Hepatitis

• 573.3 Hepatitis, unspecified

• 315.4 Developmental coordination disorder
• 718.45 Contracture of joint, pelvic region and thigh
• 719.70 Difficulty in walking
• 728.2 Muscular wasting and disuse atrophy
• 728.89 Disorders of muscle, ligament, and fascia
• 729.9 Other 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

• K75.9 Inflammatory liver disease, unspecified

• 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

• Inflammation of the liver
• Complaints include changes in bowel habits: constipation, diarrhea, bowel urgency, incontinence, cramping
• Pain, frequently referred to low back
• May be viral or secondary to toxic agents
  • Types: A, B, C (D and E are rare forms)
• Hepatitis A1
  • RNA enterovirus
  • Spread by contact with fecal matter or blood, often through ingestion of contaminated food
  • Rarely fatal
  • Treated with bed rest for 1 to 4 weeks, no alcohol consumption during that time
• Hepatitis B1
  • Spread through blood, semen, vaginal secretions, saliva approximately 4 to 6 weeks after symptoms develop
  • May heal slowly
  • Leading cause of chronic liver disease and cirrhosis
• Hepatitis C1
  • Remains in blood for years
  • Accounts for large percentage of cirrhosis, liver failure, liver cancer cases
  • Transmitted through blood transfusion, possibly sexual intercourse
• Hepatitis D and Hepatitis E: not commonly seen

Essentials of Diagnosis

• Change in urine color (dark urine)
• Change in skin color and eyes (yellow)
• Abdominal pain (constant or intermittent)
• Abdominal tenderness
• Nausea
• Vomiting
• Changes in bowel habits: diarrhea, constipation
• Bloating
• Rectal bleeding possible
• Rectal/anal irritation
• Acute drop in blood pressure causing decreased blood flow to intestines
• Inability to swallow
• Lack of appetite
• Unexplained weight loss
• Abdominal pain upon ingesting food
• Joint pain possible
• Dark stool or bright red blood in stool
• Malaise, fatigue

General Considerations

• GI disorders may be acute, post-operative, chronic, viral, bacterial, or congenital/hereditary
• While PT may not manage GI disorders specifically, clients may receive care for secondary problems: weakness, gait abnormalities, limited aerobic endurance, sarcopenia, musculoskeletal problems, neuromuscular problems, weight loss, or weight gain
• Diagnosis for occult problems may take time and require intensive diagnostic testing
• 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
• GI disorders frequently refer pain to other body areas; individuals may be inappropriately referred to PT
• GI problems may be related to stress, constipation
• More serious problems include autoimmune conditions, such as Crohn’s disease
• Acute pain indicative of appendicitis
• GI complaints in females may indicate cancer/tumors in reproductive organs, or gynecological problems: endometriosis, uterine fibroids, ectopic pregnancies
• May indicate inguinal or umbilical hernia
• History of heartburn/indigestion may ...