Irritable bowel syndrome - A specified psychiatric condition Factor

In the SOP for irritable bowel syndrome the RMA has defined a specified psychiatric condition to mean:

(a)   a psychiatric condition with features of anxiety, including:

(i)        generalised anxiety disorder, ICD code 300.02; or

(ii)       panic disorder, ICD code 300.01; or

(iii)      adjustment disorder with features of anxiety, ICD code 309.24, 309.28, 309.3, 309.4, or 309.9; or

iv)      post traumatic stress disorder, ICD code 309.81; or

(b)     a psychiatric condition with depressive features, including:

(i)        major depressive disorder, ICD code 296.2 or 296.3; or

(ii)       neurotic depression, ICD code 300.4; or

(iii)      other depressive disorders, ICD code 311; or

(iv)      adjustment disorder with depressed mood, ICD code 309.0, 309.1, 309.4 or 309.28;

(b) (i)-(iii) above are covered by the SOP for depressive disorder.

The conditions named above are not the only psychiatric conditions with features of anxiety or depression. It is possible that a person may have a psychiatric condition with features of anxiety or depression other than the examples listed by the RMA eg anxiety disorder not otherwise specified (ICD 300.00) and obsessive-compulsive disorder (ICD 300.3).  Obtain medical advice if the evidence is not clear if a diagnosed psychiatric condition has features of anxiety or depression.

Last reviewed for CCPS 14 December 1998.

Preliminary questions [683]

21822 the veteran has suffered from a specified psychiatric condition at some time.

25643  the specified psychiatric condition is an illness or injury which is identifiable.

690        the veteran has established the causal connection between the psychiatric condition, and VEA service for irritable bowel syndrome.

21823 the veteran was suffering from the identified illness or injury, a specified psychiatric condition, within the six months immediately before the clinical onset of irritable bowel syndrome.

21806   the veteran has established the causal connection between the psychiatric condition and VEA service for the clinical onset of irritable bowel syndrome.

21808  the veteran has established the causal connection between the psychiatric condition and operational service for the clinical onset of irritable bowel syndrome.

or

21809  the veteran has established the causal connection between the psychiatric condition and eligible service for the clinical onset of irritable bowel syndrome.

or

21804 the clinical onset of the veteran's irritable bowel syndrome occurred after the end of the veteran's last period of VEA service.

21805 the veteran's irritable bowel syndrome permanently worsened.

21824 the veteran was suffering from the identified illness or injury, a specified psychiatric condition, within the six months immediately before the clinical worsening of irritable bowel syndrome.

21807   the veteran has established the causal connection between the psychiatric condition and VEA service for the clinical worsening of irritable bowel syndrome.

21810  the veteran has established the causal connection between the psychiatric condition and operational service for the clinical worsening of irritable bowel syndrome.

or

21811  the veteran has established the causal connection between the psychiatric condition and eligible service for the clinical worsening of irritable bowel syndrome.

Clinical onset and operational service [21808]

6024     the identified illness or injury, a psychiatric condition, is causally related to operational service.

Clinical onset and eligible service [21809]

6026     the identified illness or injury, a psychiatric condition, is causally related to eligible service.

Clinical worsening and operational service [21810]

6024     the identified illness or injury, a psychiatric condition, is causally related to operational service.

21859 the clinical onset of irritable bowel syndrome occurred prior to that part of operational service to which the identified illness or injury, a psychiatric condition, is causally related.

Clinical worsening and eligible service [21811]

6026     the identified illness or injury, a psychiatric condition, is causally related to eligible service.

21860 the clinical onset of irritable bowel syndrome occurred prior to that part of eligible service to which the identified illness or injury, a psychiatric condition, is causally related.

Irritable bowel syndrome - Episode of severe diarrhoea Factor

Diarrhoea is the acute onset of the passage of frequent loose watery motions accompanied by a marked urgency to defaecate. For diarrhoea to be a factor in the development of irritable bowel syndrome it must be an acute illness, caused by an infective organism, and of sufficient severity to warrant medical attention, or in the absence of medical intervention, lasting at least four days.

Last reviewed for CCPS 14 December 1998.

Investigative Documents

Type	Title	PDF Format	Word Format
Claimant Report	An Episode of Severe Diarrhoea	CR9078.pdf [5]	CR9078.docx [6]
Medical Report	An Episode of Severe Diarrhoea	MR9112.pdf [7]	MR9112.docx [8]

Preliminary questions [684]

692        the veteran has had an episode of severe diarrhoea at some time.

21826 the veteran has suffered from an episode of diarrhoea which required medical intervention at some time.

or

21827 the veteran has suffered from an episode of diarrhoea which lasted for four days at some time.

22282 the veteran has had an episode of severe diarrhoea which was due to an infective organism at some time.

21825  the veteran has established the causal connection between the episode of severe diarrhoea and VEA service for irritable bowel syndrome.

21836 the veteran suffered from an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical onset of irritable bowel syndrome.

21830   the veteran has established the causal connection between the episode of severe diarrhoea and VEA service for the clinical onset of irritable bowel syndrome.

21832  the veteran has established the causal connection between the episode of severe diarrhoea and operational service for the clinical onset of irritable bowel syndrome.

or

21833  the veteran has established the causal connection between the episode of severe diarrhoea and eligible service for the clinical onset of irritable bowel syndrome.

or

21804 the clinical onset of the veteran's irritable bowel syndrome occurred after the end of the veteran's last period of VEA service.

