Risk analysis of upper gastrointestinal tract disorders in the health preservation strategy among the military personnel involved in combat operations

Relevance . Professional health preservation in the military personnel is a pivotal objective of military medicine. The current situation demonstrates a shortage of comprehensive data regarding the risk factors contributing to the development of upper digestive tract pathologies among combatants. The objective is to assess the apparent prevalence of upper gastrointestinal tract diseases including both newly diagnosed cases and exacerbations of pre–existing conditions by evaluating the impact, quantity, and intensity of specific risk factors among servicemen of the Russian National Guard operating under different military service conditions, with a focus on combatants. Methods . The study enrolled the military personnel (n = 256) of the Russian National Guard North Caucasus District who are characterized by a complicated gastrointestinal history, including 118 combatants and 138 non–combatants. The groups were formed randomly as the patients were admitted to hospital for treatment and rehabilitation. Based on the incidence data from February 2022 to February 2023, the prevalence of upper gastrointestinal tract diseases (Chapter XI of the International Classification of Diseases and Related Health Problems, ICD–10) was assessed by frequency analysis using contingency tables. The epidemiological significance of risk factors was evaluated using attributable risk metrics, including attributable fraction, relative risk, and odds ratio. Results and analysis. Comparative incidence of gastrointestinal diseases showed a higher prevalence of isolated and combined acute erosive and ulcerative lesions of the esophageal, gastric, and duodenal mucosa, as well as chronic duodenal ulcers (K20–K31 in the ICD–10) among combatants, predominantly observed in career officers 93 (79 %). Meanwhile, in the control group, chronic peptic ulcer disease was more prevalent (41 %), with fewer cases of combined erosive and ulcerative lesions (7 %), likewise predominantly among career officers (29 %). These observed clinical and epidemiological patterns and statistically significant group differences were not random, but linked to specific risk factors. Risk analysis in the combatant group confirmed the significance of 11 controllable risk factors (total attributable weight 43 %) and 9 partially controllable factors (total attributable weight 33 %) contributing to the development of the identified gastrointestinal pathologies. Conclusion . Understanding the dynamics in the prevalence of upper gastrointestinal tract diseases considering both new cases and exacerbations of existing conditions and their association with specific risk factors, including their number and intensity of impact in the examined military personnel of the Russian Guard deployed for military service under various conditions (using combat veterans as an example) provides a framework for further risk management strategies. This approach is essential to reduce the incidence of digestive system diseases among military personnel and is a critical component of health preservation strategies in combat environments.