The military is physically demanding. What can service members do to manage GI symptoms while meeting their physical requirements?

It’s really important to recognize when there is an issue, and how we do that if you’re not able to train or things are different than, previous. If your bowel movements are not as normal as they used to be. You know, recognizing a change is really important because you need to be mission ready. You need to be healthy, you need to be able to train and able to accomplish the mission. And if you’re not able to do that, then, you know, you’re not really able to function as a service person. And so recognizing when there is a change, recognizing when there is an issue and taking care of that. Seeking help and guidance, during that time is really important, and it, and you know I tell service people that, you know, it’s important to be your own advocate. Recognizing that when you have a problem, you need to get it taken care of, because only then will you be able to accomplish the goal and to be able to function in the mission.

Experiencing occasional stomach cramps, aches or heartburn can be normal. How do service members know when to seek care from a medical provider?

It’s really important to recognize what we call as clinicians “red flags” when you see blood in your urine or in your stool. When you’re not able to have a bowel movement within a couple of days. If that’s your normal then that’s okay, you can wait a little bit longer. If you have experienced some type of trauma, you know, within the military, sometimes we are faced with episodes where we may get hit within our abdominal region or in our back area, and those are things that, you know, kind of make you think twice when you experience pain. You know, other things, that especially for service women with female biology, if there’s any chance of pregnancy, then it’s really important to seek further guidance. When you cannot eat, without experiencing pain. When pain wakes you up in the middle of the night and it just doesn’t go away. Those are things that I would call “red flags,” that make you, you know, think twice and make you really think about seeking some type of care.

GI doctors might ask about some embarrassing symptoms. What can service members do before or during a visit to calm their nerves?

When you talk about your own health, one should not be embarrassed, first of all, but it’s good to write down those symptoms that you were having or that cause concern and cause you to seek care. Write them down because sometimes it’s easier to give a piece of paper than to actually talk about those things, and so, just you know, you can talk to yourself in the mirror and, you know, kind of get comfortable with talking about certain things, such as, you know, that change in bowel movements. You know, a lot of times we say, “Are you having diarrhea or when was the last time you had a bowel movement?” and you know, a lot of times it’s hard to be able to answer those questions without getting embarrassed, and so it’s important to, you know, get that comfort because that’s the only way that a clinician will be able to figure out what’s going on, and you know, knowing what is they need to focus more on by getting that history and the only way they can get that history is by you, the the patient, the service person, being able to expound on those symptoms.

What if a medical provider dismisses a service member’s symptoms? When do they know to advocate for a referral?

It’s really important that each service person recognizes that, number one, they are their own advocate. If they feel that they did not get the attention or feel that they just were not heard, then, you know, it’s best to, number one, go to their chain of command and really explain what’s going on and and the problems. And then, you know, as to potentially see another clinician, that’s okay. And especially, you know, when it comes to one’s health and so many times we don’t don’t feel that you have enough time to get those questions answered and things like that. So, you know, again, writing down the issues that you need to be addressed. Those symptoms, so that you can really focus in on what’s going on. And if you don’t feel that you’re being heard, then again, you know, go to your chain of command, see if you can see another clinician. Those things are okay, and they’re actually welcomed, especially if you do not feel that you’re being heard.

If a service member is diagnosed with a GI condition and the condition improves with medication or other treatment, can they remain in the military?

It really depends on the condition. There are certain things that are what we call rules based on the area of operation where you’re going. You know, for instance, if someone has Crohn’s Disease, there are certain areas where they cannot go unless they’re stable. And so that does not mean that you get out of the military, but you may need waivers, letters of stability. Different things will need to be presented to ensure that you’re going to be able to go to a certain area safely. It’s all about your health, and not only ensuring that you’re there to be able to accomplish the mission, but also making sure that you’re at your best and that your wellness and health is number one. So, there are, you know, rules and there’s different things that align up with different conditions, but again, knowing those and seeking the health of your healthcare clinician is really important to be able to know those things prior to any deployment or mobilizations that you may be facing.

Do some medications affect the ability to train or deploy?  Are there ways to treat GI conditions or improve symptoms without medication? 

It depends on which condition we have. A lot of times, it’s just a change in the diet, whereas we know that changes in diet can exacerbate, make conditions worse. It can also, a lot of times, make conditions better. You know, if you’re able to increase your fiber, if you’re having constipation, increasing fluids and water and  things like that can definitely improve certain conditions. If one may have celiac disease, you know, ensuring that they have a gluten-free diet, really helps to improve those particular symptoms. So, yeah, there are ways that we can help without medications, but again, it really is dependent on the condition, and what the treatment for that particular condition is.

Do GI conditions affect fertility?

There are certain conditions that have been found to affect fertility and I mentioned celiac disease. That’s the autoimmune disease and sometimes that can impact fertility. Something else that is not necessarily a GI condition, but individuals experience abdominal pain and that’s like endometriosis. It’s where, you know, the tissue, the endometrial tissue, grows outside of the uterus and a lot of times that can impact fertility. Just think about the stress and the change in one’s body. We know that those particular things can impact  fertility, so if you know, there could be some direct impacts, and then some indirect impacts, definitely.

One other thing is, if one is noting like unexplained weight loss, that’s really, really important and we know that we’re always trying to maintain a healthy weight, but if you’re losing weight, if you are not able to really hold on to what your normal weight is, if you’re having fever… Um, certain things are really important for one to know, that you know, I need to seek out some additional help ensuring that we continue to advocate for ourselves, continue as service people to recognize that, yes, mission is first and foremost, but if you’re not healthy enough, if you’re not well enough to accomplish that mission, then something is wrong and we need to  impact and make sure that we address those particular issues so that health and well-being, number one, because that definitely impacts readiness, and making sure that one advocates for themselves. If that’s not able to be accomplished, then there are others that will advocate for you.