There is no diagnostic code in the VA rating schedule called "chronic constipation." The condition is not listed anywhere in 38 CFR 4.114, so VA rates it under the listed code that most closely matches the cause and symptoms, a process governed by 38 CFR 4.20. In practice, four codes do almost all the work: DC 7319 (irritable bowel syndrome), DC 7356 (gastrointestinal dysmotility syndrome), DC 7332 (impairment of sphincter control, which expressly covers retention), and DC 7301 (adhesions of the peritoneum). The code your rater picks matters more than anything else in the claim, because the ceilings range from 30% to 100%.
This guide covers what changed in the May 2024 digestive system rewrite, the exact criteria under each of the four codes, how much each rating pays in 2026, the December 31, 2026 deadline that affects Gulf War veterans with functional constipation, and how to file.
Which Diagnostic Code VA Uses for Constipation
The right code depends on why you are constipated, not on how severe the constipation feels. Here is how the four realistic routes compare.
| Diagnostic Code | Condition | Rating Range | Best fit when |
|---|
| 7319 | Irritable bowel syndrome | 0% to 30% | Functional constipation with abdominal pain related to defecation, no structural cause found |
| 7356 | Gastrointestinal dysmotility syndrome | 10% to 80% | Documented motility disorder or chronic intestinal pseudo-obstruction, including constipation managed by prescribed dietary management |
| 7332 | Rectum and anus, impairment of sphincter control | 0% to 100% | Stool retention requiring a physician-prescribed bowel program, digital stimulation, or medication beyond laxatives |
| 7301 | Peritoneum, adhesions of | 0% to 80% | Constipation following abdominal surgery, trauma, or infection, with symptomatic adhesions |
The 0% levels for DC 7319 and DC 7356 are not printed in the schedule. They come from 38 CFR 4.31, which requires VA to assign 0% any time a diagnostic code has no noncompensable tier and the veteran does not meet the minimum compensable criteria.
What the May 2024 Digestive Rewrite Changed
VA overhauled the digestive system portion of the rating schedule in a final rule published March 20, 2024, effective May 19, 2024. Two of those changes reshaped how constipation claims are decided.
First, DC 7319 was renamed. It used to be "irritable colon syndrome (spastic colitis, mucous colitis, etc.)" and its 30% criterion literally read "severe; diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress." Constipation appeared in the text of the code itself. The new DC 7319 is titled "Irritable bowel syndrome (IBS)" and the word constipation is gone from the criteria, replaced by Rome-style symptom counting.
Second, and more useful for constipation claimants, the rewrite added a note directly under DC 7319:
"This diagnostic code may include functional digestive disorders (see § 3.317 of this chapter), such as dyspepsia, functional bloating and constipation, and diarrhea. Evaluate other symptoms of a functional digestive disorder not encompassed by this diagnostic code under the appropriate diagnostic code, to include gastrointestinal dysmotility syndrome (DC 7356), following the general principles of § 4.14 and this section."
That note is the closest thing to an official answer on this topic. VA is telling raters that functional constipation belongs under DC 7319, and that anything DC 7319 does not capture should go to DC 7356. DC 7356 itself is brand new as of the 2024 rewrite.
DC 7319 Criteria: The Default Route
DC 7319 is where most constipation claims land. The criteria as codified in the current 38 CFR 4.114:
| Rating | Criteria |
|---|
| 30% | Abdominal pain related to defecation at least one day per week during the previous three months, and two or more of the following: change in stool frequency, change in stool form, altered stool passage (straining and/or urgency), mucorrhea, abdominal bloating, or subjective distension |
| 20% | Abdominal pain related to defecation for at least three days per month during the previous three months, plus two or more of the same six symptoms |
| 10% | Abdominal pain related to defecation at least once during the previous three months, plus two or more of the same six symptoms |
| 0% | Service-connected but criteria for 10% not met (assigned under 38 CFR 4.31) |
Read the first clause of every tier carefully, because it is where most constipation claims fail. Abdominal pain related to defecation is required at all three compensable levels. A veteran with painless chronic constipation, no matter how infrequent the bowel movements, does not meet the 10% criterion under DC 7319 and will be rated 0%.
If you do have pain related to defecation, the two-symptom requirement is usually easy for a constipation-predominant veteran to satisfy. Reduced stool frequency is a change in stool frequency. Hard or lumpy stools are a change in stool form. Straining and the sensation of incomplete evacuation both fall under altered stool passage. Bloating and distension are separately listed. The problem is almost never the symptom count. It is the pain criterion and the three-month documentation window.
The maximum under DC 7319 is 30%. For the full breakdown of this code, see our VA disability rating for IBS guide.
