Celiac disease

• 579.0 Celiac disease

• 718.45 Contracture of joint; pelvic region and thigh
• 719.70 Difficulty in walking
• 728.2 Muscular wasting and disuse atrophy
• 728.89 Other disorders of muscle, ligament, and fascia
• 729.9 Other disorders of soft tissue
• 780.7 Malaise and fatigue
• 781.2 Abnormality of gait: ataxic, paralytic, spastic, staggering
• 782.3 Edema
• 786.0 Dyspnea and respiratory abnormalities
• 786.05 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 products
• Clients may have GI pathology and be receiving physical therapy for secondary problems, such as weakness, gait abnormalities, and limited aerobic endurance
• Changes in bowel habits: constipation, diarrhea, bowel urgency, incontinence, abdominal cramping
• Pain frequently referred to the low back

Essentials of Diagnosis

• Must be made by a physician and confirmed by medical diagnostic testing
• Abdominal pain; constant or intermittent
• Abdominal tenderness
• Nausea
• Vomiting
• Changes in bowel habits: diarrhea or constipation
• Bloating
• Possible rectal bleeding
• Rectal/anal irritation
• Acute drop in blood pressure, may result in decreased blood flow to intestines
• Lack of appetite
• Unexplained weight loss
• Abdominal pain upon ingesting food, especially meals containing gluten products
• Possible joint pain
• Dark stool or bright red blood in stool
• Malaise/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 gain
• Symptoms 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 cancer
• Diagnosis for more occult problems may take time and require intensive medical diagnostic testing
• GI disorders often refer pain to other body areas; individuals may be referred to PT inappropriately
• In adult females, GI complaints may indicate cancer/tumors in the reproductive organs or gynecological problems such as endometriosis, uterine fibroids, and ectopic pregnancies
• May indicate inguinal or umbilical hernias in males or females
• History of heartburn or indigestion may indicate GI or cardiac problems
• Iron deficiency anemia
• Early onset osteoporosis or osteopenia
• Vitamin K deficiency associated with hemorrhaging risk
• Vitamin and mineral deficiencies
• Central and peripheral nervous system disorders: usually due to unsuspected nutrient deficiencies
• Pancreatic insufficiency
• Intestinal lymphomas and other GI cancers (malignancies)
• Gall bladder malfunction
• Neurological manifestations

Demographics

• Can occur at any age
• Men and women equally affected
• Familial
• Higher incidence in people of white European descent
• Overall incidence unknown; underdiagnosed
• Estimated incidence: 1 in 5,000 to 1 in 1004

Signs and Symptoms