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Condition/Disorder Synonyms

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  • Spastic colon

  • Irritable colon

  • Mucous colitis

  • Spastic colitis

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ICD-9-CM Code

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  • 564.1 Irritable bowel syndrome

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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

  • 782.3 Edema

  • 786.0 Dyspnea and respiratory abnormalities

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ICD-10-CM Code

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  • K58.9 Irritable bowel syndrome without diarrhea

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Preferred Practice Pattern

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

  • While physical therapists may not manage GI disorders specifically, many clients may have GI pathology and be receiving care as a result of secondary problems such as weakness, gait abnormalities and limited aerobic endurance

  • They may be acute, post-operative, chronic, viral, bacterially related, or congenital/hereditary1

  • Abdominal pain and altered bowel habits without pathology

  • Considered a disorder and not a disease

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

  • Pain is frequently referred to the low back

  • Does not result in permanent damage to colon and is not inflammatory

  • Symptoms may come and go or, in some cases, disappear

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Essentials of Diagnosis

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  • Abdominal pain; constant or intermittent history

  • ROME Criteria

    • Abdominal pain over course of 12 weeks, not necessarily continuous weeks

    • At least 2 of the following:

      • A change in the frequency or consistency of the bowels

      • Straining, urgency or a feeling that the bowels will not completely empty

      • Mucus in the stool

      • Bloating or abdominal distension

  • Diarrhea or constipation

  • Bloating

  • Possible rectal bleeding

  • Rectal/anal irritation

  • Acute falls in blood pressure, which may result in decrease blood flow to intestines

  • Inability to swallow

  • Lack of appetite

  • Unexplained weight loss

  • Abdominal pain related to ingesting food

  • Possible joint pains

  • Dark stool or bright red blood in stool

  • Malaise/fatigue

  • Cramping

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General Considerations

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

  • GI disorders occur cross the lifespan; birth through geriatric

  • 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, such as when referred to the low back

  • GI problems may be commonly related to stress ...

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