[Gastrointestinal diseases and abdominal pain in combat veterans]

To analyze the role of consequences of combat stress in the development of gastrointestinal tract (GIT) diseases.

One hundred and sixty-one combat veterans aged 24 to 69 years were examined. All underwent a clinical and neurological examination using the McGill pain questionnaire (MPQ), Beck depression inventory, Kotenev trauma stress questionnaire, and visual analogue scale to determine pain intensity. Anxiety, impairments in memory and sleep, and depression were identified. The SF-36 questionnaire was used to estimate quality of life in the patients. Gastric secretory function was investigated; esophagogastroduodenoscopy, X-ray and ultrasound studies, clinical and biochemical blood tests, coprological examinations, fecal tests for dysbiosis, if indicated, occult blood were made.

Combat stress and its consequences as posttraumatic stress disorder have been shown to play an important role in the pathogenesis of GIT diseases and in the development of chronic abdominal pain. GIT diseases in combat veterans are in larger measure a sequel of impaired processes of adjustment to combat stress. Chronic abdominal pains were heterogeneous. On the one hand, chronic GIT disease serves as a source of pain syndrome; on the other hand, the central nervous system is of importance in the development of chronic abdominal pain.

In addition to therapy for GIT and hepatobiliary diseases, the treatment of GIT diseases in this category of patients involves psychotherapy and neuroprotection, aimed at reducing the consequences of combat stress in combat veterans.