Malabsorption syndromes

• 579 Intestinal malabsorption
• 579.0 Celiac disease
• 579.1 Tropical sprue
• 579.2 Blind loop syndrome
• 579.3 Other and unspecified postsurgical nonabsorption
• 579.4 Pancreatic steatorrhea
• 579.8 Other specified intestinal malabsorption
• 579.9 Unspecified intestinal malabsorption

• 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 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

• K90.1 Tropical sprue
• K90.2 Blind loop syndrome, not elsewhere classified
• K90.3 Pancreatic steatorrhea
• K90.4 Malabsorption due to intolerance, not elsewhere classified
• K90.89 Other intestinal malabsorption
• K90.9 Intestinal malabsorption, unspecified
• K91.2 Postsurgical malabsorption, not elsewhere classified

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

• Malabsorption: decreased absorption of fat and other nutrients caused by liver, biliary, pancreatic, or intestinal disease1
• Impaired absorption of nutrients in gastrointestinal tract
• Symptoms such as gas, bloating, abdominal pain, diarrhea resulting from malabsorption
• May be acute, post-operative, chronic, viral, bacterial, congenital/hereditary
• Complaints of change in bowel habits (constipation, urgency, incontinence, cramping)
• Referred pain in low back
• Inflammatory bowel diseases (IBD): chronic or recurring immune response, inflammation of GI tract
  • Ulcerative colitis
  • Crohn’s disease

Essentials of Diagnosis

• Intraluminal abnormalities1
• Mucosal abnormalities1
• Vascular abnormalities1
• Metabolic genetic disease1
• Abdominal pain (constant or intermittent)
• Abdominal tenderness
• Nausea
• Vomiting1
• Changes in bowel habits: diarrhea, constipation
• Bloating
• Possible rectal bleeding
• Rectal irritation
• Acute drop in blood pressure, may result in decreased blood flow to intestines
• Inability to swallow
• Lack of appetite
• Unexplained weight loss
• Abdominal pain upon ingesting food
• Possible joint pain
• Dark stool or bright red blood in stool
• Malaise, fatigue

General Considerations

• 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, musculoskeletal problems, neuromuscular problems, weight loss or weight gain
• Diagnosis for occult problems may take time and require intensive diagnostic testing
• GI disorders frequently refer pain to other body areas; individuals may be inappropriately referred to PT
• GI problems commonly related to stress or constipation
• More serious problems include autoimmune conditions like Crohn’s
• 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 indicate GI or cardiac problems
• Chronic diarrhea, episodic diarrhea, loss of bowel control, blood in stool may indicate inflammatory disease, pre-cancerous condition, cancer

Demographics

• GI ...