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ABOUT GASTROINTESTINAL 

HEALTH

• Gastrointestinal problems are among

the illnesses reported by many Gulf War 

Veterans. These problems include irritable 

bowel syndrome, which is marked by 

chronic cramping, bloating, and diarrhea.

• More than 1 million Americans have

inflammatory bowel disease, which 

includes Crohn’s disease and ulcerative 

colitis. Crohn’s disease affects the entire 

gastrointestinal tract, while ulcerative 

colitis is limited to the colon.

• Frequent heartburn, or gastroesophageal

reflux disease (GERD), is a common 

gastrointestinal issue. About one in 10 

Americans experiences GERD symptoms at 

least once a week.

• Colorectal cancer is the third most

common cancer in the United States.

VA RESEARCH ON 

GASTROINTESTINAL HEALTH: 

OVERVIEW

• VA researchers are exploring new

techniques to treat Clostridium difficile 

(C. difficile) infections, such as doses of 

non-toxic C. difficile spores and fecal 

transplantation. C. difficile is often resistant 

to standard treatments such as antibiotics.

• Researchers from three VA sites

developed new guidelines for screening 

and managing precancerous cells that 

could develop into colon cancer in patients 

with inflammatory bowel disease.

• VA has made it a priority to screen its

patients aged 50 years or older for colon 

cancer. Evidence from the American Cancer 

Society suggests that screening efforts 

have helped lower the number of deaths 

from colon cancer in recent years.

• VA researchers are looking for potential

drug therapies to help Veterans with 

gastrointestinal problems such as stomach 

ulcers, C. difficile infections, irritable bowel 

syndrome, inflammatory bowel disease, 

colon cancer, and GERD. They are also 

exploring less invasive treatments and 

seeking supportive strategies for Veterans 

during and after treatment.

SELECTED MILESTONES AND 

MA JOR EVENTS 

1950s – Greatly expanded, through 

the work of Dr. Morton I. Grossman, the 

understanding of the physiology and 

regulation of gastrointestinal secretions

1977 – Received the Nobel Prize in 

physiology or medicine (Dr. Rosalyn Yalow), 

for developing a new way to measure 

insulin and other hormones in the blood

2004 – Found that the open technique is 

superior to the laparoscopic technique for 

mesh repair of primary hernias

2013 – Learned that treatment with the 

drug infliximab and an immunomodulator 

significantly reduces the risk of 

hospitalization and surgery

2013 – Determined that weight is not a 

factor in whether proton-pump inhibitors 

can successfully treat gastroesophageal 

reflux disease

2015 – Found that giving spores of 

non-toxic C. difficile by mouth can stop 

repeated bouts of infection

RECENT STUDIES: SELECTED 

HIGHLIGHTS

• Giving spores of non-toxic C. difficile

by mouth can stop repeated bouts of C. 

difficile infection, found an international 

team of researchers led by Dr. Dale Gerding 

of the Edward Hines, Jr. VA Hospital. C. 

difficile is an intestinal bacterial infection 

that is often difficult to treat and frequently 

reoccurs. (Journal of the American Medical 

Association, May 5, 2015)

• A procedure called fecal

transplantation, which may date back 

thousands of years, can effectively 

battle C. difficile infections, according to a 

systematic review by VA and University of 

VA research on 

GASTROINTESTINAL HEALTH

Gastroenterology is a medical specialty that deals 

with the diagnosis and treatment of disorders of the 

digestive system. Such disorders may involve the 

digestive tract, pancreas, liver, or gallbladder.

(Continued on back)

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VA researchers are looking for potential drug therapies to 

help Veterans with gastrointestinal problems, exploring 

less invasive treatments, and seeking supportive strategies 

for Veterans during and after treatment.

Minnesota researchers. This procedure 

involves inserting stool containing 

healthy bacteria into sick patients to 

combat the infection. (Annals of Internal 

Medicine, May 5, 2015)

• Taking the drug infliximab (sold 

as Remicade) together with an 

immunomodulator significantly 

reduces the risk of hospitalization and 

surgery after one year in men with 

inflammatory bowel disease, found 

researchers from the Michael DeBakey 

VA Medical Center in Houston and 

Baylor College of Medicine. (Clinical 

Gastroenterology and Hepatology, 

October 2013)

• A study of more than 666,000 

Veterans of Iraq and Afghanistan 

showed that those with PTSD were 

more likely to have autoimmune 

disorders such as inflammatory 

bowel disease. The study was led by 

researchers at the San Francisco VA 

Medical Center. (Biological Psychiatry, 

Feb 15, 2015)

• About 1 in 10 Americans 

experiences GERD symptoms at least 

once a week. People who are obese 

are more likely to have GERD. A study of 

patients treated at the Kansas City, Mo., 

VA Medical Center and the University 

of Kansas showed that weight was not 

a factor in the success of the strongest 

treatment available for frequent 

heartburn, the proton-pump inhibitor 

esomeprazole. (Journal of Clinical 

Gastroenterology, September 2013)

• Current antibiotic therapies to treat 

H. pylori bacteria—a major cause 

of ulcers—may be obsolete, because 

the bug is now resistant to many 

common antibiotics. VA’s Dr. David 

Graham and two non-VA colleagues 

suggest that improving counseling 

and education for patients, reviewing 

the patient’s personal history with 

antibiotics, and taking into account 

local patterns of antibiotic resistance 

can boost the effectiveness of antibiotic 

regimens. (Clinical Gastroenterology and 

Hepatology, February 2014)

• A quarter of patients with low-risk 

benign tumors received follow-up 

colonoscopies too early, and more 

than half of patients with high-risk 

benign tumors received follow-up 

colonoscopies too late or not at all, 

according to a study by Durham VA and 

University of North Carolina researchers. 

System-level improvements are needed 

so that Veterans receive colonoscopies 

at the appropriate time, say the 

researchers. (Clinical Gastroenterology 

and Hepatology, March 2016)

• Multi-target stool DNA testing 

is significantly more sensitive 

at detecting colorectal cancer and 

precancerous lesions than a fecal 

immunochemical test, according a 

team led by to researchers at the Center 

for Innovation at Roudebush Veterans 

Affairs Medical Center in Indianapolis, 

Ind. However, multi-target stool DNA 

testing gives more false positives than 

fecal immunochemical testing. (New 

England Journal of Medicine, April 3, 

2014)

For more information on VA studies 

on gastrointestinal health and other 

key topics relating to Veterans’ 

health, please visit 

www.research.va.gov/topics

GASTROINTESTINAL HEALTH

Updated September 2016 • For a digital version of this fact sheet with active links to sources, visit www.research.va.gov/topics