High-Stress Jobs Tough on GI System

(Ivanhoe Newswire) -- High stress, high exposure occupations are closely linked to long-term gastrointestinal disorders. This phenomenon is particularly apparent in soldiers who have seen combat and in first responders to the World Trade Center disaster in 2001.

Studies performed by the United States Navy and the State University of New York (SUNY), Stonybrook, examined the long-term effects of infectious gastroenteritis (IGE) among active duty military and the interaction between gastroesophageal reflux (GERD) and mental health disorders among World Trade Center workers.

Dr. Mark Riddle of the United States Navy led the study that examined functional gastrointestinal disorders (FGD) within the active military and their connection to IGE. During deployments, active duty military personnel are at high risk to IGE caused by bacterial pathogens, protozoa and certain viruses.

"In both historical and modern times, wherever and whenever military personnel have been placed into the austere environments of combat operations or humanitarian relief missions, the acute impact of IGE is present," Dr. Riddle was quoted as saying. "Until now, the long term consequences of IGE exposure and the resultant consequences have not been documented or considered. Given the self-limited nature of IGE and effective antibiotic therapy, we tend to relegate these infections to mere 'battle-field nuisances'. However, our view of disease burden must extend beyond the deployment time horizon and consider the health of the sailors, soldiers, marines and airmen who return home and become veterans. Consideration of both the acute illness and chronic sequelae reinforce our need to enhance current strategies and develop novel solutions to limit and prevent exposure at the outset."

Dr. Douglas Brand and Dr. Yvette Lam were part of a team at the Long Island World Trade Center (WTC) Responder Center that examined the results of 697 WTC responders who were seen in 2005 to determine whether gastroesophageal reflux (GERD) and mental health disorders (MHD) persisted over time and whether they were related to one another.

Forty-one percent of the responders examined still had GERD, more than twice the 20 percent incidence rate among the general population. Patients with GERD also had a higher prevalence of mental health disorders, including Post-Traumatic Stress Disorder and depression. In fact, patients with greater numbers of mental health disorders had progressively higher rates of GERD at their assessment.

The researchers evaluated other environmental and lifestyle factors commonly associated with GERD, including smoking and obesity, but found no association with the increased frequency of GERD among WTC workers. Length of exposure at the WTC site, however, correlated with the diagnosis of both PTSD and GERD.

"Eight years after 9/11 we are still realizing the after-effects on those who responded and participated in the massive clean-up efforts," Dr. Brand was quoted as saying. "Shortly after this highly stressful and toxic exposure, the appearance of GERD characterized by high co-morbidity with mental health disorders, but no relation to obesity or smoking, suggests that mental health disorders may play an important role in the persistence of GERD among these workers. Thus, treatment of the underlying mental health disorder may be necessary to resolve the physical manifestation of GERD."

SOURCE: Presented at the American College of Gastroenterology's Annual Scientific Meeting, San Diego, October 26, 2009

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