Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Intestinal Upset

intestinal upset in русский (Россия)

Related Terms

  • Gastrointestinal Distress

Differential Diagnosis

  • Acute pancreatitis or pancreatic cancer
  • Bacterial, viral, or parasitic gastrointestinal (GI) infections
  • Bowel ischemia
  • Bowel obstruction
  • Constipation
  • Diverticular disease
  • Gallbladder inflammation (cholecystitis)
  • GI bleeding
  • GI gas (flatus)
  • Immobile bowel (paralytic ileus)
  • Inflammatory bowel disease (Crohn's disease or ulcerative colitis)
  • Ingestion of toxic substances
  • Irritable bowel disease
  • Irritable bowel syndrome
  • Tumors (colon or rectal cancer)
  • Viral gastroenteritis

Specialists

  • Emergency Medicine Physician
  • Family Physician
  • Gastroenterologist
  • General Surgeon
  • Internal Medicine Physician
  • Oncologist

Comorbid Conditions

  • Blood diseases, including bleeding disorders
  • Cancer
  • Cardiovascular disease
  • Diabetes
  • Immune suppression
  • Malnutrition
  • Pulmonary disease

Factors Influencing Duration

Factors that may influence length of disability include advanced age, underlying cause, severity of symptoms, and response to treatment.

Medical Codes

ICD-9-CM:
564.5 - Functional Digestive Disorders Not Elsewhere Classified, Functional Diarrhea
564.89 - Functional Digestive Disorders Not Elsewhere Classified, Other Specified Functional Disorders of Intestine; Atony of Colon

Overview

Intestinal upset is a term used to describe a variety of symptoms that arise from disturbances in the lower intestinal tract (either small intestine, large intestine, or both). Intestinal upset is often associated with changes in intestinal motility (peristalsis) and bowel habits that result in diarrhea, constipation, or rectal bleeding.

Lower intestinal disturbances that can cause intestinal upset include intestinal infections (bacterial, viral, or parasitic), food sensitivity (e.g., milk/lactose products) or food allergies, intestinal diseases such as inflammatory bowel disease (Crohn's disease or ulcerative colitis), intestinal masses, lack of circulation to the intestine (intestinal ischemia), or motility disorders (dysmotility, pseudo-obstruction, or paralytic ileus).

Depending on the cause, the intestinal upset may occur as an isolated incident, such as following an intestinal infection, or may be recurring with persistent discomfort. Intestinal upset associated with food sensitivities or inflammatory bowel diseases tends to be recurrent. Intestinal upset associated with masses, ischemia, or motility disorders tends to be persistent.

Incidence and Prevalence: Intestinal upset is associated with a broad range of illnesses and chronic conditions, making it impossible to ascertain its exact prevalence and incidence. It occurs in people of all ages, both male and female.

Source: Medical Disability Advisor



Causation and Known Risk Factors

The presence of any chronic or acute intestinal illness may be characterized by or may lead to intestinal upset.

Source: Medical Disability Advisor



Diagnosis

History: Individuals may complain of abdominal pain, cramping, bloating, rumbling, gas, diarrhea, constipation, or rectal bleeding. They may describe their discomfort as continuous or intermittent. Those with intermittent intestinal upset may be able to pinpoint certain foods or conditions (e.g., stress) that seem to trigger their symptoms. Certain body positions may relieve discomfort or accentuate it. Some individuals may complain of fever, chills, nausea, vomiting, and the inability to eat as well.

Physical exam: Careful examination of the abdomen may reveal tenderness, distention, or a localized mass. Bowel sounds may be hyperactive and loud, or diminished or absent, depending on how active and/or distended the involved bowel is with air, in the case of inflammation of the lining of the stomach (gastritis) or bowel obstruction. Hyperactive, loud bowel sounds may be present in cases of acute infection or inflammatory bowel disease. Other findings associated with inflammatory bowel disease include inflamed joints (osteoarthritis) or inflamed eyes (iritis). Prolonged diarrhea may result in dehydration causing low blood pressure, rapid heart rate, and low urine output. Fever may be present if there is a bacterial or parasitic infection. A rectal exam performed by placing a gloved finger in the rectum may reveal masses or tears in the anus or rectum. Fecal material obtained from the rectal exam may demonstrate frank blood.

Tests: Stools are examined for the presence of blood, pathogenic organisms (e.g., bacteria or parasites), or fat (steatorrhea). Allergy testing may be done if food allergies are suspected. X-rays may be taken of the lower intestine using barium contrast. A lighted flexible scope may be used to examine the rectum (sigmoidoscopy) or colon (colonoscopy) to identify inflammatory conditions, masses, or obstructions. Masses found in these exams are biopsied to rule out cancer. An x-ray exam of the circulatory system of the bowel (mesenteric angiography) helps rule out ischemia of the bowel. Motility studies may be performed to determine whether or not the muscles or nerves of the intestinal wall are functioning properly to move feces through the bowel.

