caa a22 4500 445797991 CHVBK 20180317145132.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1007/s10620-011-1762-3 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1762-3 Risk of Functional Gastrointestinal Disorders in U.S. Military Following Self-Reported Diarrhea and Vomiting During Deployment [Elektronische Daten] [Chad Porter, Kayleen Gloor, Brooks Cash, Mark Riddle] Introduction: Military personnel are frequently deployed to regions of the world with high travelers' diarrhea (TD) rates. Pathogens associated with TD have been linked to several post-infectious sequelae, including functional gastrointestinal disorders (FGD), such as irritable bowel syndrome (IBS) and functional dyspepsia. Furthermore, stress associated with deployment may potentiate the increased FGD risk. Aim: We sought to assess whether self-reported diarrhea, vomiting, and stressors during deployment were associated with increased FGD risk. Methods: Using active duty military medical encounter data from the Defense Medical Surveillance System (DMSS), we conducted a matched case-control study to assess the odds of FGD (IBS, functional constipation, functional diarrhea, dyspepsia) following self-reported diarrhea or vomiting during deployment. Only first-time deployers with detailed self-reporting of deployment-related exposures from 2008 and 2009 were included. Univariate and multivariate analyses were performed. Results: A total of 129 cases of FGD were identified, with the following distribution: constipation (n=67), dyspepsia (n=15), IBS (n=22), and overlapping disorders (n=25). Diarrhea and/or vomiting during deployment were significantly associated with the development of FGD. Other demographic factors were also associated with variable risk. We found no consistent effect of war-related stressors or non-combat-related correlates of stress. Conclusions: Deployment-related TD is common in deployed military personnel and is associated with an increased risk of several FGD. When considering effective countermeasures and mitigation strategies, both the acute effects and chronic sequelae of enteric infections should be considered. Increased emphasis on existing and novel primary prevention strategies are needed, as well as outcome studies among those developing these conditions. Springer Science+Business Media, LLC (Outside the USA), 2011 Military personnel nationallicence Functional gastrointestinal disorders nationallicence Travelers' diarrhea nationallicence Epidemiology nationallicence Porter Chad Enteric Diseases Department, Infectious Disease Directorate, Naval Medical Research Center, 503 Robert Grant Avenue, 20910-7500, Silver Spring, MD, USA aut Gloor Kayleen The George Washington University, Washington, DC, USA aut Cash Brooks National Naval Medical Center, Bethesda, MD, USA aut Riddle Mark Enteric Diseases Department, Infectious Disease Directorate, Naval Medical Research Center, 503 Robert Grant Avenue, 20910-7500, Silver Spring, MD, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/11(2011-11-01), 3262-3269 0163-2116 56:11<3262 2011 56 10620 https://doi.org/10.1007/s10620-011-1762-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1762-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Porter Chad Enteric Diseases Department, Infectious Disease Directorate, Naval Medical Research Center, 503 Robert Grant Avenue, 20910-7500, Silver Spring, MD, USA aut NATIONALLICENCE 700 1- Gloor Kayleen The George Washington University, Washington, DC, USA aut NATIONALLICENCE 700 1- Cash Brooks National Naval Medical Center, Bethesda, MD, USA aut NATIONALLICENCE 700 1- Riddle Mark Enteric Diseases Department, Infectious Disease Directorate, Naval Medical Research Center, 503 Robert Grant Avenue, 20910-7500, Silver Spring, MD, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/11(2011-11-01), 3262-3269 0163-2116 56:11<3262 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer