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Condition/Disorder Synonyms

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  • Crohn's disease

  • Ulcerative colitis (UC)

  • Regional enteritis

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ICD-9-CM Codes

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  • 555 Regional enteritis

  • 555.0 Regional enteritis of small intestine

  • 555.1 Regional enteritis of large intestine

  • 555.2 Regional enteritis of small intestine with large intestine

  • 555.9 Regional enteritis of 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 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

  • 782.3 Edema

  • 786.0 Dyspnea and respiratory abnormalities

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ICD-10-CM Codes

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  • K50.00 Crohn's disease of small intestine without complications

  • K50.10 Crohn's disease of large intestine without complications

  • K50.80 Crohn's disease of both small and large intestine without complications

  • K50.90 Crohn's disease, unspecified, without complications

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Preferred Practice Pattern

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  • As of February 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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  • Chronic inflammation of the GI track

  • Crohn's can affect any part of the gastrointestinal tract, all or part of the GI system, from the mouth to anus

  • Ulcerative colitis affects somewhere from the colon to the rectum

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

  • Pain is frequently referred to the lower back

  • Inflammatory bowel diseases (IBD) describes disorders with chronic or recurring immune response and inflammation of the gastrointestinal tract

  • A common inflammatory bowel disease

  • There is a broad array of GI disorders that may be encountered by physical therapists

  • Many clients with GI pathology may be receiving physical therapy as a result of secondary problems such as weakness, gait abnormalities, and limited aerobic endurance

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Essentials of Diagnosis

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  • Normal healthy bowel between patches of diseased bowel

  • Abdominal pain; constant or intermittent

  • Abdominal tenderness

  • Nausea

  • Vomiting

  • Diarrhea or constipation

  • Changes in bowel habits

  • Bloating

  • Possible rectal bleeding

  • Rectal/anal irritation

  • Acute drops in blood pressure, which may result in decreased blood flow to intestines

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General Considerations

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  • Crohn's disease commonly involves the terminal ileum

  • May result in secondary problems such as aerobic capacity and muscle endurance impairment, sarcopenia, weakness/impaired muscle performance, musculoskeletal problems, neuromuscular problems, weight loss, or weight gain, indicating the need for physical therapy intervention depending on severity

  • Because GI disorders frequently refer pain to other body areas, individuals may get referred to PT inappropriately (i.e., referred for low back pain)

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

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