Loma Linda University Loma Linda, CA, United States
Chandrasekhar Kesavan, PhD1, Anjali Das, BS1, Christian Jackson, MD1, Preeya Goyal, MD2, Richard M. Strong, MD1 1VA Loma Linda Healthcare System, Loma Linda, CA; 2Loma Linda University, Loma Linda, CA
Introduction: Many veterans deployed to Gulf war areas (GWA) suffer from chronic diarrhea diagnosed as IBS-D. Causes for IBS-D and Gulf War Syndrome that have been suggested include: exposure to depleted uranium, sarin gas, pyridostigmine bromide, burn pits, certain forms of biological warfare, and indigenous flora. Extensive laboratory and endoscopic evaluations in this population demonstrated only the presence of Vitamin D deficiency (VDD). To determine whether administration of Vitamin D (Vit D) to patients would not only rescue low Vit D levels but would also decrease IBS-D symptoms in Post-Gulf war (PGW) veterans, we performed a retrospective chart review of four thousand, two hundred and twenty-one patients seen from 9/1/2014 to 9/1/2020 at VA Loma Linda Healthcare System (VALLHCS).
Methods: The study protocol is approved by Institutional Review Board. This study produced one hundred and five PGW veterans with IBS-D in which sixty-nine patients completed the necessary evaluation and follow up. All patients were evaluated and treated by one investigator (RMS) and subjected to the same evaluations. The patients were advised to take Vit D (3000-5000 units) in the morning due to better absorption. Vit D levels, Vit D dose, and diarrhea before and after treatment were documented. The age, BMI, zip codes, and number of deployments to GWA of were compared with Vit D levels.
Results: One paired t-test showed that all patients exhibited VDD [t-11.62, df68 and sig(2-tailed) 0.0001]. Our data revealed no correlation of VDD with age (mean age of 40.5) and BMI (mean of 32.2) (Figure 1A and B). VDD did not change with number of times deployment in PGW veterans (Figure 1C). The data also shows that certain zip codes had a higher frequency of PGW veterans with VDD (Figure 1D). Not only did Vit D levels improve with treatment (P< 0.0001) (Figure 1E), but the number of bowel movements decreased (p< 0.0001) (Figure 1F).
Discussion: Our study demonstrates that the Vit D treatment daily in morning significantly reduced IBS-D in the PGW veterans and that even one deployment is sufficient to cause VDD in those deployed. There were no side-effects from repleting Vit D nor hypercalcemia post treatment. The study shows that VDD in the PGW veterans is not influence by age or BMI. In conclusion, administering daily dose of Vit D in PGW suffering from IBS-D can have significant impact on their symptoms and quality of life.
Figure: Figure 1
Disclosures: Chandrasekhar Kesavan indicated no relevant financial relationships. Anjali Das indicated no relevant financial relationships. Christian Jackson indicated no relevant financial relationships. Preeya Goyal indicated no relevant financial relationships. Richard Strong indicated no relevant financial relationships.
Chandrasekhar Kesavan, PhD1, Anjali Das, BS1, Christian Jackson, MD1, Preeya Goyal, MD2, Richard M. Strong, MD1. P2488 - A Retrospective Assessment Vitamin D Deficiency (VDD) and Chronic Diarrhea (IBS-D) from Veterans Deployed in the Gulf War, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.