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  • 562 Diverticula of intestine
  • 562.01 Diverticulitis of small intestine (without mention hemorrhage)
  • 562.11 Diverticulitis of colon (without mention of hemorrhage)

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  • 718.45 Contracture of joint; pelvic region and thigh
  • 781.2 Abnormality of gait
  • 728.89 Other disorders of muscle, ligament, and fascia
  • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified
  • 729.9 Other and unspecified disorders of soft tissue
  • 719.70 Difficulty in walking involving joint site unspecified
  • 782.3 Edema
  • 315.4 Developmental coordination disorder
  • 786.05 Shortness of breath
  • 780.7 Malaise and fatigue
  • 786.0 Dyspnea and respiratory abnormalities

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  • K57.12 Diverticulitis of small intestine without perforation or abscess without bleeding
  • K57.32 Diverticulitis of large intestine without perforation or abscess without bleeding

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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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Description

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  • Focal inflammation of the diverticula (sacs) in any part of the digestive tract but most commonly in the large intestine1
  • Secondary problems such as weakness, gait abnormalities and limited aerobic endurance
  • May be acute, post-operative, chronic, viral or bacterially related, or congenital/hereditary
  • Diverticulosis are pouches in the wall of the colon, when inflamed called diverticulitis

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Essentials of Diagnosis

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  • Individuals may be referred to PT with complaints of back pain, or anterior chest and shoulder pain, which is not attributable to the structures in that anatomical area
  • Diagnosis for more occult problems may take time and require intensive medical diagnostic testing
  • Sudden onset may mimic colon cancer or tumors, irritable bowel syndrome, colitis, or gynecological problems in females such as endometriosis, uterine fibroids, or ectopic pregnancies
  • Abdominal pain often on left side of abdomen (may start slow and worsen over days, but this is less common)
  • It is not the purview of a physical therapist to medically diagnose a GI pathology, but rather to recognize the possibility in the differential diagnosis process, especially when the findings are not consistent with conditions commonly treated (musculoskeletal, neuromuscular, integumentary, cardiopulmonary)

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General Considerations

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  • 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
  • Chronic diarrhea, episodic diarrhea, loss of bowel control (incontinence or urgency), and blood in stool may be symptomatic of diverticulitis

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Demographics

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  • Most common after 40 years of age
  • Low fiber diets
  • Those who lack exercise
  • Obesity
  • Uncommon in third world or developing countries

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Signs and Symptoms

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  • Left lower quadrant pain
  • Constipation; chronic, acute
  • Abdominal or stomach pain or cramping, often left sided with sudden onset
  • Abdominal (stomach or intestinal) pain after ingesting food or liquid
  • Difficulty swallowing (related to esophageal diverticulitis)
  • Abdominal tenderness
  • Fever
  • Nausea and ...

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