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  • Cirrhosis of the liver

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  • 571.5 Cirrhosis of liver without mention of alcohol

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  • K74.0 Hepatic fibrosis
  • K74.60 Unspecified cirrhosis of liver
  • K74.69 Other cirrhosis of liver

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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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  • 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
  • 781.2 Abnormality of gait
  • 782.3 Edema
  • 786.0 Dyspnea and respiratory abnormalities
  • 786.05 Shortness of breath

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Description

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  • Destruction of liver, liver disease
  • May result from excessive alcohol use over time
  • Complaints often include changes in bowel habits: constipation, diarrhea, urgency, incontinence, cramping
  • Pain is frequently referred to lower back

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Essentials of Diagnosis

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  • Abdominal pain or tenderness (constant, intermittent)
  • Nausea, vomiting
  • Changes in bowel habits: diarrhea, constipation
  • Bloating
  • Acute drop in blood pressure; may cause decreased blood flow to intestines
  • Lack of appetite, unexplained weight loss
  • Abdominal pain upon ingesting food
  • Joint pain possible
  • 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, sarcopenia, musculoskeletal/ neuromuscular problems, weight loss/gain
  • 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
  • Diagnosis for occult problems may take time, require intensive diagnostic testing
  • GI disorders frequently refer pain to other body areas; individuals may be inappropriately referred to PT
  • GI problems commonly related to stress, constipation
  • More serious problems include autoimmune conditions: Crohn’s, appendicitis (acute pain)
  • May indicate inguinal or umbilical hernia
  • In females, GI complaints may indicate gynecological problems: cancer/tumors in reproductive organs, endometriosis, uterine fibroids, ectopic pregnancies
  • History of heartburn or indigestion may indicate GI or cardiac problems
  • Chronic or episodic diarrhea, loss of bowel control (incontinence or urgency), blood in stool may be symptomatic of inflammatory disease, pre-cancerous condition, or cancer

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Demographics

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  • Affects adults; higher rate among alcoholics
  • Familial

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Signs and Symptoms

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  • Jaundice
  • Itching
  • Spiderlike vessels on the skin
  • Extremity edema
  • Splenomegaly
  • Hepatic encephalopathy
  • Sensitivity to medications
  • Insulin resistance
  • Pain
    • Abdominal/stomach pain, cramping (constant or intermittent, severe)
    • Pain upon ingesting food or liquid
      • May be cardiac in nature
    • Lower abdominal pain
    • Pain with defecation
    • Pain after ingesting fatty foods (gallbladder sign)
    • Joint pain
  • Bowel changes
    • Diarrhea (acute, chronic)
    • Constipation (acute, chronic)
    • Blood in stool, dark or fresh-bleeding
    • Rectal bleeding
    • Change in stool odor or color
    • Feeling of having to ...

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