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  • 153.9 Malignant neoplasm of colon unspecified site

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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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  • C18.9 Malignant neoplasm of colon, unspecified

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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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Description

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  • Malignancy of the colon
  • May metastasize and result in death if untreated, curable if caught in early stages
  • Complaints often include changes in bowel habits: constipation, diarrhea, bowel urgency, incontinence, and cramping
  • Pain frequently referred to low back

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Essentials of Diagnosis

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  • 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 may cause decrease 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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  • While PT may not manage GI disorders specifically, clients may receive care for secondary problems: weakness, gait abnormalities, limited aerobic endurance, musculoskeletal problems, neuromuscular problems, weight loss or weight gain
  • Symptoms may include chronic or episodic diarrhea, incontinence or urgency of bowel movements, blood in stool
    • May be symptomatic of inflammatory disease, pre-cancerous condition, cancer
  • Diagnosis for occult problems may take time and require intensive diagnostic testing
  • GI disorders frequently refer pain to other body areas; individuals may be inappropriately referred to PT
  • May be related to stress, constipation
  • More serious problems include autoimmune conditions like Crohn’s
  • Acute pain indicative of appendicitis
  • GI complaints in females may indicate cancer/tumors in reproductive organs, or gynecological problems: endometriosis, uterine fibroids, ectopic pregnancies
  • May indicate inguinal or umbilical hernia
  • History of heartburn/indigestion may indicate GI or cardiac problems

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Demographics

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  • GI disorders occur throughout lifespan (birth through geriatric)
  • More common in people aged 50 years or older
    • Increased risk with older age
  • More common if history of polyps or personal history of cancer
  • Overall incidence of colon and rectal cancer 45.5 per 100,0001
    • Causasians 44.3 per 100,000
    • African Americans 53.1 per 100,00
    • Asians 34.9 per 100,000
    • American Indians 31.1 per 100,000

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Signs and Symptoms

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  • Symptoms may be characteristic of multiple GI disorders, confounding medical diagnosis
  • PT should recognize the possibility of GI pathology in differential diagnosis, especially when findings are not consistent with conditions commonly treated
  • Pain
    • Abdominal/stomach pain, cramping (constant or intermittent, severe)
    • Pain upon ingesting food or liquid
      • May ...

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