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Condition/Disorder Synonyms

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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

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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 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 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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  • Inflammation of large intestine and bowel

  • Ulcer formation may cause some constipation

  • Frequent diarrhea associated with bowel urgency and cramping

  • Pathologic features 1

  • 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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General Considerations

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  • Various types of colitis

    • Short-term: resolves quickly

    • Lifelong: chronic, recurrent

  • Broad array of GI disorders may be encountered by physical therapists

  • 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 and require intensive diagnostic testing

  • Referred pain to back possible

  • May mimic colon cancer, tumors, irritable bowel

  • Chronic or episodic diarrhea, loss of bowel control, and/or blood in stool may indicate inflammatory disease, pre-cancerous condition, or cancer

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Demographics

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  • Higher incidence in Caucasians and Jews of European descent

  • May occur at any age; onset most common between ages 15 and 30 years, less common between ages 50 to 70 years

  • 10% of cases develop before age 18

  • Affects men and women equally

  • Familial

  • Estimated incidence in U.S.: 1.4 in 100,000

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Clinical Findings

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Signs and Symptoms

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  • Pain

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

    • Pain upon ingesting food or liquid

      • May be cardiac in nature

    • Lower abdominal pain

    • Pain with defecation

    • Joint pain

  • Bowel changes

    • Diarrhea (acute, chronic)

    • Constipation (acute, chronic)

    • Blood in stool, dark or fresh-bleeding

    • Rectal bleeding

    • Change in ...

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