Understanding Digestive Disorders Among Veterans
For many veterans, chronic digestive disorders develop as a direct result of their service experiences, from exposures to infections, medications, contaminated food or water, or even the severe stress you may have gone through. Conditions like IBS, Crohn’s Disease, GERD, and liver or pancreas disorders can severely limit your quality of life and daily functioning.
Accurate and detailed medical documentation is the foundation of an effective evaluation of your digestive condition. This guide empowers you to gather comprehensive medical evidence for your condition.
How the VA Rates Digestive Disorders
Department of Veterans Affairs (VA) evaluates conditions under Diagnostic Codes 7300–7348 (38 CFR Part 4, Subpart B). Ratings emphasize symptom frequency and severity, presence of incapacitating episodes, nutritional impairment, and significant weight loss:
Gastrointestinal Disorders (Examples):
- Irritable Bowel Syndrome (7319): Ratings determined by frequency of abdominal distress episodes (mild, moderate, severe), diarrhea, and constipation.
- Inflammatory Bowel Disease—Crohn’s & Ulcerative Colitis (7323): Ratings based on frequency of flare-ups, incapacitating episodes, severity of symptoms, malnutrition, anemia, weight loss.
- Gastroesophageal Reflux Disease (7346): Rated by symptoms severity/frequency, dietary restrictions, chronic medication reliance, and esophageal damage (e.g. strictures, Barrett’s esophagus).
- Pancreatitis (7347): Evaluated based on frequent incapacitating attacks, abdominal pain, diarrhea, nutritional impairment, pancreatic enzyme deficiency.
- Liver Conditions—Cirrhosis, Chronic Hepatitis (7312, 7345): Ratings consider severity of liver damage, presence of ascites, hepatic encephalopathy symptoms, nutritional impairment, need for frequent hospitalizations or ongoing treatment.
Essential Medical Documentation for Digestive Disorders
Objective clinical evidence and clear specialist records accurately represent your digestive condition. Documentation should include:
Gastroenterology Specialist Notes:
- Clearly stated diagnosis (e.g. “Crohn’s disease–active ileocolonic disease”)
- Frequency, duration, severity of symptoms and flares
- Detailed records of treatments and response
Diagnostic Testing Results (Relevant Examples):
- Endoscopy/Colonoscopy with biopsy: Noting inflammation, ulcerations, strictures, polyps
- Imaging Tests: CT enterography, MR enterography, abdominal ultrasound, capsule endoscopy (small intestine imaging), MRI/MRCP (pancreatitis, liver)
- GI Lab Values:
- CRP (>10 mg/L), ESR (>20 mm/hr in active IBD), fecal calprotectin (>250 µg/g indicating intestinal inflammation)
- Nutritional Deficits: Albumin (<3.5 g/dL indicates malnutrition), hemoglobin levels (anemia), vitamin B12, vitamin D deficiencies
- Liver Function Tests (LFTs): ALT, AST, bilirubin, alkaline phosphatase, GGT, albumin/PT/INR clearly indicating severity
- Specialized Tests: 24-hour esophageal pH monitoring (DeMeester >14.7 abnormal: significant reflux)
Weight and Nutritional Documentation:
- Clearly documented involuntary weight loss (5–20% over 6 months)
- Dietitian or nutritionist evaluations showing malnutrition status
- Records reflecting prescriptions for nutritional supplements or dietary changes
Functional Limitation Documentation:
- Detailed medical notes showing daily life limitations due to symptoms
- Documentation of frequency and duration of incapacitating episodes requiring complete rest or hospitalization
- Personal symptom logs and diaries, verified by specialist referencing
Secondary Conditions due to Digestive Disorders
GI disorders commonly lead to or worsen other conditions due to nutritional deficiencies, chronic inflammation, or medication effects:
- Mental Health Conditions (depression, anxiety): Clearly documented diagnosis, linked specifically to digestive symptoms (anxiety due to unpredictable flare-ups, social isolation)
- Musculoskeletal Disorders (arthritis): Associated joint pain or arthritis clearly linked to inflammatory bowel disorders
- Skin Conditions (erythema nodosum, pyoderma gangrenosum): Linked explicitly in specialist evaluations to inflammatory bowel diseases
- Peripheral Neuropathy: Nutritional deficiencies (B12, folate deficiencies) causing neurological impairment; supported by lab documentation and neurology specialist notes
- Chronic Fatigue Syndrome: Persistent fatigue linked explicitly to chronic inflammatory condition or anemia documented in medical notes
Related Guide: Chronic Fatigue Syndrome VA Rating- Understanding Qualifying Conditions
Examples: Vague vs. Strong Documentation
Crohn’s Disease Documentation
- Vague and Weak Example:
“Patient has Crohn’s Disease, occasional pain and diarrhea managed by medication.”
- Strong Documentation Example:
“Veteran diagnosed with moderate-to-severe Crohn’s Disease (ICD-10: K50.90); colonoscopy & biopsies (03/2024) demonstrate significant ulcerations/stricture formation in terminal ileum and ascending colon. CRP elevated at 32 mg/L (normal <5), fecal calprotectin 650 µg/g (normal <50). CT enterography confirms inflammatory bowel wall thickening.”
GERD Documentation
- Vague and Weak Example:
“GERD symptoms controlled with antacids.”
- Strong Documentation Example:
“Veteran has severe GERD (ICD-10: K21.0). Endoscopy (01/2024) shows severe erosive esophagitis Grade C and biopsy-confirmed Barrett’s esophagus. 24-hour pH testing (DeMeester score 42.8) reflects severe reflux not responsive to max medication (omeprazole 40mg twice-daily). Documentation of daily regurgitation, severe chest discomfort, nocturnal choking coughing disrupting sleep consistently. Surgical consultation recommends Nissen fundoplication due to medication failure.”
Key Diagnostic Tests and Lab Values Chart
| Lab Test | Indicator of Condition Severity |
| CRP | Elevated (>10 mg/L) (inflammatory bowel) |
| ESR | Elevated (>20 mm/hr) |
| Fecal Calprotectin | Elevated (>250 µg/g severe inflammation) |
| Serum Albumin | Decreased <3.5 g/dL (malnutrition) |
| Hemoglobin | Decreased <12.0 g/dL (anemia) |
Questions to Ask Your Medical Provider
- “Could we clearly document my diagnosis with symptoms frequency and severity?”
- “Please include specifics from my lab/imaging results clearly showing my current disease status.”
- “Can you document clearly how my condition impacts my ability to function daily, socially, occupationally?”
- “Would you reference my symptom diary/symptom tracking in your notes for clarity?”
Digestive Symptom Tracking Template
| Date | Abdominal Pain | No. Bowel Movements | Consistency | Blood in Stool | Dietary Issues | Fatigue Level (0–10) | Functional Limitations |
| (0-10) | Yes/No |
Quick Medical Terminology Reference:
- Dysphagia: Difficulty swallowing
- Steatorrhea: Fatty stools from malabsorption
- Melena: Black stools from internal bleeding
- Ascites: Fluid buildup in abdomen
- Tenesmus: Feeling of incomplete bowel evacuation
- Encephalopathy: Brain impairment due to liver disease
Remember: Choices Belong to You
You are always in control of your medical evidence and documentation. Engage with your medical providers proactively to obtain a clear, accurate, detailed clinical record reflecting your digestive health condition.
Carefully consult qualified medical professionals regarding your personal health situation.
Disclaimer:
This information is educational and not legal advice. We do not prepare, submit, or prosecute VA benefit applications. Consult qualified medical and legal professionals for individualized guidance.