DC 7356 Criteria: Gastrointestinal Dysmotility Syndrome
DC 7356 did not exist before May 2024. It is the only digestive code in the current schedule that names constipation as a qualifying symptom at a compensable level, and it goes to 80%.
| Rating | Criteria |
|---|
| 80% | Requiring complete dependence on total parenteral nutrition (TPN) or continuous tube feeding for nutritional support |
| 50% | Requiring intermittent tube feeding for nutritional support, with recurrent emergency treatment for episodes of intestinal obstruction or regurgitation due to poor gastric emptying, abdominal pain, recurrent nausea, or recurrent vomiting |
| 30% | Symptoms of chronic intestinal pseudo-obstruction (CIPO) or symptoms of intestinal motility disorder, including but not limited to abdominal pain, bloating, feeling of epigastric fullness, dyspepsia, nausea and vomiting, regurgitation, constipation, and diarrhea, managed by ambulatory care, and requiring prescribed dietary management or manipulation |
| 10% | Intermittent abdominal pain with epigastric fullness associated with bloating, and without evidence of a structural gastrointestinal disease |
The 30% tier is the one to know. It requires a motility diagnosis or CIPO symptoms plus prescribed dietary management, and it does not require abdominal pain related to defecation the way DC 7319 does. A veteran whose gastroenterologist has diagnosed slow-transit constipation or colonic inertia and prescribed a fiber and fluid regimen has a stronger argument at 30% under DC 7356 than at 10% under DC 7319. The dietary modification must be medically prescribed, not self-directed.
DC 7356 also carries its own note: use this code for illnesses associated with 38 CFR 3.317(a)(2)(i)(B)(3), meaning Gulf War functional gastrointestinal disorders, other than those that can be evaluated under DC 7319.
DC 7332: The Retention Code Most Veterans Miss
DC 7332 is titled "Rectum and anus, impairment of sphincter control," and veterans and representatives routinely assume it applies only to incontinence. It does not. Every compensable tier reads "incontinence or retention." Retention is the medical term for the inability to evacuate, and severe obstructed defecation, neurogenic bowel after a spinal cord injury, and pelvic floor dyssynergia can all produce it.
| Rating | Criteria (condensed) |
|---|
| 100% | Complete loss of sphincter control with incontinence or retention not responsive to a physician-prescribed bowel program, requiring surgery or digital stimulation, medication beyond laxative use, and special diet |
| 60% | Incontinence or retention partially responsive to a physician-prescribed bowel program, requiring surgery or digital stimulation, medication beyond laxative use, and special diet |
| 30% | Incontinence or retention fully responsive to a physician-prescribed bowel program, requiring digital stimulation, medication beyond laxative use, and special diet |
| 10% | Incontinence or retention fully responsive to a physician-prescribed bowel program, requiring medication or special diet |
| 0% | History of loss of sphincter control, currently asymptomatic |
The phrase "medication beyond laxative use" appears at 30%, 60%, and 100%, which tells you VA drew a deliberate line: routine laxatives alone will not carry a claim above 10% here. Digital stimulation and a formally prescribed bowel program are what move the rating.
There is a second reason DC 7332 is worth pursuing. The anti-combination rule in 38 CFR 4.114 bars combining ratings under DCs 7301 through 7329, 7331, 7342, 7345 through 7350, 7352, and 7355 through 7357 with each other. DC 7332 is not on that list. DC 7319 and DC 7356 are. So a veteran cannot hold separate ratings under 7319 and 7356, but a rating under 7332 is not barred by that rule, provided the manifestations being rated are genuinely distinct and the general anti-pyramiding rule at 38 CFR 4.14 is respected.
DC 7301: Constipation After Abdominal Surgery
If your constipation began after an abdominal surgery, penetrating trauma, or an intra-abdominal infection during service, DC 7301 is the likely code. Constipation is listed by name as one of the six qualifying symptoms at the 10%, 30%, and 50% levels.
| Rating | Criteria (condensed) |
|---|
| 80% | Persistent partial bowel obstruction that is inoperable and refractory to treatment, or requires TPN for obstructive symptoms |
| 50% | Symptomatic adhesions persisting or recurring after surgery, trauma, inflammatory disease, or infection, with clinical evidence of recurrent obstruction requiring hospitalization at least once a year, medically directed dietary modification other than TPN, and at least one of: abdominal pain, nausea, vomiting, colic, constipation, or diarrhea |
| 30% | Symptomatic adhesions as above, with medically directed dietary modification other than TPN, and at least one of the same six symptoms |
| 10% | Symptomatic adhesions as above, with at least one of the same six symptoms |
| 0% | History of peritoneal adhesions, currently asymptomatic |
Note that the 10% tier requires only symptomatic adhesions confirmed by a healthcare provider plus one symptom. Constipation alone satisfies the symptom element.
