It is common for veterans with Post-Traumatic Stress Disorder (PTSD) to experience gastrointestinal symptoms associated with their condition. But when investigating, a physical condition may not always be detected. This might lead veterans or their doctors to continue repeating these medical investigations, sometimes unnecessarily.


Research published as part of an on-going project into the frequency of physical investigations in veterans  and the impact of PTSD on health care utilisation has shown a higher rate of upper abdominal investigations in veterans with PTSD than in those without PTSD.


Why is this research important?

The psychological effects of PTSD are associated with many physical symptoms, some of which can mirror that of gastrointestinal conditions, including upper abdominal pain, nausea, dyspepsia and vomiting. To diagnose the cause of these symptoms, medical practitioners often need to investigate through upper endoscopy or abdominal ultrasound.


However, in some cases, investigations may not find any issues of concern, which may result in veterans with PTSD and gut symptoms being repeatedly tested as they search for a diagnosis.


“Through this research, which is part of a larger study, we’re aiming to inform and educate veterans to help them understand that some physical complaints can be part of the symptomology of PTSD. This can help veterans feel more secure in realising that their doctor has investigated appropriately, and repeated testing may not always be needed,” said Dr Mellor.


About our research

In light of our previous research that showed veterans with PTSD were up to 81% more likely to undergo colonoscopy than veterans without PTSD, we were interested in determining if a diagnosis of PTSD also impacted utilisation of upper abdominal investigations in veterans with PTSD.


This study analysed the same data set as the previous research, which included more than 138,000 case records of male veterans over the age of 50 who accessed health services funded by the Department of Veterans’ Affairs.


Key research findings

This study found that veterans with PTSD were 77-81% more likely to undergo upper gastrointestinal procedures than veterans without PTSD. A possible explanation for this is a bi-directional relationship between PTSD and gastrointestinal conditions, where chronic stress from trauma exposure triggers physiological processes that produce gut symptoms. The results may reflect, in part, limited clinician awareness of the association between PTSD and gut symptoms.


“Our results add strength to a large body of evidence demonstrating that individuals with PTSD utilise medical health services to a greater extent than those without PTSD. We know that PTSD symptomatology influences gastrointestinal investigation rate, and so more emphasis on clinician and patient education is recommended regarding stress-related gut symptoms,” said Dr Mellor.


The brief communication titled The impact of Post-Traumatic stress disorder on upper gastrointestinal investigations in Australian Defence Force veterans – a retrospective review was published in Internal Medicine Journal on the 5th of May 2023.  Read the  Research Article


The study was funded by Gallipoli Medical Research Foundation.


Learn more about our Veteran Health research.