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Condition/Disorder Synonyms

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  • Cirrhosis of the liver

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ICD-9-CM Code

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  • 571.5 Cirrhosis of liver without mention of alcohol

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ICD-10-CM Codes

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  • K74.0 Hepatic fibrosis

  • K74.60 Unspecified cirrhosis of liver

  • K74.69 Other cirrhosis of liver

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Preferred Practice Pattern

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  • As of November 2012, 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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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 involving joint site unspecified

  • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified

  • 728.89 Other 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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Key Features

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Description

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  • Destruction of liver, liver disease

  • May result from excessive alcohol use over time

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

  • Pain is frequently referred to lower back

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Essentials of Diagnosis

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  • Abdominal pain or tenderness (constant, intermittent)

  • Nausea, vomiting

  • Changes in bowel habits: diarrhea, constipation

  • Bloating

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

  • Lack of appetite, unexplained weight loss

  • Abdominal pain upon ingesting food

  • Joint pain possible

  • 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, sarcopenia, musculoskeletal/ neuromuscular problems, weight loss/gain

  • Symptoms may be characteristic of multiple GI disorders, confounding medical diagnosis

  • PT should recognize possible GI pathology in differential diagnosis, especially when findings are inconsistent with conditions commonly treated

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

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

  • GI problems commonly related to stress, constipation

  • More serious problems include autoimmune conditions: Crohn's, appendicitis (acute pain)

  • May indicate inguinal or umbilical hernia

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

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

  • Chronic or episodic diarrhea, loss of bowel control (incontinence or urgency), blood in stool may be symptomatic of inflammatory disease, pre-cancerous condition, or cancer

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Demographics

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  • Affects adults; higher rate among alcoholics

  • Familial

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Clinical Findings

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Signs and Symptoms

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  • Jaundice

  • Itching

  • Spiderlike vessels on the skin

  • Extremity edema

  • Splenomegaly

  • Hepatic encephalopathy

  • Sensitivity to medications

  • Insulin resistance

  • Pain

    • Abdominal/stomach pain, cramping (constant or intermittent, severe)

    • Pain upon ingesting food or liquid

      • May ...

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