Eosinophilic Esophagitis and Gulf War Veterans | All You Need To Know

0:05Leah Bucholz Hey, guys. It's Leah B from Prestige Veteran Medical Consulting. I am a US army veteran, physician assistant, and former compensation and pension examiner. Today, I wanna come on and discuss eosinophilic esophagitis and how that can be related to VA disability. So many veterans are service connected for Eosinophilic Esophagitis and a variety of other gastrointestinal disorders.

0:24 Sometimes this, condition can be related on a primary or direct basis or can be connected on a secondary basis. Today I want to focus on how this can be related to Gulf War exposures because there are many veterans that have been service connected for the disorder as it relates to their Gulf War exposures. So let's start off by talking about what Eosinophilic Esophagitis is, Right? So a lot of people probably haven't even heard of that. Okay?

0:49 So I'm I'm gonna tell you what the Mayo Clinic defines it as. So it's a chronic immune system disease. With this disease, a type of white blood cell called an eosinophil builds up in the lining of the tube that connects your mouth to your stomach. This tube is called the esophagus. This buildup, which is a reaction to foods, allergens, or acid reflux can inflame or injure the esophageal tissue.

1:12 Damaged esophageal tissue can lead to difficulty swallowing or cause food to get stuck when you swallow. Eosinophilic esophagitis has been identified only since the early 90s but is now considered a major cause of digestive system illness. So some symptoms difficulty swallowing also called dysphasia, food getting stuck in the esophagus after swallowing also known as impaction, chest pain, often centrally located that does not respond to antacids, backflow of undigested food known as regurgitation. So let's see some causes so reactions of the esophagus so that lining of the esophagus reacts to allergens such as food or pollens, multiplication of eosinophils so those eosinophils multiply in your esophagus and produce a protein that causes inflammation, damage to the esophagus, so inflammation can lead to scarring, narrowing, and formation of excessive fibrous tissue in the lining of your esophagus, and so on and so forth. So there's really, you know, the bottom line here is that in eosinophilic esophagitis, you have an allergic reaction to an outside substance.

2:22 Okay? So this can get kinda tricky because with Gulf War illnesses, when it comes to the GI system, VA really does a great job of of really illustrating that it should be functional gastrointestinal disorders, not structural disorders that that they consider related. Okay? So if there is a functional disorder, that's generally gonna be constipation, diarrhea, IBS, functional dyspepsia, things that impair function. Right?

2:50 As opposed to structural disorders, which are things like inflammatory bowel disease, GERD, you know, things like that, ulcerative colitis, Crohn's disease, etcetera. So this condition is tricky because it's sort of like this haywire response of the immune system, right? So similar to like allergies or some, you know, which is well known to be related to Gulf War illness or Gulf War exposures in some veterans. Right? So I personally believe and I have seen this be service connected for many many veterans because of the nature of the disorder.

3:27 So I'd like to go over some of the literature that I use. Really should not need or require... Nexus letters are never required. Medical opinion letters are never required. They can just be helpful in some instances. But especially in presumptive cases, it should be pretty straightforward. Sometimes like, especially with this one, it's not really well defined. So sometimes I have seen, an opinion maybe from your treating doctor that can kinda outline some of these things. It might be helpful. It might not.

3:58 You, of course, would wanna follow-up with a legal professional to advise you on, you know, the specifics of your case. I'm not a legal professional. I'm not an attorney. I'm not a VSO. I'm just a medical professional. I work with a lot of attorneys that handle these types of cases and and have had a lot of success with them. So some of that literature that you might wanna take a look at or discuss with your treating doc. So an etiologic role for aeroallergens and eosinophils in experimental esophagitis published in the Journal of Clinical Investigation summarized that their investigations dissect the cellular and molecular mechanisms involved in eosinophil homing in the esophagus and demonstrate that intranasal allergen exposure induces marked eosinophil infiltration into the esophagus. Another one, gut DNA virome diversity and its association with host bacteria regulate inflammatory phenotype and neuro... Neuronal immunotoxicity in experimental goal for illness.

4:56 That is published in viruses. It just discusses enteric viral populations, especially bacteriophages were altered in Gulf War illness, and then it talks about, different pro inflammatory cytokines and changes that happen. So one more, health status of Persian Gulf War veterans, self reported symptoms, environmental exposures, and the effects of stress published in the International Journal of Epidemiology. So that's a good article as well. So there's not a ton, one more for you.

5:30 Systemic review of multisystem conditions in Gulf War veterans published in psycho... Psychological medicine looks at, summarizing multisymptom conditions in Gulf War veterans exposed to their comparison groups. So there's not there's not a ton of literature out there that's going to say, yes, eosinophilic esophagitis is caused by Gulf War exposure, but those aeroallergens, you have to extrapolate that data and and say, okay. The the veteran was exposed to some of these burn pits, these aero allergens, and could this, have provided some type of inflammatory response and hate wiring of the GI system. Right?

6:06 So this is very much along the lines of that allergic rhinitis, same kind of direction. Right? So I hope this was helpful. The ratings are always subject to change. I know there were a lot of gastrointestinal changes, back in March 2024. So it's it's always best to check on that to to hook up with your VSO or whoever's helping you file the claim to look and see, you know, where you may fall on the ratings for that, to look at the DBQ, to see what may be helpful for your C and P exam if you're gonna go for it. So if you haven't, you know, considered this, if you have eosinophilic esophagitis, it may be something that you want to consider especially if it started after you served at a specific location. If you were diagnosed in service specifically, it's something that can be related to service or if it's somehow secondarily related to another service connected disability that you have from a causation or aggravation standpoint. So please drop some comments if you guys have any thoughts on this. Please let me know if you have any other videos that you'd like to see in the future.

7:06 I know this one was a little tough, but I think it's important to shine that light on conditions that I see frequently that veterans I know suffer from, but they just may not be aware are things that can be related to service. All right. So thanks a lot for watching and talk to you guys soon.