Mechanisms of Gulf War Illness

Many veterans with Gulf War Illness developed chronic gastrointestinal symptoms during their deployment to the Persian Gulf. The pathophysiologic mechanisms of these chronic gastrointestinal symptoms are not well understood but cause significant morbidity in veterans. Our proposed studies will provide an innovative and novel treatment trial for chronic gastrointestinal symptoms in veterans with Gulf War Illness that were deployed into war zones. Given that there are currently no specific treatments for these disorders, and that current symptomatic approaches are far from ideal, proof of principle of our trial would be an extremely important advance as it would not only have a beneficial impact on the health of many thousands of our veterans, but also it would substantially reduce the many negative economic effects of this ailment on the VA Health Care System.

Inclusion Criteria: 1. Veterans 18-65 years old with GWI and chronic GI symptoms (abdominal pain, diarrhea, bloating) that started during their deployment in the Persian Gulf 2. Veterans 18-65 years old with GWI and chronic GI symptoms (abdominal pain, diarrhea, bloating) 3. increased intestinal permeability on the lactulose/mannitol permeability test (ratio \>0.07) 4. able and willing to cooperate with the study Exclusion Criteria: 1. current participation in another research protocol or unable to give informed consent 2. women with a positive urine pregnancy test or breastfeeding 3. history of inflammatory bowel disease, lactose intolerance and/or celiac sprue 4. \+ hydrogen breath test for bacterial overgrowth 5. \+ anti-endomysial antibody titer 6. use of NSAIDs 2 weeks before or during the study 7. known allergy to glutamine or whey protein 8. abdominal surgery except for removal of gallbladder, uterus, or appendix \>6 months prior to entry into the study 9. Abnormal serum BUN and/or creatinine 10. Mannitol recovery out of the normal range of 5-25 U/g 11. history of kidney disease 12. allergies to monosodium glutamate 13. current use of anti-seizure medications