Inside the exam room
1. You will be asked how often belly pain occurred during the past three months and how it relates to bowel movements. Use a log or label your counts as estimates.
2. You will be asked about stool changes, urgency, straining, mucus, and bloating. Identify your symptoms, tests, and treatment.
3. You will be asked how symptoms interrupt daily life. Explain urgent breaks, accidents, changes to travel, and whether treatment helps.
How VA rates irritable bowel syndrome
Record when bowel movements cause pain and any changes in stool, frequency, urgency, mucus, or bloating. The table needs pain at the stated frequency plus at least two of the bowel problems listed below. VA rates IBS under the revised 38 CFR § 4.114, DC 7319. The current schedule uses frequency of abdominal pain related to having a bowel movement plus at least two of six bowel problems listed below; it no longer uses the former mild/moderate/severe wording.
What each rating percentage means
Match the whole description with your exam and records. A single symptom or illustration does not decide your rating.
| Rating | What the rule requires |
|---|---|
| 10% | Pain related to having a bowel movement at least once during the previous 3 months, plus at least two bowel problems listed below |
| 20% | Pain related to having a bowel movement at least 3 days per month during the previous 3 months, plus at least two bowel problems listed below |
| 30% | Pain related to having a bowel movement at least 1 day per week during the previous 3 months, plus at least two bowel problems listed below |
Check these details in your records
The examiner uses a condition form called a Disability Benefits Questionnaire (DBQ). Compare these items with your own records and explain what actually happens in daily life.
- Abdominal pain related to having a bowel movement at least once in the previous three months, plus at least two listed bowel changes10%Current DC 7319
- Abdominal pain related to having a bowel movement at least 3 days per month for 3 months, plus at least two listed bowel changes20%Current DC 7319
- Abdominal pain related to having a bowel movement at least 1 day per week for 3 months, plus at least two listed bowel changes30%Current DC 7319
What may happen in the exam room
- The examiner asks about your symptoms and examines your belly
- Review of testing used to rule out or identify other digestive conditions
- Review of treatment and symptom pattern
What the measurements tell you
- Frequency of pain related to having a bowel movement
- How often you have bowel movements and how the stool looks
- Straining or needing to rush to the bathroom
- Mucus in the stool, bloating, or feeling that the belly is swollen
Questions the examiner may cover
- How often is pain related to bowel movements?
- Which stool changes occur?
- How do urgency or symptoms affect work and travel?
- What testing and treatment have you had?
Questions to expect
How often was pain related to bowel movements during the past three months?
Explain: Use a diary or labeled estimate and explain the relation of pain to bowel movements.
Rating connection: DC 7319 uses this pain-frequency period plus associated bowel changes, not just the number of bathroom trips.
Which bowel changes accompany it?
Explain: Describe stool frequency or form, urgency or straining, mucus, bloating or distension, plus treatment and daily interruptions.
Rating connection: Each row also requires at least two listed bowel problems. Straining and urgency form one category, not two.
Your answer outline
Over [period], I have had [actual bowel symptoms] about [frequency]. Pain occurs [relationship to bowel movements, if any]. This changes [work, travel, or daily activity] by [specific effect]. [Treatment or adjustments] have [actual effect].
Mark approximate dates and counts as estimates.
My notes: ________________________
Service connection records
1. How is this connected to your service?
For a direct claim, identify your current disability, what happened in service, and evidence linking them. Being on active duty or orders alone does not prove that link.
- Write the 5 Ws and how: who was there; what happened; when; where; why you were there; how the problem began. Add duty status, treatment, witnesses, and records. Mark uncertain dates as estimates.
- Guard or Reserve: find your orders, dates, duty type, and any line-of-duty records. Active duty, training, and drills have different rules.
- Secondary condition: it may start after service. Identify the service-connected condition and evidence that it caused or worsened this problem. A medical opinion may help explain the link.
- Started before service? Record what changed during service. Presumptive condition? Check the required diagnosis and service history; qualifying claims do not require separate proof of a link.
- Already service connected and seeking an increase? Focus on what has worsened and the records showing it.
If you do not know the cause, say so. Do not guess a medical connection.
