New research plan tackles deployment-linked digestive woes

VA Research is planning a series of studies on to gain insight into the gastrointestinal and liver problems that beset many Veterans after deployments. The goal is to bring new treatments to bear as soon as possible.

The studies will be coordinated in the framework of a “roadmap” hammered out by GI and liver experts from VA and elsewhere. Many took part in a VA-sponsored conference in San Diego in May. A report on the meeting and the resulting roadmap will be in the journal Gastroenterology. It reflects the input of more than 20 clinicians and biomedical scientists.

Dr. Arun Sharma, a health science officer in VA’s Office of Research and Development (ORD), says VA patients have a “very high incidence” of GI conditions like irritable bowel syndrome, inflammatory bowel disease, and infectious diarrhea. Liver diseases such as cirrhosis are also common.

“Much of the discussion at the meeting focused on how many of these diseases can be triggered by severe stress and infections in military personnel who are deployed in different overseas environments,” says Sharma. He notes that combat exposure adds to the problem, both because of the emotional impact and the risk of physical wounds to the gut.

Like many other wounds of war, these ailments don’t necessarily get better once the service member is back home. They can become chronic. How and why that happens is of particular interest to the researchers. Some have already been studying how war-related conditions like PTSD worsen gut health over time.

“Emerging evidence indicates that deployment-related diseases such as PTSD, Gulf War illness, and traumatic brain injury can change the composition of gut microbes and further exacerbate GI and liver diseases,” notes Sharma, summarizing one of the themes in the journal paper.

These gut problems, in turn, lead to other health problems, both mental and physical.

As a result of the meeting and journal paper, ORD expects to fund several study proposals from VA researchers. The focus will be on the gut microbiome. That refers to the bacteria and other tiny organisms inside the intestines. Some bugs are friendly and vital to life. Others are harmful invaders.

The first step is gaining more knowledge of how these microbes affect GI and liver health. Clinical trials will build off that knowledge, testing and refining therapies such as probiotics or fecal transplants.

Dr. Zafar Iqbal, also a health science officer in ORD, says any lab research that is funded will have a clear path toward clinical trials.

“We’re looking for solutions to help Veterans. Certain studies have to be performed first so we have a clear idea of what combinations of bugs [therapies like probiotics—essentially, live bacteria that help the gut] need to be used, which are the most effective for treating different diseases. We want to support studies that will help us move to clinical trials. We’re interested in not only treating GI disease, but also helping pain, and other symptoms that impact quality of life. The end goal is to improve Veterans’ overall health.”

Visit the VA Research website to read more about this initiative, including an interview with VA researchers Dr. Jasmohan Bajaj and Dr. Pradeep Dudeja on the links between deployment and gut health. You can also learn more about VA research on gastrointestinal health in general.

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