Inflammatory bowel disease (IBD)

• Crohn’s disease
• Ulcerative colitis (UC)
• Regional enteritis

• 555 Regional enteritis
• 555.0 Regional enteritis of small intestine
• 555.1 Regional enteritis of large intestine
• 555.2 Regional enteritis of small intestine with large intestine
• 555.9 Regional enteritis of unspecified site

• 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 Other disorders of muscle, ligament, and fascia
• 729.9 Other and unspecified disorders of soft tissue
• 780.7 Malaise and fatigue
• 782.3 Edema
• 786.0 Dyspnea and respiratory abnormalities

• K50.00 Crohn’s disease of small intestine without complications
• K50.10 Crohn’s disease of large intestine without complications
• K50.80 Crohn’s disease of both small and large intestine without complications
• K50.90 Crohn’s disease, unspecified, without complications

• As of February 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

• Chronic inflammation of the GI track
• Crohn’s can affect any part of the gastrointestinal tract, all or part of the GI system, from the mouth to anus
• Ulcerative colitis affects somewhere from the colon to the rectum
• Complaints often include changes in bowel habits such as constipation, diarrhea, bowel urgency, incontinence, and cramping
• Pain is frequently referred to the lower back
• Inflammatory bowel diseases (IBD) describes disorders with chronic or recurring immune response and inflammation of the gastrointestinal tract
• A common inflammatory bowel disease
• There is a broad array of GI disorders that may be encountered by physical therapists
• Many clients with GI pathology may be receiving physical therapy as a result of secondary problems such as weakness, gait abnormalities, and limited aerobic endurance

Essentials of Diagnosis

• Normal healthy bowel between patches of diseased bowel
• Abdominal pain; constant or intermittent
• Abdominal tenderness
• Nausea
• Vomiting
• Diarrhea or constipation
• Changes in bowel habits
• Bloating
• Possible rectal bleeding
• Rectal/anal irritation
• Acute drops in blood pressure, which may result in decreased blood flow to intestines

General Considerations

• Crohn’s disease commonly involves the terminal ileum
• 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
• Because GI disorders frequently refer pain to other body areas, individuals may get referred to PT inappropriately (i.e., referred for low back pain)
• Chronic diarrhea, episodic diarrhea, loss of bowel control (incontinence or urgency), and blood in stool may be symptomatic of inflammatory disease, pre-cancerous conditions, or cancer

Demographics

• Higher incidence in Jews of European descent
• Women may have slightly higher incidence than males
• Familial: Occurring or tending to occur among members of a family, usually ...