Diagnostic Code 7316 · 38 CFR §4.114
Cholangitis is inflammation of the bile ducts — the channels that drain bile from the liver and gallbladder into the small intestine. Chronic cholangitis is the smoldering, recurring form of that inflammation, often caused by repeated mild obstruction from gallstones, parasitic infection picked up during overseas deployment, autoimmune conditions like primary sclerosing cholangitis, or surgical scarring after gallbladder or liver procedures. Symptoms include intermittent right-upper-abdominal pain, low-grade fevers, jaundice during flares, itching, fatigue, and pale or clay-colored stools. The disease can be slowly progressive — repeated inflammation scars the ducts, which narrows them and produces more obstruction. The VA rates DC 7316 under the chronic cholecystitis framework from DC 7314.
| Rating | Criteria |
|---|---|
| 0% | Mild disease — episodic mild symptoms without functional impairment, normal liver enzymes between flares, no need for ongoing intervention. |
| 10% | Moderate disease — confirmed bile-duct inflammation on imaging or biopsy, intermittent symptoms (post-meal discomfort, fatty-food intolerance, fatigue), with infrequent acute flares averaging no more than two or three per year. |
| 30% | Severe disease — frequent recurring flares with right-upper-quadrant pain, fever, or jaundice, producing meaningful interference with daily life and often requiring repeated medical management. |
MRCP (magnetic resonance cholangiopancreatography) or ERCP imaging that shows duct narrowing, beading, or strictures is the strongest objective evidence. Liver enzyme panels showing elevated alkaline phosphatase and GGT during flares document active inflammation. A liver biopsy, if performed, characterizes the histology. Blood work for primary sclerosing cholangitis (autoantibodies, IgG4) is relevant when that is the underlying cause. Records from each acute flare — labs, imaging, treatment — establish the recurrence pattern that drives the rating. Service records or post-deployment infectious-disease workups that document a parasitic or bacterial trigger support the nexus when relevant.
Yes. Certain parasitic infections endemic to Southeast Asia, Central Asia, and parts of Africa can colonize the bile ducts and produce a chronic inflammatory state that persists long after the acute infection has been treated. Service in those regions, plus a post-service diagnosis of chronic cholangitis, plus a nexus opinion from a gastroenterologist linking the two is a viable pathway to service connection.
Primary sclerosing cholangitis (PSC) is a specific autoimmune subtype of chronic cholangitis with a characteristic imaging appearance and an association with inflammatory bowel disease. PSC is rated under DC 7316 like other forms of chronic cholangitis, but the underlying mechanism and the long-term outlook differ significantly. PSC tends to progress to cirrhosis more often, which is why secondary claims for hepatic complications matter more in PSC.
Gallstones (DC 7315) live in the gallbladder; cholangitis (DC 7316) is inflammation of the bile ducts themselves. The two can coexist — stones can migrate into the ducts and cause cholangitis — but they are distinct conditions with separate diagnostic codes. The imaging studies that confirm them are different (ultrasound for gallstones, MRCP for duct disease), and the long-term course of cholangitis is generally more progressive.