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CONDITION/DISORDER SYNONYM

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  • Ulcerative colitis

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ICD-9-CM CODES

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  • 009.1 Colitis, enteritis, and gastroenteritis of presumed infectious origin

  • 556.9 Ulcerative colitis, unspecified

  • Associated physical therapy diagnoses

    • 315.4 Developmental coordination disorder

    • 718.45 Contracture of joint, pelvic region and thigh

    • 719.70 Difficulty in walking involving joint site unspecified

    • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified

    • 728.89 Disorders of muscle, ligament, and fascia

    • 729.9 Other and unspecified disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 781.2 Abnormality of gait

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

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ICD-10-CM CODES

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  • A09 Infectious gastroenteritis and colitis, unspecified

  • K51.90 Ulcerative colitis, unspecified, without complications

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PREFERRED PRACTICE PATTERN

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  • As of June, 2014, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology; therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.

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PATIENT PRESENTATION

A 40-year-old male presents with abdominal discomfort and low back spasms. The back pain was insidious. Special tests were negative for straight leg raise (SLR) and slump tests. Bilateral lower extremity (LE) strength, reflexes, and sensation were within normal limits. Pain was not reproducible. Review of the systems reveals a 2-month history of decreased appetite, a 10 lb unintentional weight loss, and occasional bright red blood in his stools. He denies recent use of antibiotics, recent travel, or exposure to sick people. He does report a history of “some sort of irritable bowel problems” ailing his father and uncle for years. Physical examination is unremarkable except for minimal lower abdominal tenderness to deep palpation. The patient was referred to his primary care physician with a 3-month history of back pain, abdominal bloating, pain, cramping, and diarrhea. The physician did a digital rectal examination revealing hemoccult positive stool, so the patient was referred to a gastroenterologist for further evaluation. Colonoscopy revealed colonic mucosal erythema with occasional areas of bleeding.

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FIGURE 35-1

Ulcerative colitis. White exudate is present overlying an abnormal colonic mucosa that has lost its typical vascular pattern. (From Hay WM, Levin MJ, Deterding RR, Abzug MJ. Current Diagnosis & Treatment: Pediatrics. 21st ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
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KEY FEATURES

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Description
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  • Inflammation of large intestine and bowel

  • Ulcer formation may cause some constipation

  • Frequent diarrhea associated with bowel urgency and cramping

  • Pathologic features1

  • Involves mainly mucosa

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Essentials of Diagnosis
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  • Unknown etiology

  • Abdominal pain, tenderness

  • Nausea, vomiting

  • Diarrhea: Watery, may be bloody

  • Bloating

  • Rectal bleeding possible

  • Acute drop in blood pressure may cause decreased blood flow to intestines

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FIGURE 35-2

Pathologic features of ulcerative colitis. (From Chandrasoma P, Taylor CR. Concise Pathology. 3rd ed. www.accessmedicine.com...

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