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Oct. 27, 2009 -- Stress can be hard on your gut. And that may be especially true when the work environment is extraordinarily stressful -- such as cleaning up after the 9/11 attacks or serving in the military, according to researchers who have found a link between these stressful jobs and gastrointestinal problems.
The studies were presented this week at the annual meeting of the American College of Gastroenterology in San Diego.
Workers who helped with the cleanup at the World Trade Center after the 9/11 attacks are more likely than the general population to get GERD (gastroesopheal reflux disease), in which contents of the stomach travel back up to the esophagus, says Yvette Lam, MD, a gastroenterologist at Stony Brook University Medical Center, N.Y., who presented the results of a study at the meeting.
She also found an association between GERD and mental health disorders.
With her colleagues, she evaluated 697 patients, ages 34 to 50, who helped with the cleanup. At the first visit, conducted between October 2005 and September 2006, 41% had GERD, compared with about 20% of the general population.
The researchers also found those with GERD were more likely to have mental health disorders such as depression or anxiety. At the first visit, 21% of those with GERD had posttraumatic stress disorder (PTSD), 21.5% had depression, and nearly 30% had anxiety disorder.
In all, 413 patients came for the second visit conducted about two years later, to see if the problems persisted. At visit two, the mental health problems persisted, with 21.3% of those who had GERD at the first visit reporting PTSD and 32.8% reporting depression.
''The GERD prevalence also rose with an increasing number of mental health disorders," Lam says. Obesity, considered a risk factor for GERD, wasn't linked with it in this study. But exposure to such things as dealing with human remains was associated with both the GERD and the PTSD, she says.
Treatment of the mental health disorders may be crucial to resolving the GERD, Lam says.
Gastrointestinal problems are also prevalent in military personnel, says Mark Riddle, MD, DrPH, a researcher at the Naval Medical Research Center in Silver Spring, Md. Servicemen and servicewomen, he says, "are under a lot of stress as you can imagine during deployment."
Riddle says the fourth leading cause of visits to VA Medical Centers is gastrointestinal disorders.
To find out more, Riddle and his colleagues evaluated data from the Defense Medical Surveillance System, identifying nearly 32,000 cases of gastrointestinal problems in active duty U.S. military personnel between 1999 and 2007. Among the problems were constipation, diarrhea, irritable bowel syndrome (IBS), and indigestion after an infection of the stomach and intestines (gastroenteritis).