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  • 573.3 Hepatitis, unspecified

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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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  • K75.9 Inflammatory liver disease, unspecified

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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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  • Inflammation of the liver
  • Complaints include changes in bowel habits: constipation, diarrhea, bowel urgency, incontinence, cramping
  • Pain, frequently referred to low back
  • May be viral or secondary to toxic agents
    • Types: A, B, C (D and E are rare forms)
  • Hepatitis A1
    • RNA enterovirus
    • Spread by contact with fecal matter or blood, often through ingestion of contaminated food
    • Rarely fatal
    • Treated with bed rest for 1 to 4 weeks, no alcohol consumption during that time
  • Hepatitis B1
    • Spread through blood, semen, vaginal secretions, saliva approximately 4 to 6 weeks after symptoms develop
    • May heal slowly
    • Leading cause of chronic liver disease and cirrhosis
  • Hepatitis C1
    • Remains in blood for years
    • Accounts for large percentage of cirrhosis, liver failure, liver cancer cases
    • Transmitted through blood transfusion, possibly sexual intercourse
  • Hepatitis D and Hepatitis E: not commonly seen

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Essentials of Diagnosis

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  • Change in urine color (dark urine)
  • Change in skin color and eyes (yellow)
  • 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 causing decreased 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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  • GI disorders may be acute, post-operative, chronic, viral, bacterial, or congenital/hereditary
  • While PT may not manage GI disorders specifically, clients may receive care for secondary problems: weakness, gait abnormalities, limited aerobic endurance, sarcopenia, musculoskeletal problems, neuromuscular problems, weight loss, or weight gain
  • Diagnosis for occult problems may take time and require intensive diagnostic testing
  • 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
  • GI disorders frequently refer pain to other body areas; individuals may be inappropriately referred to PT
  • GI problems may be related to stress, constipation
  • More serious problems include autoimmune conditions, such as Crohn’s disease
  • 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 ...

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