Dysentery is the term pertaining to a variety of disorders in the intestines involving inflammation of the mucous membrane. In this category, bacillary dysentery is an acute infection of the bowel is caused by Shigella organisms.

Shigellosis (the infection caused by Shigella organisms) is found in all parts of the world, and is the most common cause of inflammatory dysentery. It is the primary cause of 5 to 10% of diarrheal illness in many areas. Fecal-oral routes are responsible for direct spread of infection. Indirect spread is via contaminated food and inanimate objects. Flies serve as carriers, and epidemics are common in populations where overcrowding and inadequate sanitation are problems. Shigella organisms enter the mucosa of the lower intestine, producing mucus secretion, hyperemia, white blood cell (leukocytic) infiltration, edema, and mucosal ulcerations.

The incubation period is 1 to 4 days. Initially, fever, nonbloody and nonmucoid diarrhea, with little or no tenesmus, may occur. However, first symptoms may also include periods of gripping abdominal pain; urgency to defecate; and passage of formed feces that temporarily relieves the pain. These periods recur with escalating severity and frequency. Rectal prolapse, and resulting fecal incontinence may occur from severe tenesmus. In adults, the disease usually resolves without intervention in 4 days to up to 6 weeks depending on the severity. On rare occasions, the condition can start suddenly with watery diarrhea or bloody stools. Vomiting may occur resulting in severe dehydration. Infection can possibly occur with delirium, convulsions and coma, and death may be imminent within 12 to 24 hours.

Shigella is found in the stools via cultures. Proctoscopes may be utilized to visualize the mucosa of the lower intestine. Smears may be done to identify leukocytes.

Dehydration is treated with fluid therapy to replace lost fluids from diarrhea. Antibiotics may be administered depending on the severity of the condition.

True life-long carriers are rare. Infection conveys little or no immunity. It is possible for reinfection to occur.

• This disease shall be granted service connection as a result of tropical service, although not otherwise established as incurred in service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 or 38 CFR 3.308 following service in a period of war or following peacetime service provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 (b) Disease subject to presumptive service connection].

• In cases of chronic dysentery, when the Veteran is a former prisoner of war and was interned or detained for not less that 30 days, this disease shall be service connected if manifest to a degree of disability of 10 percent or more at any time after discharge or release from active military, naval, or air service even though there is no record of such disease during service, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 (c) [Disease subject to presumptive service connection]

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• Rate as for ulcerative colitis.

• Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation.[38 CR 4.114]

• There are diseases of the digestive system, particularly within the abdomen, which, while differing in the site of pathology, produce a common disability picture characterized in the main by varying degrees of abdominal distress or pain, anemia and disturbances in nutrition. Consequently, certain coexisting diseases in this area, as indicated in the instruction under the title “Diseases of the Digestive System,” do not lend themselves to distinct and separate disability evaluations without violating the fundamental principle relating to pyramiding as outlined in 38 CFR 4.14.  [38 CFR 4.113]