Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ 579.0 Celiac disease ++ 718.45 Contracture of joint; pelvic region and thigh719.70 Difficulty in walking728.2 Muscular wasting and disuse atrophy728.89 Other disorders of muscle, ligament, and fascia729.9 Other disorders of soft tissue780.7 Malaise and fatigue781.2 Abnormality of gait: ataxic, paralytic, spastic, staggering782.3 Edema786.0 Dyspnea and respiratory abnormalities786.05 Shortness of breath ++ K90.0 Celiac disease ++ 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 +++ Description ++ Intolerance of the protein gluten, found in wheat, rye, and barley productsClients may have GI pathology and be receiving physical therapy for secondary problems, such as weakness, gait abnormalities, and limited aerobic enduranceChanges in bowel habits: constipation, diarrhea, bowel urgency, incontinence, abdominal crampingPain frequently referred to the low back +++ Essentials of Diagnosis ++ Must be made by a physician and confirmed by medical diagnostic testingAbdominal pain; constant or intermittentAbdominal tendernessNauseaVomitingChanges in bowel habits: diarrhea or constipationBloatingPossible rectal bleedingRectal/anal irritationAcute drop in blood pressure, may result in decreased blood flow to intestinesLack of appetiteUnexplained weight lossAbdominal pain upon ingesting food, especially meals containing gluten productsPossible joint painDark stool or bright red blood in stoolMalaise/fatigue +++ General Considerations ++ GI disorders occur across the lifespan (birth through geriatric)Depending on severity, secondary problems may indicate the need for physical therapy, such as aerobic capacity, muscle endurance impairment, sarcopenia, weakness, impaired muscle performance, musculoskeletal problems, neuromuscular problems, weight loss, or weight gainSymptoms include chronic diarrhea, episodic diarrhea, loss of bowel control (incontinence or urgency), blood in stool, which may also be symptomatic of inflammatory disease, pre-cancerous conditions, or cancerDiagnosis for more occult problems may take time and require intensive medical diagnostic testingGI disorders often refer pain to other body areas; individuals may be referred to PT inappropriatelyIn adult females, GI complaints may indicate cancer/tumors in the reproductive organs or gynecological problems such as endometriosis, uterine fibroids, and ectopic pregnanciesMay indicate inguinal or umbilical hernias in males or femalesHistory of heartburn or indigestion may indicate GI or cardiac problemsIron deficiency anemiaEarly onset osteoporosis or osteopeniaVitamin K deficiency associated with hemorrhaging riskVitamin and mineral deficienciesCentral and peripheral nervous system disorders: usually due to unsuspected nutrient deficienciesPancreatic insufficiencyIntestinal lymphomas and other GI cancers (malignancies)Gall bladder malfunctionNeurological manifestations +++ Demographics ++ Can occur at any ageMen and women equally affectedFamilialHigher incidence in people of white European descentOverall incidence unknown; underdiagnosedEstimated incidence: 1 in 5,000 to 1 in 1004 +++ Signs ... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free a profile for additional features.