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ICD-9-CM Code

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  • 573.3 Hepatitis, 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

  • 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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  • K75.9 Inflammatory liver disease, unspecified

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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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  • Inflammation of the liver

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

  • Pain, frequently referred to low back

  • May be viral or secondary to toxic agents

    • Types: A, B, C (D and E are rare forms)

  • Hepatitis A 1

    • RNA enterovirus

    • Spread by contact with fecal matter or blood, often through ingestion of contaminated food

    • Rarely fatal

    • Treated with bed rest for 1 to 4 weeks, no alcohol consumption during that time

  • Hepatitis B 1

    • Spread through blood, semen, vaginal secretions, saliva approximately 4 to 6 weeks after symptoms develop

    • May heal slowly

    • Leading cause of chronic liver disease and cirrhosis

  • Hepatitis C 1

    • Remains in blood for years

    • Accounts for large percentage of cirrhosis, liver failure, liver cancer cases

    • Transmitted through blood transfusion, possibly sexual intercourse

  • Hepatitis D and Hepatitis E: not commonly seen

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Essentials of Diagnosis

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  • Change in urine color (dark urine)

  • Change in skin color and eyes (yellow)

  • 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 causing decreased 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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  • GI disorders may be acute, post-operative, chronic, viral, bacterial, or congenital/hereditary

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

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

  • 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

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

  • GI problems may be related to stress, constipation

  • More serious problems include autoimmune conditions, such as Crohn's disease

  • Acute pain indicative of ...

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