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  • Spastic colon
  • Irritable colon
  • Mucous colitis
  • Spastic colitis

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  • 564.1 Irritable bowel syndrome

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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
  • 782.3 Edema
  • 786.0 Dyspnea and respiratory abnormalities

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  • K58.9 Irritable bowel syndrome without diarrhea

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  • As of January 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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  • There is a broad array of GI disorders that may be encountered by physical therapists
  • While physical therapists may not manage GI disorders specifically, many clients may have GI pathology and be receiving care as a result of secondary problems such as weakness, gait abnormalities and limited aerobic endurance
  • They may be acute, post-operative, chronic, viral, bacterially related, or congenital/hereditary1
  • Abdominal pain and altered bowel habits without pathology
  • Considered a disorder and not a disease
  • Complaints often include changes in bowel habits such as constipation, diarrhea, bowel urgency, bloating, incontinence, and cramping
  • Pain is frequently referred to the low back
  • Does not result in permanent damage to colon and is not inflammatory
  • Symptoms may come and go or, in some cases, disappear

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Essentials of Diagnosis

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  • Abdominal pain; constant or intermittent history
  • ROME Criteria
    • Abdominal pain over course of 12 weeks, not necessarily continuous weeks
    • At least 2 of the following:
      • A change in the frequency or consistency of the bowels
      • Straining, urgency or a feeling that the bowels will not completely empty
      • Mucus in the stool
      • Bloating or abdominal distension
  • Diarrhea or constipation
  • Bloating
  • Possible rectal bleeding
  • Rectal/anal irritation
  • Acute falls in blood pressure, which may result in decrease blood flow to intestines
  • Inability to swallow
  • Lack of appetite
  • Unexplained weight loss
  • Abdominal pain related to ingesting food
  • Possible joint pains
  • Dark stool or bright red blood in stool
  • Malaise/fatigue
  • Cramping

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General Considerations

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  • Diagnosis for more occult problems may take time and require intensive medical diagnostic testing
  • GI disorders occur cross the lifespan; birth through geriatric
  • 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
  • Because GI disorders frequently refer pain to other body areas, individuals may get referred to PT inappropriately, such as when referred to the low back
  • GI problems may be commonly related to stress or constipation, more serious problems such as autoimmune conditions like Crohn’s, or acute pain indicative of appendicitis
  • In adults females, GI complaints may actually be related or indicative of cancer or tumors in the reproductive organs, or gynecological problems ...

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