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Condition/Disorder Synonyms

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  • Fecal incontinence (FI)

  • Faecal incontinence

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ICD-9-CM Codes

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  • 315.4 Coordination disorder (clumsiness, dyspraxia, and/or specific motor development disorder)

  • 718.45 Contracture of joint; pelvic region, and thigh

  • 719.70 Difficulty in walking

  • 728.2 Muscular wasting and disuse atrophy

  • 728.89 Other disorders of muscle, ligament, and fascia

  • 729.9 Other 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

  • 787.6 Incontinence of feces

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ICD-10-CM Codes

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  • R 15 Fecal incontinence

  • R15.9 Full incontinence of feces

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Preferred Practice Pattern

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  • The American Physical Therapy Association (APTA) Guide to Physical Therapist Practice does not include practice patterns for organ systems pathology; therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.

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Key Features

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Description

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  • Involuntary loss of bowel control, complete or occasional.1,2

  • There is a broad array of gastrointestinal (GI) disorders that may be encountered, though not managed specifically, by physical therapists (PTs).

  • Patients with GI pathology may receive care as a result of secondary problems such as weakness, gait abnormalities, and limited aerobic endurance.

  • Symptoms may be acute, postoperative, chronic, viral, bacterially related, or congenital/hereditary.

  • Complaints often include changes in bowel habits: Constipation, diarrhea, bowel urgency, incontinence, and cramping.

  • Pain is frequently referred to the low back.

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Essentials of Diagnosis

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  • Must be made by a physician and confirmed by medical diagnostic testing

  • Complaints of the following:

    • - Abdominal pain; constant or intermittent

    • - Abdominal tenderness

    • - Nausea

    • - Vomiting

    • - Diarrhea or constipation; changes in bowel habits

    • - Bloating

    • - Possible rectal bleeding

    • - Rectal/anal irritation

    • - Acute drops in blood pressure that may result in decreased blood flow to intestines

    • - Inability to swallow

    • - Lack of appetite

    • - Unexplained weight loss

    • - Abdominal pain upon ingesting food

    • - Possible joint pains

    • - Dark stool or bright red blood in stool

    • - Malaise/fatigue

  • Description by individual

    • - Recent illness (bacterial, viral)

    • - Ingestion of spoiled food

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General Considerations

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  • PTs should recognize the possibility of GI pathology in differential diagnosis, especially when findings are not consistent with conditions commonly treated: musculoskeletal, neuromuscular, integumentary, cardiopulmonary, functional and mobility dysfunction secondary to medical pathology.

  • As GI symptoms are frequently referred to the back and shoulders, patients may be inappropriately referred to PT.

  • Diagnosis for more occult problems may take time and require intensive medical diagnostic testing.

  • GI disorders occur throughout the life span (birth through geriatric).

  • May result in secondary problems indicating the need for physical therapy (PT) intervention: Impairment of aerobic capacity and muscle endurance, sarcopenia, weakness, impaired muscle performance, musculoskeletal problems, neuromuscular problems, weight loss, or weight gain.

  • Symptoms may include chronic diarrhea, episodic diarrhea, loss of bowel control (incontinence or urgency), ...

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