How Rating by Analogy Works
When VA rates an unlisted condition, 38 CFR 4.20 permits rating under a closely related disease or injury where the functions affected, the anatomical localization, and the symptomatology are all closely analogous. The regulation adds two limits worth knowing: conjectural analogies are to be avoided, and ratings assigned to organic diseases and injuries are not to be assigned by analogy to conditions of functional origin.
When that happens, 38 CFR 4.27 requires the rater to build a hyphenated code. The first two digits identify the body system, the last two digits are 99 for the unlisted condition, and the code actually used for the criteria follows a hyphen. For a digestive condition, that produces something like 7399-7319 on your rating decision. If you see a hyphenated code on your decision letter, the number after the hyphen is the criteria VA applied, and that is the set of criteria you must argue against on appeal.
The 2024 note under DC 7319 arguably takes functional constipation out of pure analogy territory, since VA has now stated in the regulation that the code may include functional constipation. Either way, the practical effect is the same set of criteria.
Gulf War Veterans: The December 31, 2026 Deadline
38 CFR 3.317 provides presumptive service connection for Persian Gulf veterans with qualifying chronic disabilities, and functional gastrointestinal disorders are one of the three listed medically unexplained chronic multisymptom illnesses. The note to that paragraph lists specific examples, and "functional constipation" is named explicitly.
The theater of operations covered by 3.317 includes Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations.
The regulation requires that the qualifying disability became manifest either during service in that theater or to a degree of 10 percent or more not later than December 31, 2026. That is a manifestation deadline, not a filing deadline, and it is the current date in the regulation after VA extended it in 2021. If you are a Persian Gulf veteran with functional constipation, getting the condition documented at a compensable level of severity before the end of 2026 is time-sensitive. Direct service connection remains available after that date, but it requires proving a nexus rather than relying on the presumption.
2026 VA Disability Pay by Rating
These are the monthly amounts for a veteran with no dependents, effective December 1, 2025, reflecting the 2.8% cost-of-living adjustment.
| Rating | Monthly Pay (Veteran Alone) |
|---|
| 0% | $0 |
| 10% | $180.42 |
| 20% | $356.66 |
| 30% | $552.47 |
| 50% | $1,132.90 |
| 60% | $1,435.02 |
| 80% | $2,102.15 |
| 100% | $3,938.58 |
At 10% and 20%, the payment is the same regardless of family size. Starting at 30%, VA adds amounts for a spouse, children, and dependent parents. A veteran rated 30% with a spouse and no children receives approximately $617.47 per month in 2026.
These figures are for the constipation rating alone. Most veterans carry several service-connected conditions, and the actual check is based on the combined rating calculated with VA math, not by adding the percentages together.
Secondary Service Connection for Constipation
Many constipation claims are stronger as secondary claims than as direct ones. Secondary service connection under 38 CFR 3.310 covers a condition proximately due to, or aggravated by, an already service-connected disability. Common paths:
- Opioid-induced constipation. Long-term opioid therapy for a service-connected back, knee, or neuropathic pain condition is a well-documented cause. The claim is that the constipation is proximately due to treatment for the service-connected condition.
- Medication side effects generally. Certain antidepressants, anticholinergics, iron supplements, and some antihypertensives slow bowel transit. If the prescription treats a service-connected disability, the side effect can be claimed as secondary.
- Neurogenic bowel. Spinal cord injury, cauda equina syndrome, multiple sclerosis, and diabetic autonomic neuropathy can all cause retention. These claims usually belong under DC 7332 rather than DC 7319.
- Hypothyroidism. Constipation is a recognized manifestation, and if the thyroid condition is service-connected the bowel symptoms are typically evaluated as part of that disability picture rather than separately, to avoid pyramiding.
A secondary claim needs a medical opinion tying the constipation to the service-connected condition or its treatment, stated at least at the "at least as likely as not" standard.
Evidence That Actually Moves a Constipation Rating
The criteria in all four codes are written around countable, documented facts. Build the file to match them.
- A gastroenterology diagnosis by name. Slow-transit constipation, colonic inertia, chronic idiopathic constipation, pelvic floor dyssynergia, or CIPO. A named diagnosis is what unlocks DC 7356.
- Objective testing. Colonic transit study, anorectal manometry, balloon expulsion test, or defecography. These rule structural disease in or out and separate a documented disorder from an unsupported complaint.
- A prescribed regimen in writing. Prescribed dietary management, a physician-ordered bowel program, or prescription medication beyond over-the-counter laxatives. The words "prescribed" and "physician-prescribed" appear throughout DC 7356 and DC 7332 for a reason.
