GASTRITIS

Summary

The veteran served from March 1987 to February 1991, including service in the Southwest Asia theater of operations during the Persian Gulf War. The veteran appealed the denial of service connection for gastrointestinal problems, specifically ulcerative colitis and irritable bowel syndrome (IBS), claiming these conditions were due to Persian Gulf War environmental hazards and ionizing radiation. The Board granted service connection for recurrent gastritis, noting that service treatment records showed an early gastritis diagnosis in service and a recent VA examination confirmed gastritis. The Board found the evidence persuasive for gastritis in the absence of contrary evidence. However, the claims for ulcerative colitis and IBS were remanded due to conflicting medical evidence regarding the Veteran's diagnoses and the need for further evaluation. The Board requires a VA intestinal examination to determine the relationship between any identified intestinal disability and active service, specifically addressing Persian Gulf exposures and other conceded Toxic Exposure Risk Activities (TERAs). The examiner must opine on the likelihood of onset during service or relation to service incidents, considering all potential exposures.

Rationale

Service treatment records show diagnosis of early gastritis in service.; VA examination confirmed gastritis.; No persuasive evidence to the contrary.

Full Decision Text

Citation Nr: A26009617
Decision Date: 02/02/26	Archive Date: 02/02/26

DOCKET NO. 241216-499189
DATE: February 2, 2026

ORDER

Entitlement to service connection for recurrent gastritis is granted. 

REMANDED

Entitlement to service connection for a recurrent intestinal disability to include ulcerative colitis and irritable bowel syndrome (IBS), claimed as due to exposure to Persian Gulf War environmental hazards and ionizing radiation, is remanded.

FINDING OF FACT

Recurrent gastritis originated during active service.  

CONCLUSION OF LAW

The criteria for service connection for recurrent gastritis have been met.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. 

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service from March 1987 to February 1991. 

In November 2024, the Agency of Original Jurisdiction denied service connection for "gastrointestinal problems and irritable bowel."  In November 2024, the Veteran submitted a Decision Review Request: Board Appeal (Notice of Disagreement), VA Form 10182, but did not select a Board of Veterans' Appeals (Board) review option.  In December 2024, the Veteran submitted a Decision Review Request: Board Appeal (Notice of Disagreement), VA Form 10182, and elected the Direct Review docket.  The Board may only consider the evidence of record at the time of the Agency of Original Jurisdiction decision on appeal.  38 C.F.R. § 20.301.  If evidence was submitted during the period after the Agency of Original Jurisdiction issued the decision, the Board did not consider it in its decision.  38 C.F.R. §§ 20.300, 20.301, 20.801.  If the Veteran would like Department of Veterans Affairs (VA) to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim, VA Form 20-0995, and submit or identify this evidence.  If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered.  38 C.F.R. § 3.2501.  Specific instructions for filing a supplemental claim are included with this decision.  

Service Connection for Recurrent Gastritis

Service connection may be granted for recurrent disability arising from disease or injury incurred in or aggravated by active service.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a).  Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303(d).  

The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

The service treatment records reflect that the Veteran was seen for gastritis.  A June 1989 treatment record states the Veteran was diagnosed with "early gastritis." 

The report of a July 2024 stomach examination conducted for the Department of Veterans Affairs (VA) states the Veteran was diagnosed with gastritis. 

The service treatment records convey that the Veteran was diagnosed with early gastritis.  He was diagnosed with gastritis on VA examination.  In the absence of any persuasive evidence to the contrary, the Board concludes that service connection for recurrent gastritis is warranted.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303.

REASONS FOR REMAND

Entitlement to service connection for a recurrent intestinal disability to include ulcerative colitis and IBS, claimed as due to exposure to Persian Gulf War environmental hazards and ionizing radiation, is remanded.

The Veteran asserts that service connection for a recurrent intestinal disability is warranted as the diagnosed ulcerative colitis and IBS are related to his Persian Gulf War environmental hazards and other in service Toxic Exposure Related Activities (TERAs).  

Unfortunately, another remand is required in this case.  Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the Veteran's claim so that he is afforded every possible consideration.  

VA's duty to assist includes,
.

REASONS FOR REMAND

Entitlement to service connection for a recurrent intestinal disability to include ulcerative colitis and IBS, claimed as due to exposure to Persian Gulf War environmental hazards and ionizing radiation, is remanded.

The Veteran asserts that service connection for a recurrent intestinal disability is warranted as the diagnosed ulcerative colitis and IBS are related to his Persian Gulf War environmental hazards and other in service Toxic Exposure Related Activities (TERAs).  

Unfortunately, another remand is required in this case.  Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the Veteran's claim so that he is afforded every possible consideration.  

VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive.  McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121, 124 (1991).  When VA undertakes to obtain an evaluation, it must ensure that the evaluation is adequate.  Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). 

Service connection may be granted on a presumptive basis for a Persian Gulf veteran who exhibits objective indications of qualifying chronic disability, including resulting from undiagnosed illness, that became manifest either during active service in the Southwest Asia theater of operations during the Persian Gulf War, or to a degree of 10 percent or, and which by history, physical examination, and laboratory tests cannot be attributed to any known clinical diagnosis.  38 U.S.C. § 1117; 38 C.F.R. § 3.317(a)(1).  The term "Persian Gulf veteran" means a veteran who served on active military, naval, or air service in the Southwest Asia Theater of operations during the Persian Gulf War.  38 C.F.R. § 3.317(e)(1).  

