Pennsylvania Physical Therapy Ebook Continuing Education

Differential Diagnosis for Physical Therapy: Hematological, Cardiovascular, Immune, and Digestive System Disorders: Summary 126 Gastrointestinal (GI) Physiology

• Esophagitis pain: Relieved by upright sitting and intensified by laying supine • Cardiac pain: Relieved by nitroglycerin or supine position Melena : Black or tarry stools due to blood in stool • Caused by upper GI tract lesions such as ulcers or varices • If stool is melanotic, bleeding is from upper GI tract • If bright red, bleeding is coming from colon, rectum, or hemorrhoids Epigastric Pain with Radiation: Pain radiating to back occurs from chronic ulcers, usually occurs 30 to 90 minutes after eating • Musculoskeletal findings could support back dysfunction ○ Diagnostic interviewing is essential for proper diagnosis and treatment Early Satiety: Occurs when client feels hungry but gets full with only one or two bites of food • Full sensation out of proportion with time of previous meal and hunger experienced Constipation : Prolonged retention of fecal content in GI tract due to decreased motility of colon or difficulty expelling stool • May be due to diet, medications, personality, mood, stress, inactivity, prolonged bed rest, neurological diagnosis, or obstructions • Renal failure common cause of constipation: Fluid restriction Diarrhea : Abnormal increase in stool liquidity/frequency, greater two times per day • May be accompanied by urgency, perianal discomfort, fecal incontinence, nausea, cramping • May be caused by alcohol, food, laxatives/ other drugs (antibiotics), or travel • Acute: Caused by enteric infection when accompanied by fever, cramps, and blood/pus in stool

• Functions to aid in ingestion/digestion of food, absorb water/electrolytes, and eliminate waste products • Consists of two tracks: Upper : Mouth, esophagus, stomach ○ Esophagus: Hollow tube made up of skeletal and smooth muscle; contains cardiac sphincter, which prevents reflux of contents of stomach ○ Stomach: Made up of smooth muscle that contracts to assist with the peristaltic movement of food; the stomach stores food, mixes it with gastric secretions, and empties it into small intestine through the pyloric pump Lower : Intestines ○ Intestines: Consist of large intestine and small intestine ○ Small intestine: 90% of nutrient absorption occurs in the small intestine ■ Duodenum: Connects to stomach ■ Jejunum: Middle portion ■ Ileum: Connects to large intestine ○ Large intestine ■ Cecum: Connects to small intestine ■ Colon: Reabsorption of water/ electrolytes/bile ■ Rectum GI Pathophysiology Dysphagia : Sensation of food catching in esophagus • Causes ○ Peptic esophagitis ○ Neoplasm ○ Neuro diagnosis such as a cardiovascular accident (CVA) Achalasia: Inability of cardiac sphincter to relax Odynophagia : Pain during swallowing • Caused by esophagitis/spasm, fungal infection • May mimic cardiac pain

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