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Condition/Disorder Synonyms

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  • GERD

  • Reflux esophagitis

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ICD-9-CM Code

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  • 530.81 Esophageal reflux

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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, 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 Code

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  • K21.9 Gastro-esophageal reflux disease without esophagitis

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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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Key Features

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Description

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  • Condition in which stomach acid backs up into esophagus

  • Patients experience burning feeling in abdominal, chest, or throat areas

  • Common symptom and complaint is “heartburn”

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Essentials of Diagnosis

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  • Acid reflux or indigestion, minimum twice weekly1

  • Inability to or difficulty with swallowing

  • Burning in chest

  • Hoarseness

  • Sore throat

  • Regurgitation of food or sour liquid (acid reflux)

  • Complaint of lump in throat

  • Cough without mucous production or congestion

  • Chest pain

  • Nausea, vomiting

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General Considerations

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  • 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

    • Problems may be acute, post-operative, chronic, viral, bacterial, or congenital/hereditary

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

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

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

  • May lead to more serious conditions such as Barrett's esophagus

  • May increase risk of cancer or ulcer

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Demographics

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  • GI disorders occur throughout lifespan (birth through geriatric)

  • 55 to 60% of general population suffer from occasional symptoms of GERD2

  • Some indication of genetic tendency

  • Depending on the pathology, occurrence rates may differ based on ethnicity, diet, lifestyle, gender, age

  • High incidence in general population due to potential for lifespan occurrence

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Clinical Findings

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Signs and Symptoms

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  • Chronic indigestion

  • Burning in throat, heartburn

  • Relief with antacids

  • Indigestion at least twice weekly

  • Symptoms worsen when lying flat

  • Wheezing

  • Hiccups

  • Difficulty swallowing (related to esophageal or oral problems rather than neuromuscular)

  • Pain

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

    • Chest pain

    • Pain upon ingesting food or liquid

      • May be cardiac in nature

    • Pain after ingesting fatty foods (gallbladder sign)

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