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  • Ulcerative colitis

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  • 009.1 Colitis, enteritis, and gastroenteritis of presumed infectious origin
  • 556.9 Ulcerative colitis, unspecified

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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 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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  • A09 Infectious gastroenteritis and colitis, unspecified
  • K51.90 Ulcerative colitis, unspecified, without complications

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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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  • Inflammation of large intestine and bowel
  • Ulcer formation may cause some constipation
  • Frequent diarrhea associated with bowel urgency and cramping
  • Pathologic features1
  • Involves mainly mucosa

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Essentials of Diagnosis

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  • Unknown etiology
  • Abdominal pain, tenderness
  • Nausea, vomiting
  • Diarrhea: watery, may be bloody
  • Bloating
  • Rectal bleeding possible
  • Acute drop in blood pressure may cause decreased blood flow to intestines

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General Considerations

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  • Various types of colitis
    • Short-term: resolves quickly
    • Lifelong: chronic, recurrent
  • Broad array of GI disorders may be encountered by physical therapists
  • 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 and require intensive diagnostic testing
  • Referred pain to back possible
  • May mimic colon cancer, tumors, irritable bowel
  • Chronic or episodic diarrhea, loss of bowel control, and/or blood in stool may indicate inflammatory disease, pre-cancerous condition, or cancer

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Demographics

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  • Higher incidence in Caucasians and Jews of European descent
  • May occur at any age; onset most common between ages 15 and 30 years, less common between ages 50 to 70 years
  • 10% of cases develop before age 18
  • Affects men and women equally
  • Familial
  • Estimated incidence in U.S.: 1.4 in 100,000

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Signs and Symptoms

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  • 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
    • 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 move bowels constantly
  • Intestinal hemorrhage
  • Abdominal distention
  • Abdominal muscle spasm, guarding
  • Fever, chills
  • Dysplasia
  • Pseudopolyps
  • Crypt abscesses
  • Fatigue
  • Anemia
  • Weight loss, loss of appetite
  • Skin lesions
  • Failure to grow if onset at early age

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