":[{"name":"Cooperative Studies Program Epidemiology Center-Durham, Durham VA Medical Center, Durham VA Health Care System , Durham, NC 27705,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0297-2949","authenticated-orcid":false,"given":"Donna L","family":"White","sequence":"additional","affiliation":[{"name":"VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center , Houston, TX 77030,","place":["USA"]},{"name":"Section of Health Services Research, Department of Medicine, Baylor College of Medicine , Houston, TX 77030,","place":["USA"]},{"name":"Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine , Houston, TX 77030,","place":["USA"]},{"name":"Graduate School of Biomedical Sciences, Baylor College of Medicine , Houston, TX 77030,","place":["USA"]},{"name":"Texas Medical Center Digestive Disease Center, Baylor College of Medicine , Houston, TX 77030,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Steele","sequence":"additional","affiliation":[{"name":"Veterans Health Research Program, Beth K. and Stuart C. 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