From the Research
Yes, ulcerative colitis is associated with Persian Gulf War service, as evidenced by the higher prevalence of gastrointestinal symptoms in veterans who served in the Persian Gulf War compared to non-deployed veterans. The exact mechanism linking Gulf War service to ulcerative colitis isn't fully understood, but exposure to environmental hazards during deployment may play a role, as suggested by studies such as 1 and 2. These include oil well fires, chemical and biological warfare agents, pesticides, vaccines, and depleted uranium. Veterans with symptoms of ulcerative colitis (such as chronic diarrhea, abdominal pain, rectal bleeding, and fatigue) who served in the Persian Gulf War should inform their healthcare providers about their service history, as this information is important for diagnosis and treatment planning, and may qualify them for service-connected disability benefits through the VA.
Some key points to consider in the management of ulcerative colitis in veterans with a history of Persian Gulf War service include:
- The importance of screening for irritable bowel syndrome (IBS) in veterans with Gulf War Illness, as there is a high degree of comorbidity between the two conditions, as shown in 3
- The potential for altered microbiome, reactive enteric nervous system, or leaky gut to contribute to gastrointestinal problems in Gulf War Illness, as discussed in 4
- The need for a comprehensive approach to care, including consideration of non-gastrointestinal symptoms, as veterans with Gulf War Illness may experience a range of symptoms beyond just gastrointestinal issues, as noted in 5 and 2
Treatment typically involves anti-inflammatory medications like mesalamine, corticosteroids in acute flares, immunomodulators such as azathioprine or 6-mercaptopurine for maintenance, and biologics like infliximab or adalimumab for more severe cases. However, the most recent and highest quality study, 1, suggests that the development of irritable bowel syndrome, dyspepsia, diarrhea, bloating, and constipation is frequently seen in deployed Gulf War Veterans, and these gastrointestinal symptoms commonly persist upon returning home. Therefore, it is essential to prioritize the diagnosis and treatment of ulcerative colitis in veterans with a history of Persian Gulf War service, taking into account the potential for comorbidities and the need for a comprehensive approach to care.