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ICD-9-CM Code

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  • 153.9 Malignant neoplasm of colon unspecified site

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Associated Physical Therapy Diagnoses

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  • 315.4 Developmental coordination disorder

  • 718.45 Contracture of joint, pelvic region and thigh

  • 719.70 Difficulty in walking

  • 728.2 Muscular wasting and disuse atrophy

  • 728.89 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

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ICD-10-CM Code

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  • C18.9 Malignant neoplasm of colon, unspecified

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Preferred Practice Pattern

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  • As of March, 2013, 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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Key Features

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Description

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  • Malignancy of the colon

  • May metastasize and result in death if untreated, curable if caught in early stages

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

  • Pain frequently referred to low back

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Essentials of Diagnosis

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  • Abdominal pain (constant or intermittent)

  • Abdominal tenderness

  • Nausea

  • Vomiting

  • Changes in bowel habits: diarrhea, constipation

  • Bloating

  • Rectal bleeding possible

  • Rectal/anal irritation

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

  • Inability to swallow

  • Lack of appetite

  • Unexplained weight loss

  • Abdominal pain upon ingesting food

  • Joint pain possible

  • Dark stool or bright red blood in stool

  • Malaise, fatigue

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General Considerations

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  • While PT may not manage GI disorders specifically, clients may receive care for secondary problems: weakness, gait abnormalities, limited aerobic endurance, musculoskeletal problems, neuromuscular problems, weight loss or weight gain

  • Symptoms may include chronic or episodic diarrhea, incontinence or urgency of bowel movements, blood in stool

    • May be symptomatic of inflammatory disease, pre-cancerous condition, cancer

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

  • GI disorders frequently refer pain to other body areas; individuals may be inappropriately referred to PT

  • May be related to stress, constipation

  • More serious problems include autoimmune conditions like Crohn's

  • Acute pain indicative of appendicitis

  • GI complaints in females may indicate cancer/tumors in reproductive organs, or gynecological problems: endometriosis, uterine fibroids, ectopic pregnancies

  • May indicate inguinal or umbilical hernia

  • History of heartburn/indigestion may indicate GI or cardiac problems

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Demographics

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  • GI disorders occur throughout lifespan (birth through geriatric)

  • More common in people aged 50 years or older

    • Increased risk with older age

  • More common if history of polyps or personal history of cancer

  • Overall incidence of colon and rectal cancer 45.5 per 100,0001

    • Causasians 44.3 per 100,000

    • African Americans 53.1 per 100,00

    • Asians 34.9 per 100,000

    • American Indians 31.1 per 100,000

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Clinical Findings

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Signs and Symptoms

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  • Symptoms may be characteristic of multiple GI disorders, ...

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