Body system: Digestive SystemRegulation: 38 CFR § 4.114
Intestinal fistulous disease means you have abnormal openings or tunnels from your intestines to the outside of your body, causing drainage of intestinal contents through your skin. The VA rates this condition based on how severe the drainage is and whether you need special nutrition support to stay healthy. Ratings range from 30% for intermittent drainage lasting over 3 months, to 100% for severe cases requiring feeding tubes or IV nutrition.
Rating levels
- 100% — You qualify for this rating if your intestinal fistula (abnormal opening from your intestine to outside your body) is so severe that you need IV nutrition feeding directly into your bloodstream, OR you need tube feeding plus one of these conditions: your fistula drains so much that it fills four or more large ostomy bags daily, you need to change protective pads ten or more times per day due to drainage, or you're severely underweight (BMI under 16) with ongoing drainage for over a month in the past year. This rating covers the most serious cases where the fistula significantly impacts your nutrition and daily functioning.
- 60% — You must need special nutritional support delivered directly to your digestive system (enteral nutrition, usually through a feeding tube) AND have one of these conditions: either daily drainage that fills up to 3 small collection bags, or needing to change protective pads fewer than 10 times per day due to leakage, or being significantly underweight (BMI between 16-18, which is quite thin) with ongoing drainage for more than 2 months within the past year. This rating applies when you have an abnormal connection between your intestines and the outside of your body that causes these serious digestive and nutritional problems.
- 30% — For this rating, you must have an abnormal opening from your intestines to the outside of your body (called a fistula) that causes waste material to leak out through your skin intermittently rather than continuously. The drainage must have persisted for more than 3 months total within the past year, even if it comes and goes rather than happening every single day.