- A three-month symptom log. DC 7319 measures abdominal pain related to defecation over the previous three months. A dated log of pain episodes, stool frequency, stool form, and straining maps directly onto the criteria.
- The DBQ. The examiner will typically use VA Form 21-0960G-3, Intestinal Conditions (Other Than Surgical or Infectious). Your own treating physician can complete the same form for you to submit as evidence.
How to File a Chronic Constipation Claim
- Get the diagnosis and the code you are aiming for. Decide before you file whether your facts fit DC 7319, DC 7356, DC 7332, or DC 7301. Name the condition on the application by its medical diagnosis, not as "constipation."
- Gather service treatment records and current medical records. You need evidence of an in-service event, injury, or illness for a direct claim, or evidence of the primary service-connected condition for a secondary claim.
- Obtain a nexus opinion if the claim is secondary or the link is not obvious. A private opinion that explains the mechanism, for example opioid therapy slowing colonic transit, is usually decisive.
- File on VA Form 21-526EZ. Submit online at VA.gov, by mail, or with the help of an accredited representative. Filing an Intent to File first preserves your effective date for up to one year.
- Attend the C&P exam. Describe your worst days, not your average day, and be specific about frequency and about anything you have been prescribed. Bring your symptom log.
- Review the decision letter for the diagnostic code. If VA assigned a hyphenated code such as 7399-7319 and you believe DC 7356 or DC 7332 better matches your symptoms, that is a specific, arguable error you can raise on a Supplemental Claim or Higher-Level Review.
Frequently Asked Questions
Is there a VA diagnostic code for chronic constipation?
No. The rating schedule at 38 CFR 4.114 has no code titled chronic constipation. VA rates it under the listed code that most closely matches the underlying condition, most often DC 7319 (irritable bowel syndrome) or DC 7356 (gastrointestinal dysmotility syndrome), and may assign a built-up code such as 7399-7319 under 38 CFR 4.27.
What is the highest VA rating for chronic constipation?
It depends entirely on the code. DC 7319 caps at 30%. DC 7301 goes to 80%. DC 7356 goes to 80%. DC 7332, which covers stool retention as well as incontinence, goes to 100%. The 100% level requires complete loss of sphincter control with retention that does not respond to a physician-prescribed bowel program and requires surgery or digital stimulation plus medication beyond laxatives plus a special diet.
Can I get a rating for constipation without abdominal pain?
Not under DC 7319. Every compensable tier of that code requires abdominal pain related to defecation. Painless chronic constipation should be pursued under DC 7356, which at 30% requires motility disorder symptoms managed by ambulatory care with prescribed dietary management, or under DC 7332 if retention requires a prescribed bowel program.
Can I get separate ratings for IBS and constipation?
No. Both are manifestations of the same bowel disability picture, and rating the same symptoms twice is barred by 38 CFR 4.14. The anti-combination rule in 38 CFR 4.114 also prohibits combining ratings under DCs 7301 through 7329 with each other. When more than one of those codes applies, VA assigns a single evaluation under the code reflecting the predominant disability picture and elevates it to the next higher level if the overall severity warrants.
Does constipation from pain medication qualify for VA disability?
It can, as a secondary claim under 38 CFR 3.310, if the opioid or other medication is prescribed to treat an already service-connected condition. You need a medical opinion linking the constipation to the medication, and the constipation is then evaluated under one of the digestive codes above.
Do Gulf War veterans get a presumption for chronic constipation?
Functional constipation is expressly named in the note to 38 CFR 3.317(a)(2)(i)(B)(3) as a functional gastrointestinal disorder, which is one of the qualifying medically unexplained chronic multisymptom illnesses for Persian Gulf veterans. The regulation requires the disability to have become manifest during service in the Southwest Asia theater or to a degree of 10 percent or more no later than December 31, 2026.
How did the 2024 digestive rewrite affect existing constipation ratings?
The new criteria took effect May 19, 2024 and do not automatically change a rating assigned before that date. If your symptoms have worsened, or if you believe the current criteria or a different diagnostic code would produce a higher evaluation, you can file a claim for increased rating. Veterans who were previously rated under the old irritable colon syndrome criteria, which named alternating diarrhea and constipation at the 30% level, should look closely at whether DC 7356 now fits better.
What if my constipation causes hemorrhoids?
Chronic straining is a recognized cause of hemorrhoids, and hemorrhoids are separately rated under DC 7336 at 0%, 10%, or 20%. Because DC 7336 is outside the 7301 through 7329 non-combination range, a separate secondary rating is possible where the manifestations are distinct. See our VA disability rating for hemorrhoids guide for the current criteria.
