Colitis

• Ulcerative colitis

• 009.1 Colitis, enteritis, and gastroenteritis of presumed infectious origin
• 556.9 Ulcerative colitis, unspecified

• 315.4 Developmental coordination disorder
• 718.45 Contracture of joint, pelvic region and thigh
• 719.70 Difficulty in walking involving joint site unspecified
• 728.2 Muscular wasting and disuse atrophy not elsewhere classified
• 728.89 Disorders of muscle, ligament, and fascia
• 729.9 Other and unspecified 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

• A09 Infectious gastroenteritis and colitis, unspecified
• K51.90 Ulcerative colitis, unspecified, without complications

• 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

• Inflammation of large intestine and bowel
• Ulcer formation may cause some constipation
• Frequent diarrhea associated with bowel urgency and cramping
• Pathologic features1
• Involves mainly mucosa

Essentials of Diagnosis

• Unknown etiology
• Abdominal pain, tenderness
• Nausea, vomiting
• Diarrhea: watery, may be bloody
• Bloating
• Rectal bleeding possible
• Acute drop in blood pressure may cause decreased blood flow to intestines

General Considerations

• Various types of colitis
  • Short-term: resolves quickly
  • Lifelong: chronic, recurrent
• Broad array of GI disorders may be encountered by physical therapists
• While PT may not manage GI disorders specifically, clients may receive care for secondary problems: weakness, gait abnormalities, limited aerobic endurance, sarcopenia, musculoskeletal/ neuromuscular problems, weight loss/gain
• 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
• Diagnosis for occult problems may take time and require intensive diagnostic testing
• Referred pain to back possible
• May mimic colon cancer, tumors, irritable bowel
• Chronic or episodic diarrhea, loss of bowel control, and/or blood in stool may indicate inflammatory disease, pre-cancerous condition, or cancer

Demographics

• Higher incidence in Caucasians and Jews of European descent
• May occur at any age; onset most common between ages 15 and 30 years, less common between ages 50 to 70 years
• 10% of cases develop before age 18
• Affects men and women equally
• Familial
• Estimated incidence in U.S.: 1.4 in 100,000

Signs and Symptoms

• Pain
  • Abdominal/stomach pain, cramping (constant or intermittent, severe)
  • Pain upon ingesting food or liquid
    • May be cardiac in nature
  • Lower abdominal pain
  • Pain with defecation
  • Joint pain
• Bowel changes
  • Diarrhea (acute, chronic)
  • Constipation (acute, chronic)
  • Blood in stool, dark or fresh-bleeding
  • Rectal bleeding
  • Change in stool odor or color
  • Feeling of having to move bowels constantly
• Intestinal hemorrhage
• Abdominal distention
• Abdominal muscle spasm, guarding
• Fever, chills
• Dysplasia
• Pseudopolyps
• Crypt abscesses
• Fatigue
• Anemia
• Weight loss, loss of appetite
• Skin lesions
• Failure to grow if onset at ...