Diverticulitis

• 562 Diverticula of intestine
• 562.01 Diverticulitis of small intestine (without mention hemorrhage)
• 562.11 Diverticulitis of colon (without mention of hemorrhage)

• 718.45 Contracture of joint; pelvic region and thigh
• 781.2 Abnormality of gait
• 728.89 Other disorders of muscle, ligament, and fascia
• 728.2 Muscular wasting and disuse atrophy, not elsewhere classified
• 729.9 Other and unspecified disorders of soft tissue
• 719.70 Difficulty in walking involving joint site unspecified
• 782.3 Edema
• 315.4 Developmental coordination disorder
• 786.05 Shortness of breath
• 780.7 Malaise and fatigue
• 786.0 Dyspnea and respiratory abnormalities

• K57.12 Diverticulitis of small intestine without perforation or abscess without bleeding
• K57.32 Diverticulitis of large intestine without perforation or abscess without bleeding

• 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

Description

• Focal inflammation of the diverticula (sacs) in any part of the digestive tract but most commonly in the large intestine1
• Secondary problems such as weakness, gait abnormalities and limited aerobic endurance
• May be acute, post-operative, chronic, viral or bacterially related, or congenital/hereditary
• Diverticulosis are pouches in the wall of the colon, when inflamed called diverticulitis

Essentials of Diagnosis

• Individuals may be referred to PT with complaints of back pain, or anterior chest and shoulder pain, which is not attributable to the structures in that anatomical area
• Diagnosis for more occult problems may take time and require intensive medical diagnostic testing
• Sudden onset may mimic colon cancer or tumors, irritable bowel syndrome, colitis, or gynecological problems in females such as endometriosis, uterine fibroids, or ectopic pregnancies
• Abdominal pain often on left side of abdomen (may start slow and worsen over days, but this is less common)
• It is not the purview of a physical therapist to medically diagnose a GI pathology, but rather to recognize the possibility in the differential diagnosis process, especially when the findings are not consistent with conditions commonly treated (musculoskeletal, neuromuscular, integumentary, cardiopulmonary)

General Considerations

• 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
• Chronic diarrhea, episodic diarrhea, loss of bowel control (incontinence or urgency), and blood in stool may be symptomatic of diverticulitis

Demographics

• Most common after 40 years of age
• Low fiber diets
• Those who lack exercise
• Obesity
• Uncommon in third world or developing countries

Signs and Symptoms

• Left lower quadrant pain
• Constipation; chronic, acute
• Abdominal or stomach pain or cramping, often left sided with sudden onset
• Abdominal (stomach or intestinal) pain after ingesting food or liquid
• Difficulty swallowing (related to esophageal diverticulitis)
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