Gastrointestinal Disease in Pilots, 2001-2013

The frequency and distribution of gastrointestinal (GI) disease in the population of active duty Air Force pilots is poorly understood, even though GI illness can temporarily or permanently lead to disqualification from flying duties. Better understanding of GI disease within this population could yield considerable operational risk and human performance insight and provide data to use in assessing the effectiveness of current medical standards related to flight training and flying duties.

A dataset reflecting inpatient and outpatient healthcare visits from 2001 through 2013 was developed and reviewed. Gastrointestinal illness was grouped into 18 subcategories of disease, and the frequency and distribution of visits for these categories were tallied. The total burden of GI illness over the target dates was compared between pilots, nonpilot aircrew/special operational duty personnel, and nonaircrew/nonspecial duty personnel.

Esophageal disease and dyspeptic conditions were the two most frequently encountered diagnoses among all three population groups, comprising almost 50% of the gastrointestinal diagnoses in age and gender-matched samples of all three populations. The overall burden of disease over the total timeframe of the study was not statistically different in the three populations, with a median of four encounters per person for GI disease. Of interest, the total burden of disease increased over the course of the study period in all populations, driven in large measure by increases in esophageal disease and dyspeptic conditions.

The general distribution and overall burden of GI disease in populations of Air Force pilots, nonpilot aircrew/special operational duty personnel, and nonaircrew/nonspecial duty personnel were similar. The increase in esophageal and dyspeptic conditions over time warrants further attention.