Source: Medical Disability Advisor



Treatment

Treatment is directed at reducing the intestinal upset and treating the underlying problem. The diet is generally restricted to bland, nonirritating foods. Inflammatory conditions may be treated with medications to slow intestinal motility, reduce cramping (antispasmodics), and decrease inflammation (steroidal and nonsteroidal anti-inflammatory agents). Conversely, mild antidepressant medications may be given to increase motility. If dehydration from diarrhea is present, the individual may require intravenous fluids. Those with constipation may be treated with stool softeners, laxatives, enemas, and a high-fiber diet. Bacterial or parasitic infections are treated with appropriate antibiotics or antimicrobial medications. Viral infections, such as viral gastroenteritis, usually do not respond to medication and the individual will be treated with rest and a low-residue diet. If food sensitivities or allergies are suspected, the offending foods are eliminated from the diet. Surgery may be performed to remove mechanical obstructions, masses (colon or rectal cancer), or ischemic bowel (exploratory laparotomy with excision of mass or bowel resection).

Source: Medical Disability Advisor



Prognosis

Outcomes vary based on the underlying cause of the intestinal upset. Many types of intestinal upset resolve spontaneously without treatment. When treatment is required, most individuals enjoy a full recovery within days. Those with colon or rectal cancer have a 5-year survival rate of 50% following bowel resection. Inflammatory bowel diseases tend to be chronic and often result in recurring episodes of debilitating intestinal upset.

Source: Medical Disability Advisor



Complications

Bacterial and parasitic infections can cause severe diarrhea that can lead to significant dehydration and possible kidney failure, particularly in very young or elderly individuals. Prolonged or severe diarrhea can also cause loss of vital electrolytes (electrolyte imbalance) and contribute to a variety of physical disturbances including muscle cramping, neurological disturbances, and heart rhythm abnormalities, particularly in elderly individuals. Ischemia of the bowel can cause bowel perforation and overwhelming systemic infection (sepsis).

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Work restrictions or accommodations vary according to the underlying cause of the intestinal upset and type of treatment necessary. Some individuals may need close access to restroom facilities. The individual's physician should be consulted for specific guidelines regarding work restrictions and accommodations.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Does individual complain of abdominal cramping, bloating, gas, diarrhea, constipation, or rectal bleeding?
  • Does individual have fever, chills, and diarrhea suggesting a possible infection?
  • Is individual sick, and/or is individual's condition worsening?
  • Does individual have a history of food allergies or inflammatory bowel disease?
  • Is the discomfort continuous or intermittent?
  • If the discomfort is intermittent, can individual pinpoint diet changes or conditions such as stress that seem to trigger the symptoms?
  • Has significant weight loss occurred?
  • Did the physician find a localized mass, tenderness, or distention of the abdomen?
  • When listening with a stethoscope (auscultation), does the physician hear diminished or absent bowel sounds?
  • Are hyperactive, loud bowel sounds present (with acute infection or inflammatory bowel disease)?
  • Did a rectal exam reveal masses or tears in the anus or rectum?
  • Is there visible blood in the stools?
  • Have the stools been testing for blood, bacteria, parasites, and fat?
  • Have lower GI x-rays been obtained?
  • Have endoscopic exams been done to rule out inflammatory bowel disease, intestinal masses, or bleeding?
  • Has allergy testing been done?
  • Does a mesenteric angiography need to be done?

Regarding treatment:

  • Has individual been placed on a bland diet or diet that eliminates offending foods?
  • Has individual received supplemental fluids and electrolytes as appropriate?
  • Have antibiotics or antimicrobials been ordered in the case of intestinal infections?
  • Have medications to reduce gas and slow intestinal motility been tried?
  • Has constipation been treated with laxatives, enemas, and fiber supplementation?
  • Have tumors or masses been biopsied to rule out cancer?
  • Have intestinal obstructions been surgically removed?

Regarding prognosis:

  • Does individual have colon or rectal cancer or inflammatory bowel disease? Did individual require surgery for intestinal obstruction?
  • Has a postsurgical infection developed?
  • Did individual have severe diarrhea?
  • Does individual have underlying conditions that may impact recovery?
  • Has individual experienced complications?
  • What complications have occurred and how will they be treated?
  • What length of time is required to recover from the complication?

Source: Medical Disability Advisor



References

General

Feldman, M., L. S. Friedman, and M. H. Sleisenger, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 7th ed. Philadelphia: W.B. Saunders, 2002.

Source: Medical Disability Advisor






Feedback
Send us comments, suggestions, corrections, or anything you would like us to hear. If you are not logged in, you must include your email address, in order for us to respond. We cannot, unfortunately, respond to every comment. If you are seeking medical advice, please contact your physician. Thank you!
Send this comment to:
Sales Customer Support Content Development
 
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is published with the understanding that the author, editors, and publisher are not engaged in rendering medical, legal, accounting or other professional service. If medical, legal, or other expert assistance is required, the service of a competent professional should be sought. We are unable to respond to requests for advice. Any Sales inquiries should include an email address or other means of communication.