GI 7 Flashcards
What is inflammatory bowel disease?
collectively refers to 2 inflammatory conditions
- Crohn’s disease
- ulcerative colitis
Crohn’s vs. UC: age
both affect any age group
Crohn’s vs. UC: cancer risk
- Crohn’s: cancer risk increased but uncommon
- UC: cancer is far more common, but preventable with bowel resection
Crohn’s vs. UC: lesion location
- Crohn’s: usually small or large intestine
- UC: rectum and L colon
Crohn’s vs. UC: skip lesions
- Crohn’s: common
- UC: absent
Crohn’s vs. UC: granulomas
- Crohn’s: granulomas, thickened bowel wall, narrowed lumen, and obstruction typical
- UC: granulomas etc are uncommon
Crohn’s disease and PT implications: What would you ask about LBP and why?
- Is pain relieved after passing stool or gas?
- possibly Crohn’s if yes
Crohn’s disease and PT implications: 25% of pts present with arthritis or migratory arthralgias, monoarthritis, or polyarthritis
Which joints does this affect?
What is the implication?
- often affects ankle or knee
- comes and goes with disease process and may precede episodes of bowel sx
- need proper medical intervention to avoid permanent joint deformity!
What is a likely complication with UC?
anemia (dependent on amount of blood loss)
predominant symptoms of UC is
rectal bleeding
UC: where might the pt present with pain (referred)?
- shoulder
- back
- groin
IBS aka
common cold of the stomach
What is IBS?
- functional disorder of motility of small and large intestines
- diagnosed according to specific bowel symptom clusters
Why is IBS considered “functional”?
abn mm contraction cannot be attributed to any identifiable abnormality in the bowel
IBS sx
perceive unpleasant or inappropriate sensory experiences in the absence of any physiologic event
IBS and central processing
some evidence of dysregulation in central pain processing
take home points for screening GI disease: age
over 45
take home points for screening GI disease: prior hx of
NSAID induced GI bleeding
take home points for screening GI disease: sx affected by
- increase within 2 hours after taking NSAIDs
- affected by food anywhere from immediately to 2-4 hours later
take home points for screening GI disease: cyclical sx
presence of abd or GI sx occurring within 4-6 weeks of NMS sx
especially cyclical
take home points for screening GI disease: When should you be concerned with back/abd pain at same level?
if accompanied by constitutional sx
take home points for screening GI disease: shoulder, back, pelvic, and sacral pain
- of unknown origin
- affected by food, milk, antacids, vomiting
- accompanied by constitutional sx
take home points for screening GI disease: pain relieved by
BM
take home points for screening GI disease: LBP accompanied by constipation may be related to
pelvic floor dysfunction
take home points for screening GI disease: progression with muscle guarding
- When evaluated at early onset of referred pain, usually full and pain-free ROM
- can decrease over time with mm splinting/guarding
