Lets talk about your poop for a minute

Jonathan Kaupanger
March 29, 2018 - 2:09 pm

Photo by Shanna Lockwood-USA TODAY Sports

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This is a real crappy article but it will come out alright at the end.

Abdominal pain, bloating, constipation and diarrhea - the ABC and D’s of a good time – are symptoms of inflammatory bowel disease (IBD) and American’s spend between $14.6 and $31.6 billion a year to deal with this issue. 

Veterans with post traumatic-stress (PTS) are twice as likely to develop autoimmune disorders, like IBD, as those without PTS. According to VA’s National Center for PTSD, eight out of every 100 people will deal PTS at some point in their lives. Up to 20 percent of veterans who served in Operations Iraqi Freedom and Enduring Freedom have PTS. 12 out of every 100 Gulf War vets have PTS and up to 30 percent of all Vietnam vets have had PTS in their lifetime. 

“IBD can occur in anyone, even at a very young age, and can have devastating disease and medication related complications,” said Dr. Akbar Waljee, a gastroenterologist at VA’s Ann Arbor Healthcare System in Michigan. First reported in VA’s Research Currents, Waljee continues, “this life-long disease requires medications that are, at best, 70 to 80 percent effective, can have burdensome side effects and are often quite expensive. Anything we can do to improve IBD disease outcomes and quality of life for veterans is very important to me.”

IBD is tough to treat. It’s a chronic disease that has unpredictable episodes of intestinal inflammation, or flares, that requires medication or hospitalization. Drugs used to treat the problem can take two to three months before they take full effect, so being able to predict a flare would be very helpful, and now VA can do exactly that.

“We are now able to predict the likelihood of a flare occurring and potentially intervene to prevent it by emphasizing the need to take medication consistently or change the medication,” says Waljee. “This model could be used in clinics to identify patients at high and low risk for a flair, making it easier to tailor their care.”

Waljee and his team can predict, with about 80 percent accuracy, if a patient will need steroids or IBD hospitalization up to six months out. This is done by looking for patterns in the patients’ record data, changes in bloodwork and looking at the history of flares.  The current fecal calprotectin test, which is expensive and not widely available, is only about 71 percent accurate. 

For veterans suffering stomach issues now, this new test isn’t available at all VAMC’s yet. Waljee says the next step is to prove this in a clinical setting.  He’s in the process of creating a follow-up study and then will be able to compare it with the current standard of care.  “My hope,” Waljee says, “is to implement the model at VA after additional evaluation, intervention development and partnerships are formed.”