A "qualifying chronic disability" for VA purposes is a chronic disability resulting from (A) an undiagnosed illness, (B) a medically unexplained chronic multi-symptom illness that is defined by a cluster of signs or symptoms such as (1) chronic fatigue syndrome, (2) fibromyalgia, (3) functional gastrointestinal disorders (excluding structural gastrointestinal diseases).  Note to paragraph (a)(2)(i)(B)(3): Functional gastrointestinal disorders are a group of conditions characterized by chronic or recurrent symptoms that are unexplained by any structural, endoscopic, laboratory, or other objective signs of injury or disease and may be related to any part of the gastrointestinal tract.  Specific functional gastrointestinal disorders include, but are not limited to, IBS, functional dyspepsia, functional vomiting, functional constipation, functional bloating, functional abdominal pain syndrome, and functional dysphagia.  These disorders are commonly characterized by symptoms including abdominal pain, substernal burning or pain, nausea, vomiting, altered bowel habits (including diarrhea, constipation), indigestion, bloating, postprandial fullness, and painful or difficult swallowing.  Diagnosis of specific functional gastrointestinal disorders is made in accordance with established medical principles, which generally require symptom onset at least 6 months prior to diagnosis and the presence of symptoms sufficient to diagnose the specific disorder at least 3 months prior to diagnosis.  38 U.S.C. § 1117(a)(2); 38 C.F.R. § 3.317(a)(2)(i)(A)(B).  

"Objective indications of chronic disability" include both "signs," in the medical sense of objective evidence perceptible to a physician, and other, non-medical indicators that are capable of independent verification.  To fulfill the requirement of chronicity, the illness must have persisted for a period of six months.  38 C.F.R. § 3.317(a)(2), (3).  Signs or symptoms that may be manifestations of undiagnosed illness include, but are not limited to, the following: (1) fatigue; (2) signs or symptoms involving skin; (3) headache; (4) muscle pain; (5) joint pain; (6) neurologic signs or symptoms; (7) neuropsychological signs or symptoms; (8) signs or symptoms involving the respiratory system (upper or lower); (9) sleep disturbances; (10) gastrointestinal signs or symptoms; (11) cardiovascular signs or symptoms; and (12) abnormal weight loss.  38 C.F.R. § 3.317(b).

An VA October 2024 Toxic Exposure Risk Activity (TERA) Memorandum states, the Veteran was exposed to herbicide agents, ionizing radiation, and asbestos and served in Southwest Asia theater of operations.  

An August 
 (2) signs or symptoms involving skin; (3) headache; (4) muscle pain; (5) joint pain; (6) neurologic signs or symptoms; (7) neuropsychological signs or symptoms; (8) signs or symptoms involving the respiratory system (upper or lower); (9) sleep disturbances; (10) gastrointestinal signs or symptoms; (11) cardiovascular signs or symptoms; and (12) abnormal weight loss.  38 C.F.R. § 3.317(b).

An VA October 2024 Toxic Exposure Risk Activity (TERA) Memorandum states, the Veteran was exposed to herbicide agents, ionizing radiation, and asbestos and served in Southwest Asia theater of operations.  

An August 2006 VA treatment record states that the Veteran presented a history of an April 2006 diagnosis of ulcerative colitis on colonoscopy.  The Veteran was diagnosed with ulcerative colitis.  VA clinical documentation dated in March 2021 states that the Veteran was diagnosed with "IBS controlled with medication."  

VA clinical documentation dated in September 2023 states that in 2023 the Veteran underwent a colonoscopy and the finding was inflammatory bowel disease. 

The report of a November 2023 VA examination states the Veteran was diagnosed with ulcerative colitis and did not have a current diagnosis of IBS. 

The report of a July 2024 VA intestinal examination states the Veteran was diagnosed with ulcerative colitis and was treated with loperamide and mesalamine. 

The record is in conflict as to whether the Veteran has been diagnosed with recurrent IB during any relevant period.  Further VA intestinal evaluation is needed.  That is a pre decisional error.  

The matters are REMANDED for the following action:

Refer the Veteran's records to a VA physician for a VA intestinal evaluation to assist in determining the relationship between any identified intestinal disability and active service.  The examination notice should be incorporated into the record.  The examiner must review the record and should note that review in the report.  A rationale for all opinions should be provided.  The examiner should:

(a.) Identify all recurrent intestinal disabilities found in the record.  The examiner should specifically state whether the Veteran has recurrent irritable bowel syndrome (IBS).

(b.) Opine whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that any identified intestinal disability had its onset during active service or is related to any incident of service, including his service in Southwest Asia and the other conceded Toxic Exposure Risk Activities (TERAs).  The examiner must address the total potential exposure through all applicable military deployments, and the synergistic, combined effect of all TERAs. 

 

 

J. T. HUTCHESON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S. Smith, Associate Counsel 

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.