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7308
§ 4.114 Schedule of ratings—digestive system.

Postgastrectomy syndromes

A group of digestive problems that may occur after surgical removal of all or part of the stomach.

What the rating means

Postgastrectomy syndrome is rated under the same formula used for chronic complications of upper gastrointestinal surgery (diagnostic code 7303). The possible ratings are 0%, 10%, 30%, 50%, and 80%.

A 0% rating covers a post-operative status with no symptoms. A 10% rating applies when nausea or vomiting is managed by ongoing medical treatment. A 30% rating requires two or more of these: vomiting twice or more per week or vomiting despite medical treatment; discomfort or pain within an hour of eating that requires ongoing dietary changes; or three to five watery bowel movements every day. A 50% rating requires at least one of these: daily vomiting despite dietary changes or medication; six or more watery bowel movements per day every day, or explosive bowel movements that are hard to predict or control; or post-meal lightheadedness with sweating and the need for medication targeting dumping syndrome or delayed gastric emptying. An 80% rating applies when continuous total parenteral nutrition or tube feeding is required for more than 30 consecutive days in the last six months.

VA will not combine this rating with ratings for most other digestive conditions listed in the schedule. When more than one of those conditions warrants a rating, VA assigns one rating under the code that best reflects the overall disability, and may raise it one level if the total picture is severe enough.

Evidence that helps

Medical records that document your surgical history, your current diagnosis, and the treatment you receive are the foundation of a rating for this condition. For a 10% rating, records showing a prescription or ongoing treatment plan for nausea or vomiting are relevant. For a 30% rating, records or provider notes that track how often you vomit, what dietary changes you follow and why, and how many watery bowel movements you have each day would support the criteria.

For a 50% rating, records showing daily vomiting despite dietary changes or medication, logs or provider notes about six or more watery bowel movements daily or unpredictable explosive bowel movements, or documentation of post-meal lightheadedness with sweating and a prescription specifically for dumping syndrome or delayed gastric emptying would speak directly to those criteria. For an 80% rating, records confirming that you received continuous total parenteral nutrition or tube feeding for more than 30 consecutive days within the last six months are key.

Your own statements, and statements from people who see you daily, describing how your symptoms affect eating, work, and everyday activities can help show the frequency and severity of symptoms that may not appear in every medical record.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.