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Class 4. Impairment of the Whole Person, 46—75% Symptoms and signs of organic upper-digestive-tract disease are present or there is anatomic loss or alteration; and Symptoms are not controlled by treatment; or There is greater than a 20 pound loss of weight below the “desirable weight,” which is ascribable to a disorder of the upper digestive tract.
COLON AND RECTUM Objective procedures useful in establishing impairment of the colon and rectum include, but are not limited to:
(1) digital and endoscopic examination including anoscopy, proctoscopy, sigmoidoscopy, and colonoscopy;
(2) fecal microscopy and culture;
(3) biopsy; and
(4) fluoroscopy and radiography with contrast materials.
Classes of Colonic and Rectal Impairment
Class 1. Impairment of the Whole Person, 1—5% Signs and symptoms of colonic or rectal disease are infrequent and of brief duration; and No limitation of activities, special diet, or medication is required; and No systemic manifestations are present, and weight and nutritional state can be maintained at a desirable level;orThere are no sequelae after surgical procedures.
Class 2. Impairment of the Whole Person, 6—20% There is objective evidence of colonic or rectal disease or anatomic loss or alteration;andThere are mild gastrointestinal symptoms with occasional disturbances of bowel function accompanied by moderate pain; and Minimal restriction of diet or mild symptomatic therapy may be necessary; and No impairment of nutrition results.
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