TABLE 4-9 Digestive System Diseases


Study Design






Eisen et al., 2005 (Vol. 4)

Cross-sectional, prevalence

1061 GWVs, 1128 NDVs

Physician evaluation, questionnaire for dyspepsia; GI symptoms and medical conditions reported from earlier survey

Dyspepsia (OR 1.87, 95% CI 1.16-2.99); self-reported gastritis (OR 1.57, 95% CI 0.88-2.78)

Age, sex, race, smoking, duty type, service branch, rank, years of education

Study limited by low participation rate, length of time since war; weak diagnostic criteria

Gray et al., 1996 (Vol. 4)

Retrospective cohort study (hospitalization records)

DoD hospitals: 547,076 GWVs; 618,335 NDVs

Digestive system diseases

All ORs < 1.0

Hospitalization rates and rate ratios adjusted for age, sex; multiple logistic-regression models adjusted for all observed demographic differences between groups

Study data reflect only hospitalization experience of persons who remained on active duty through September 1993

Gray et al., 2000 (Vol. 4)

Retrospective cohort study (hospitalization records)

GWVs (August 1990-July 1992, n = 652,979) and NDVs (n = 652,922) stratified by California residence, service, and service branch of all nondeployed veterans (n = 2,912,737)

Digestive system diseases

VA hospitals: PMR 1.12 (95% CI 1.05-1.18); DoD hospitals: PMR 0.98 (95% CI 0.96-0.99); COSHPD hospitals: PMR 1.11 (95% CI 0.97-1.24)

Hospitalization records were matched on sex, age

Findings might be influenced by chance or by potential confounders, including health registry participation

Sosteck et al., 1996 (Update)

Cross-sectional, prevalence

57 male GWVs, 44 NDVs of National Guard unit

Questionnaire about GI and non-GI symptoms with recall before, during, after Gulf War period

Prevalence of GI symptoms: abdominal pain 70% vs 9%; diarrhea 74% vs 18%; incomplete rectal evacuation 60% vs 7%; gas 74% vs 23%; decreased appetite 42% vs 7% (all p < 0.001)


Response rate 74%; limitations include small sample (recall before, during, after Gulf War), questionnaire (at time of assessment)

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