Diagnostic Code 7326 · 38 CFR §4.114
Chronic enterocolitis is persistent or recurring inflammation involving both the small intestine and the colon — a combined small and large bowel inflammatory state. Like chronic enteritis (DC 7325), it is a broad category that captures veterans whose chronic GI inflammation does not fit a more specific diagnosis such as Crohn disease (typically rated under DC 7323 framework), ulcerative colitis (DC 7323), or microscopic colitis. Common causes include post-infectious enterocolitis after severe deployment-acquired GI infections (particularly when treatment was delayed or the infecting organism was resistant), radiation enterocolitis after pelvic radiation, ischemic enterocolitis after abdominal trauma or vascular disease, and certain chronic medication-induced colitis presentations. The clinical picture is similar to chronic enteritis but with additional colonic features: bloody diarrhea, mucus in the stool, lower abdominal cramping, and tenesmus alongside the small-bowel symptoms. The VA rates DC 7326 under a tier framework that mirrors chronic enteritis but reflects the broader anatomic involvement.
| Rating | Criteria |
|---|---|
| 10% | Mild chronic enterocolitis — occasional symptoms (diarrhea, abdominal cramping, mild weight loss) responding to dietary modification and intermittent medical management. |
| 30% | Moderate chronic enterocolitis — persistent symptoms with definite functional impairment (chronic diarrhea often with blood or mucus, weight loss, malabsorption, anemia), or recurring incapacitating flares requiring repeated medical management. |
| 60% | Severe chronic enterocolitis — symptoms producing substantial overall health impairment (significant weight loss, severe anemia, hypoalbuminemia, frequent hospitalization, recurrent gastrointestinal bleeding), OR ongoing requirement for parenteral nutrition or chronic immunosuppressive therapy. |
Colonoscopy with biopsy is the central study — it documents both the colonic inflammation and the distal small-bowel mucosa visible at the ileocecal valve. Capsule endoscopy or CT/MR enterography characterizes the small-bowel component. Biopsy histology distinguishes specific diagnoses (Crohn, ulcerative colitis, microscopic colitis, infectious colitis) from the broader DC 7326 category. Stool studies (cultures, parasites, C. difficile, calprotectin) rule out active infection and quantify the inflammatory burden. Blood work documents anemia, hypoalbuminemia, electrolyte abnormalities, and vitamin deficiencies. A symptom diary captures the flare pattern. Records of dietary modification, biologics, immunosuppressants, or parenteral nutrition demonstrate the management burden.
DC 7323 (ulcerative colitis) is the appropriate code when biopsy and clinical picture establish a diagnosis of ulcerative colitis specifically, and it serves by analogy for Crohn disease in many rating decisions. DC 7326 (chronic enterocolitis) is the broader catch-all category for combined small and large bowel inflammation that does not meet diagnostic criteria for a specific IBD. The DC 7323 rating ceiling reaches 100% for pronounced disease; DC 7326 caps at 60%. Getting the right diagnosis matters because the rating consequences differ substantially.
Yes. Severe enterocolitis from bacterial, parasitic, or viral GI infections can persist as chronic inflammation for months or years after the original infection is cleared by treatment. The mechanism involves persistent immune dysregulation in the bowel mucosa. A documented in-service severe infection plus current chronic enterocolitis can support service connection with a nexus opinion from a gastroenterologist.
Non-specific chronic inflammation on biopsy is consistent with chronic enterocolitis under DC 7326 when no more specific diagnosis applies. The rating still depends on the clinical severity rather than the biopsy specificity alone. A non-specific biopsy that nonetheless shows definite chronic inflammation supports the diagnosis; ongoing surveillance may eventually establish a more specific diagnosis as the disease evolves.