Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ GERDReflux esophagitis ++ 530.81 Esophageal reflux ++ 315.4 Developmental coordination disorder718.45 Contracture of joint, pelvic region and thigh719.70 Difficulty in walking728.2 Muscular wasting and disuse atrophy, not elsewhere classified728.89 Disorders of muscle, ligament, and fascia729.9 Other and unspecified disorders of soft tissue780.7 Malaise and fatigue781.2 Abnormality of gait782.3 Edema786.0 Dyspnea and respiratory abnormalities786.05 Shortness of breath ++ K21.9 Gastro-esophageal reflux disease without esophagitis ++ 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 ++ Condition in which stomach acid backs up into esophagusPatients experience burning feeling in abdominal, chest, or throat areasCommon symptom and complaint is “heartburn” +++ Essentials of Diagnosis ++ Acid reflux or indigestion, minimum twice weekly1Inability to or difficulty with swallowingBurning in chestHoarsenessSore throatRegurgitation of food or sour liquid (acid reflux)Complaint of lump in throatCough without mucous production or congestionChest painNausea, vomiting +++ General Considerations ++ Broad array of GI disorders may be encountered by physical therapistsWhile 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/gainProblems may be acute, post-operative, chronic, viral, bacterial, or congenital/hereditaryPT should recognize possible GI pathology in differential diagnosis, especially when findings are inconsistent with conditions commonly treatedGI disorders frequently refer pain to other body areas; individuals may be inappropriately referred to PTHistory of heartburn or indigestion may indicate GI or cardiac problemsMay lead to more serious conditions such as Barrett’s esophagusMay increase risk of cancer or ulcer +++ Demographics ++ GI disorders occur throughout lifespan (birth through geriatric)55 to 60% of general population suffer from occasional symptoms of GERD2Some indication of genetic tendencyDepending on the pathology, occurrence rates may differ based on ethnicity, diet, lifestyle, gender, ageHigh incidence in general population due to potential for lifespan occurrence +++ Signs and Symptoms ++ Chronic indigestionBurning in throat, heartburnRelief with antacidsIndigestion at least twice weeklySymptoms worsen when lying flatWheezingHiccupsDifficulty swallowing (related to esophageal or oral problems rather than neuromuscular)PainAbdominal/stomach pain, cramping (constant or intermittent, severe)Chest painPain upon ingesting food or liquidMay be cardiac in naturePain after ingesting fatty foods (gallbladder sign)Bowel changesDiarrhea (acute, chronic)Constipation (acute, chronic), especially with antacid ingestionOccult blood in stoolChange in stool odor or colorMucous in stool or mucous dischargeUnexplained weight lossAbdominal muscle spasm, guardingFatigueLoss of appetite, cachexia, ... Your MyAccess 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 Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth