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7333
§ 4.114 Schedule of ratings—digestive system.

Rectal or anal narrowing (stricture)

Abnormal narrowing of the rectum or anus that restricts the passage of stool.

What the rating means

VA rates rectal and anal stricture under diagnostic code 7333, with possible ratings of 10%, 30%, 60%, and 100%. The ratings are based on how much the opening is narrowed and how that narrowing affects your ability to have a bowel movement.

At 10%, there is luminal narrowing that is managed by changes in diet, with or without straining. At 30%, the lumen is reduced by less than 50% and you experience straining during defecation. At 60%, the lumen is reduced by 50% or more, with both pain and straining during defecation. At 100%, you are unable to open the anus and cannot expel solid feces at all.

This diagnostic code also covers dyssynergic defecation (levator ani) and anismus (functional constipation). If you have an ostomy, that is rated separately under diagnostic code 7329. VA will not combine this rating with most other digestive system ratings; instead, it assigns a single rating under the code that best reflects the overall disability picture and may raise it one level if the combined severity warrants it.

Evidence that helps

Medical records documenting the degree of narrowing are central to this rating. Imaging studies, colonoscopy or sigmoidoscopy reports, and anorectal manometry results can show how much the lumen is reduced, which directly separates the 30% and 60% levels. Surgical or procedure notes, including any dilation treatments, help establish the severity of the stricture over time.

Records showing pain during defecation support the 60% level, while documentation of straining alone can support the 30% level. For the 10% level, records showing the condition is controlled through dietary changes are relevant. At the 100% level, clinical findings or operative reports confirming inability to open the anus and pass solid stool would be needed.

Your own statements, and statements from people who live with you, describing how symptoms affect daily activities such as eating, working, or leaving home can add context to the clinical findings. Records from a gastroenterologist, colorectal surgeon, or primary care provider that consistently track symptom frequency and severity over time are particularly useful.

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.