Intestinal Conditions and IBS DBQ explained

What this DBQ covers

This is a broad questionnaire with separate sections for irritable bowel syndrome, inflammatory bowel disease, diverticular disease, surgery and several other intestinal disorders. Similar symptoms can occur in different diagnoses, but the sections are not interchangeable. The clinician records the established condition and applicable findings, including any surgical complications and diagnostic testing.

The important sections, explained

Match the findings to the intestinal diagnosis

This questionnaire contains separate sections for irritable bowel syndrome, inflammatory bowel disease and other intestinal disorders. IBS and inflammatory bowel disease are not interchangeable names. Bring the diagnosis and relevant specialist reports so the examiner can select the appropriate sections. Describe the pattern of bowel changes and pain in your own words, including when symptoms occur and how they affect routine activities, without using another diagnosis simply because its symptoms sound familiar.

Read the official form: page 3

Surgery and lasting effects

The surgical sections distinguish procedures and removal of portions of the small or large intestine. Later sections address additional conditions such as fistulas, celiac disease and motility disorders. An operative report can explain exactly what was done and what anatomy remains. If treatment changed eating, bowel routines or nutrition, describe the current requirements and identify clinical instructions. A general statement that you had bowel surgery may leave several important questions unanswered.

Read the official form: page 5

How to prepare useful information

Keep an accurate account of bowel symptoms, associated pain, treatment and daily disruption. Dates and patterns are more informative than a single description such as bad digestion. If you have had intestinal surgery, include the operative report because the procedure and the portion involved can affect which section applies. Describe any nutrition support or continuing complications that are actually documented.

Records to gather

Start with records you already have. Bring the relevant information to your clinician and explain any gaps or uncertain dates.

• Specialist notes and diagnostic records identifying the intestinal condition.
• A dated symptom account, including pain, bowel changes and treatment response.
• Operative and follow-up records, including documented complications or nutrition support when applicable.

A detail that is easy to miss

Check whether a symptom diary covers the period requested and whether it distinguishes separate events from continuing symptoms. Do not count multiple bathroom trips as multiple diagnosed attacks without context. After surgery, include the procedure report rather than relying only on the visible scar. If there are weight or nutritional changes, bring the dated measurements and medical assessment.

Find your way around the official form

These section headings come from the linked VA PDF. Each link opens the page where the section begins. Read the form's own instructions for the full questions and any required attachments.

1. SECTION I - DIAGNOSISPage 1
2. SECTION II - MEDICAL HISTORYPage 3
3. SECTION III - IRRITABLE BOWEL SYNDROMEPage 3
4. SECTION IV - INFLAMMATORY BOWEL DISEASEPage 4
5. SECTION V - DIVERTICULAR DISEASEPage 4
6. SECTION VI - SURGICAL PROCEDURE(S)Page 5
7. SECTION VII - CHRONIC COMPLICATIONS OF SMALL INTESTINE SURGERY (WITHOUT RESECTION)Page 5
8. SECTION VIII - RESECTION OF SMALL INTESTINEPage 5
9. SECTION IX - RESECTION OF LARGE INTESTINEPage 6
10. SECTION X - EXTERNAL INTESTINAL FISTULOUS DISEASEPage 6
11. SECTION XI - CELIAC DISEASEPage 7
12. SECTION XII - GASTROINTESTINAL DYSMOTILITY SYNDROMEPage 7
13. SECTION XIII- VISCEROPTOSISPage 8
14. SECTION XIV - TUMORS AND NEOPLASMSPage 8
15. SECTION XV - OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS, SYMPTOMS, AND SCARSPage 9
16. SECTION XVI - DIAGNOSTIC TESTINGPage 10
17. SECTION XVII - FUNCTIONAL IMPACTPage 11
18. SECTION XVIII - REMARKSPage 11
19. SECTION XIX - EXAMINER'S CERTIFICATION AND SIGNATUREPage 11

Who completes the clinical sections?

The healthcare provider completes the clinical assessment, identifies the records reviewed, and signs the questionnaire. You can gather records and describe symptoms and daily limitations. Measurements, diagnoses, and clinical conclusions belong to the examiner.

Check the official form's instructions with your provider before the appointment, including any examination or testing requirements. VA does not pay or reimburse the costs of having a private DBQ completed or submitted.

A completed DBQ can help document the medical condition. Whether it also answers a particular service-connection question depends on its content and the other evidence. VA may verify the form or request another examination.

Common questions

Are IBS and inflammatory bowel disease the same for this form?

No. They appear in separate sections and require different clinical findings. Share the diagnosis in your records and describe your symptoms accurately. The clinician should determine which sections apply rather than treating similar bowel symptoms as proof of the same underlying disease.

Do I need to describe bowel symptoms in detail?

Enough detail helps the clinician understand frequency, pattern and daily effects. Use straightforward language about what happened and when. You do not need to choose a severity label yourself or include unrelated personal information to make the history useful.

What should I bring after intestinal surgery?

Bring the operation report and relevant follow-up describing the procedure, remaining anatomy and treatment needs. A short note saying bowel surgery may omit whether any intestine was removed. Explain current bowel and nutrition routines separately from symptoms before surgery so the changes remain clear.