Is gastritis associated with Gulf War (GW) exposures?

From the Guidelines

There is no conclusive evidence that gastritis is directly caused by Gulf War exposures. While some Gulf War veterans report higher rates of gastrointestinal symptoms including gastritis, research has not established a definitive causal link between specific Gulf War exposures (such as chemical weapons, pesticides, smoke from oil well fires, or vaccines) and gastritis development 1. The Department of Veterans Affairs recognizes certain unexplained illnesses in Gulf War veterans as presumptive conditions for disability benefits, but gastritis specifically is not among these unless it can be connected to service. Veterans experiencing gastritis symptoms (stomach pain, nausea, vomiting, bloating) should seek medical evaluation, as treatment depends on the underlying cause and may include acid reducers like proton pump inhibitors (omeprazole 20-40mg daily), H2 blockers (famotidine 20mg twice daily), or antibiotics if H. pylori infection is present 1. The complex nature of Gulf War exposures and the multifactorial causes of gastritis make it difficult to establish direct causation, though ongoing research continues to investigate potential connections between military service exposures and various health conditions. Some key points to consider in the management of gastritis include:

• The importance of diagnosing and treating H. pylori infection, which is a major cause of gastritis and gastric cancer 1
• The use of proton pump inhibitors and H2 blockers to reduce acid production and alleviate symptoms
• The potential need for antibiotics in cases of H. pylori infection, with consideration of increasing resistance to certain antibiotics 1
• The importance of a thorough medical evaluation to determine the underlying cause of gastritis and guide appropriate treatment.

From the Research

Gastritis and Gulf War Exposures

• Gastritis has been identified as a potential health issue in Gulf War veterans, with studies suggesting a link between Gulf War exposures and gastrointestinal problems 2, 3, 4, 5.
• A study published in 2005 found that 35% of patients with chronic gastrointestinal symptoms had gastritis with H. pylori, and 18% had gastritis without H. pylori 3.
• Another study published in 2021 discussed the mechanisms behind gastrointestinal problems in Gulf War illness, including an altered microbiome, a reactive enteric nervous system, or a leaky gut 2.
• The 2019 study on the gut-microbiome in Gulf War veterans found significantly different gut microbiome patterns among veterans with and without gastrointestinal symptoms, and those with gastrointestinal symptoms had a greater abundance of certain phyla and families of bacteria 5.
• While the 2024 study on proton pump inhibitors dosage and duration in H. pylori eradication treatment does not directly address Gulf War exposures, it provides information on the treatment of H. pylori infection, which is relevant to gastritis 6.

Key Findings

• Gulf War veterans are at risk of developing gastrointestinal problems, including gastritis, due to their exposures during the war 2, 3, 4, 5.
• The exact mechanisms behind these problems are not fully understood, but may involve an altered microbiome, a reactive enteric nervous system, or a leaky gut 2.
• Treatment of H. pylori infection, which can cause gastritis, typically involves a combination of antibiotics and proton pump inhibitors 6.
• Further research is needed to fully understand the relationship between Gulf War exposures and gastrointestinal problems, including gastritis 2, 3, 4, 5.