21805 the veteran's irritable bowel syndrome permanently worsened.

21837 the veteran suffered from an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical worsening of irritable bowel syndrome.

21831   the veteran has established the causal connection between the episode of severe diarrhoea and VEA service for the clinical worsening of irritable bowel syndrome.

21834  the veteran has established the causal connection between the episode of severe diarrhoea and operational service for the clinical worsening of irritable bowel syndrome.

or

21835  the veteran has established the causal connection between the episode of severe diarrhoea and eligible service for the clinical worsening of irritable bowel syndrome.

Clinical onset and operational service [21832]

22421 on operational service, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical onset of irritable bowel syndrome.

Clinical onset and eligible service [21833]

22422 on eligible service, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical onset of irritable bowel syndrome.

22427 on eligible service, as a causal result of eligible service duties, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical onset of irritable bowel syndrome.

Clinical worsening and operational service [21834]

22424 on operational service, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical worsening of irritable bowel syndrome.

22425 on operational service, as a causal result of operational service duties, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical worsening of irritable bowel syndrome.

25639 the clinical onset of irritable bowel syndrome occurred prior to the episode of severe diarrhoea due to an infective organism on operational service.

Clinical worsening and eligible service [21835]

22423 on eligible service, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical worsening of irritable bowel syndrome.

22426 on eligible service, as a causal result of eligible service duties, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical worsening of irritable bowel syndrome.

25640 the clinical onset of irritable bowel syndrome occurred prior to the episode of severe diarrhoea due to an infective organism on eligible service.

Irritable bowel syndrome - Having been a prisoner of war Factor

Prisoners of war are identified on the client data base.

The veteran's statement of service will also record the fact that he was a prisoner of war.

The Repatriation Commission has defined a prisoner of war as a veteran who has been confined in a camp, building, prison or other restrictive area as a prisoner of the enemy, even if the confinement was for only a few hours.

Last reviewed for CCPS 14 December 1998.

Clinical onset and operational service [8625]

30034 there is some evidence that having been a prisoner of war may be a factor in the development of the condition under consideration.

292       the veteran was a prisoner of war at some time.

25485 the veteran was a prisoner of war before the clinical onset of the condition under consideration.

Irritable bowel syndrome - Inability to obtain appropriate clinical management for irritable bowel syndrome Factor

In the case of irritable bowel syndrome appropriate clinical management may include:

• achieving patient understanding of the chronicity of the condition, and that while alleviation of symptoms is possible, there is no cure.
• drug treatment to alter the abnormal colonic motility,
• mild sedation with tranquillisers,
• the use of anticholinergic drugs such as dicyclomine,
• treatment of troublesome diarrhoea with diphenoxylate or loperamide.
• treatment of constipation by an increase in dietary bulk [unprocessed bran or psyllium bulk laxatives].

After the exclusion of any underlying pathology, routine general physical examinations, and stool examinations for occult blood should be regularly undertaken.

Further information about irritable bowel syndrome can be found in its Diagnostic Criteria contained in the Research module of CCPS.

Inability to obtain appropriate clinical management

Last reviewed for CCPS 14 December 1998.

Investigative Documents

Type	Title	PDF Format	Word Format
Medical Report	Inability to Obtain Appropriate Clinical Management	GQACM.pdf [9]	GQACM.docx [10]

Preliminary questions [21840]

21841 there is some evidence that an inability to obtain appropriate clinical management for irritable bowel syndrome, may be a factor in the worsening of the condition under consideration.

21804 the clinical onset of the veteran's irritable bowel syndrome occurred after the end of the veteran's last period of VEA service.

21805 the veteran's irritable bowel syndrome permanently worsened.

21842 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome at some time.

21843 the inability to obtain appropriate clinical management for irritable bowel syndrome contributed to the clinical worsening of irritable bowel syndrome.

21845  the veteran has established the causal connection between the inability to obtain appropriate clinical management for irritable bowel syndrome, and VEA service for the clinical worsening of irritable bowel syndrome.

21846   the veteran has established the causal connection between the inability to obtain appropriate clinical management for irritable bowel syndrome, and operational service for the clinical worsening of irritable bowel syndrome.

or

21847   the veteran has established the causal connection between the inability to obtain appropriate clinical management for irritable bowel syndrome, and eligible service for the clinical worsening of irritable bowel syndrome.

Clinical worsening and operational service [21846]

21848 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome during operational service.

21849 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome during operational service, as a causal result of operational service duties.

21853 the veteran's inability to obtain appropriate clinical management for irritable bowel syndrome during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

21850 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome because of an illness or injury which is identifiable.

21851  the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for irritable bowel syndrome is causally related to operational service.

21852 the clinical onset of irritable bowel syndrome occurred prior to that part of operational service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for irritable bowel syndrome is causally related.

Clinical worsening and eligible service [21847]

21854 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome during eligible service.

21855 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome during eligible service, as a causal result of eligible service duties.

21856 the veteran's inability to obtain appropriate clinical management for irritable bowel syndrome during eligible service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

21850 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome because of an illness or injury which is identifiable.

21857  the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for irritable bowel syndrome is causally related to eligible service.

21858 the clinical onset of irritable bowel syndrome occurred prior to that part of eligible service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for irritable bowel syndrome is causally related.