GI 7

Question 1

What is inflammatory bowel disease?

Answer 1

collectively refers to 2 inflammatory conditions

• Crohn’s disease
• ulcerative colitis

Question 2

Crohn’s vs. UC: age

Answer 2

both affect any age group

Question 3

Crohn’s vs. UC: cancer risk

Answer 3

• Crohn’s: cancer risk increased but uncommon

- UC: cancer is far more common, but preventable with bowel resection

Question 4

Crohn’s vs. UC: lesion location

Answer 4

• Crohn’s: usually small or large intestine

- UC: rectum and L colon

Question 5

Crohn’s vs. UC: skip lesions

Answer 5

• Crohn’s: common

- UC: absent

Question 6

Crohn’s vs. UC: granulomas

Answer 6

• Crohn’s: granulomas, thickened bowel wall, narrowed lumen, and obstruction typical
• UC: granulomas etc are uncommon

Question 7

Crohn’s disease and PT implications: What would you ask about LBP and why?

Answer 7

• Is pain relieved after passing stool or gas?

- possibly Crohn’s if yes

Question 8

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?

Answer 8

• 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!

Question 9

What is a likely complication with UC?

Answer 9

anemia (dependent on amount of blood loss)

Question 10

predominant symptoms of UC is

Answer 10

rectal bleeding

Question 11

UC: where might the pt present with pain (referred)?

Answer 11

• shoulder
• back
• groin

Question 12

IBS aka

Answer 12

common cold of the stomach

Question 13

What is IBS?

Answer 13

• functional disorder of motility of small and large intestines
• diagnosed according to specific bowel symptom clusters

Question 14

Why is IBS considered “functional”?

Answer 14

abn mm contraction cannot be attributed to any identifiable abnormality in the bowel

Question 15

IBS sx

Answer 15

perceive unpleasant or inappropriate sensory experiences in the absence of any physiologic event

Question 16

IBS and central processing

Answer 16

some evidence of dysregulation in central pain processing

Question 17

take home points for screening GI disease: age

Answer 17

over 45

Question 18

take home points for screening GI disease: prior hx of

Answer 18

NSAID induced GI bleeding

Question 19

take home points for screening GI disease: sx affected by

Answer 19

• increase within 2 hours after taking NSAIDs

- affected by food anywhere from immediately to 2-4 hours later

Question 20

take home points for screening GI disease: cyclical sx

Answer 20

presence of abd or GI sx occurring within 4-6 weeks of NMS sx

especially cyclical

Question 21

take home points for screening GI disease: When should you be concerned with back/abd pain at same level?

Answer 21

if accompanied by constitutional sx

Question 22

take home points for screening GI disease: shoulder, back, pelvic, and sacral pain

Answer 22

• of unknown origin
• affected by food, milk, antacids, vomiting
• accompanied by constitutional sx

Question 23

take home points for screening GI disease: pain relieved by

Answer 23

BM

Question 24

take home points for screening GI disease: LBP accompanied by constipation may be related to

Answer 24

pelvic floor dysfunction

Question 25

take home points for screening GI disease: progression with muscle guarding

Answer 25

• When evaluated at early onset of referred pain, usually full and pain-free ROM
• can decrease over time with mm splinting/guarding