Explain what changes in daily life
Describe both what you can do and what becomes difficult. Include how often it happens and how long it lasts.
- Use a three-month symptom log when possible.
- Describe frequency and the specific bowel problems listed below.
- Explain effect on daily activities without exaggeration.
Common mistakes to avoid
- Using the old mild/moderate/severe rating rules
- Reporting diarrhea alone without pain frequency and other features
- Failing to distinguish other diagnosed digestive disease
Records to get ready before the exam
- Intestinal Conditions DBQ
- Stomach and bowel specialist notes and testing
- Medication records
- Three-month bowel-symptom log
Preparation notes
- Describe what happens in your own words.
- Do not change diet or medication for the exam without clinician guidance.
Important context
The six bowel problems in the rule: going more or less often; a change in stool shape; straining and/or urgently needing to go; mucus in the stool (mucorrhea); bloating; and feeling that the belly is swollen (subjective distension). At least two are needed along with pain at the stated frequency. Straining and urgency count together as one problem, not two.
Official rating rule and code numbers
Use this source to check the full rule and its medical terms: 38 CFR 4.114, DC 7319. Source review recorded 2026-09-04.
Could one health problem have caused another?
A condition VA has already linked to your service may cause another health problem or make it worse. VA calls this secondary service connection. Having both conditions does not prove the link. Your records need to show a current diagnosis and explain how the first condition or its treatment affected the second.
- Start with your records. Find the current diagnosis, the condition VA already linked to service, and evidence from someone qualified to explain the connection.
- Ask about cause and worsening. Did the first condition or its treatment cause the new disability, or make an existing disability worse? These are different questions. The rules call them causation under 38 CFR § 3.310(a) and aggravation under § 3.310(b). If both are raised by your records, the medical opinion should address both; answering only the cause question may not be enough (El-Amin).
- If treatment may be involved, collect the dates. List the medicine or surgery prescribed for the condition VA linked to service, the side effect, and the new diagnosis. Bring pharmacy records and dates when treatment started or stopped. A provider must explain the connection in your case; taking a medicine alone does not prove it.
- If weight gain may be involved, ask how it fits. Weight gain or obesity can be a step between the first condition and another diagnosed disability under VAOPGCPREC 1-2017. Obesity itself does not receive a VA disability rating.
- You do not need absolute certainty. VA uses the “at least as likely as not” standard and the reasonable-doubt rule under 38 CFR § 3.102. Ask a VA-accredited representative how the evidence applies to your claim.
- The same symptom cannot be counted twice. This is the rule against pyramiding in 38 CFR § 4.14. Mental-health diagnoses generally share one § 4.130 rating when they affect the same work and social abilities. Trouble sleeping may be a symptom rather than a separate disability.
- Check whether VA already assumes a link to service. Some conditions qualify based on where or when you served. These are called presumptive conditions. Examples can include chronic rhinitis, chronic sinusitis, hypertension after qualifying herbicide exposure, and type 2 diabetes. Sleep apnea (OSA) is not a PACT Act presumptive. Check eligibility before seeking a medical opinion about the link.
- An exam form and a medical opinion do different jobs. A Disability Benefits Questionnaire (DBQ) records the diagnosis and how severe it is. It may not explain why it is linked to service, often called a nexus. A VA-accredited veterans service organization (VSO) can help you file at no charge.
If another prescribed treatment may have caused a problem, ask your health care provider to record what happened and explain the connection in your case.
Sources: 38 CFR § 3.310 · 38 CFR § 4.14 · VA-accredited representatives
Other health problems to ask about
Use these notes to ask your provider about problems you already have. Your records must explain the connection. VA decides whether the condition is linked to service.
Ongoing constipation, diarrhea, or straining can contribute to hemorrhoids. If both IBS and hemorrhoids are diagnosed, bring your bowel log and treatment records. Ask your provider to explain any connection in your case. Have rectal bleeding checked; do not assume it is IBS or hemorrhoids.
Sources: NIH: IBS symptoms · NIH: hemorrhoid causes
Choose the related health problems you want to discuss. Your preparation packet will include the notes you select and the full condition guides available for them.