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American Family Physician November 1, 2006 Lyon & Clark	Diagnosis of Acute Abdominal Pain in Older Patients Acute abdominal pain is a common presenting complaint in older patients, but may be difficult to diagnose. Here are some common causes of abdominal pain in old patients and recommendations for treatment.
American Family Physician June 15, 2001 John L. Pfenninger	Common Anorectal Conditions: Part I. Symptoms and Complaints Anorectal symptoms and complaints are common and may be caused by a wide spectrum of conditions...
Nursing September 2008 Denise L. Lyons et al.	Double Trouble: When Delirium Complicates Dementia Learn to protect a patient with dementia from the disabling effects of delirium.
American Journal of Nursing September 2010 Bliss & Norton	Conservative Management of Fecal Incontinence This article summarizes the strategies that have proven most effective in uncovering and combating this prevalent yet seldom acknowledged condition.
American Journal of Nursing July 2008 Horgas & Miller	Pain Assessment in People with Dementia The Pain Assessment in Advanced Dementia (PAINAD) scale has been designed to assess pain in this population by looking at five specific indicators.
American Journal of Nursing December 2010 Baldridge & Andrasek	Pain Assessment in People with Intellectual or Developmental Disabilities Nurses in all settings need to be knowledgeable about alternate pain assessment methods.
Nursing November 2008 Michael W. Day	Fight Back Against Inflammatory Bowel Disease It takes guts to live with Crohn's disease or ulcerative colitis, both of which can take a heavy toll on their victims. Find out how to help your patient tame the attacks.
Nursing October 2009 Yvonne D'Arcy	Overturning barriers to pain relief in older adults This article will describe how to lower the barriers to effective pain control in older patients and provide practical tips for helping them receive the full benefit from pharmacologic and nonpharmacologic therapies.
American Family Physician October 15, 2006 Jennifer Kessmann	Hirschsprung's Disease: Diagnosis and Management The disease most commonly involves the rectosigmoid region of the colon but can affect the entire colon and, rarely, the small intestine. The disease usually presents in infancy, although some patients present with persistent, severe constipation later in life.
American Family Physician June 1, 2002 Daisy A. Arce	Evaluation of Constipation Constipation is the reason for 2.5 million physician visits per year in the United States, with more than one half of these visits to primary care physicians. The differential diagnosis of constipation and the approach to its evaluation differ in adults and children.
American Family Physician October 1, 2005 Salzman & Lillie	Diverticular Disease: Diagnosis and Treatment Although the pathogenic mechanisms of diverticular disease are poorly understood, they are clearly related to complex interactions of colon structure, intestinal motility, diet, and genetic features.
Nurse Practitioner May 2012 Diana L. Wadlund	Meeting the challenge of IBS IBS is the best studied, most common functional GI disorder, and is often characterized by debilitating symptoms without any pathologic findings. The predominant symptoms of IBS are abdominal pain and an alteration in bowel habits with an absence of organic pathology.
Nursing June 2008 Yvonne D'arcy	Nursing2008 Pain Management Survey Report See how your responses to this survey compare with those of nursing colleagues across the country and beyond.
American Journal of Nursing January 2008 Maslow & Mezey	Recognition of Dementia in Hospitalized Older Adults Recognition of Dementia in Hospitalized Older Adults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures.
American Journal of Nursing October 2008	Wandering in Hospitalized Older Adults: Identifying Risk is the First Step in This Approach to Preventing Wandering in Patients with Dementia. People who have dementia are at risk for wandering away from the safety of the care setting and becoming lost in the community. Here are three critical elements of prevention and action.
Nursing September 2008 Susan Simmons Holcomb	Acute Abdomen: What a Pain! So many things - some life-threatening - can cause abdominal pain. Here's how to capture the clues quickly and accurately.
American Family Physician April 1, 2005 Manning-Dimmitt et al.	Diagnosis of Gastrointestinal Bleeding in Adults The clinical evaluation of gastrointestinal bleeding depends on the hemodynamic status of the patient and the suspected source of the bleeding.
American Journal of Nursing January 2008 Fick & Mion	How to Try This: Delirium Superimposed on Dementia Delirium is common in older adults who have dementia, but too often nurses confuse the symptoms of delirium with those of dementia and it goes unrecognized and untreated. Delirium can signal a serious underlying condition such as infection or dehydration.
Nurse Practitioner January 2010 Chien & Bradway	Acquired fecal incontinence in community-dwelling adults Although the economic cost of fecal incontinence has not yet been determined, it is projected to be similar to the estimated $14 billion that it costs community-dwellers to manage urinary incontinence.
Nursing July 2008 Held-Warmkessel & Schliech	Responding to 4 Gastrointestinal Complications in Cancer Patients If your patient has cancer, be prepared to help her manage such serious GI complications as bowel obstruction, peritonitis, fistula formation, and intestinal perforation.
American Journal of Nursing April 2010 Mary Curry Narayan	Culture's Effects on Pain Assessment and Management When patients belong to a culture or speak a language that's different from that of their health care provider, the provider faces additional challenges in successfully assessing and managing the patients' pain.
American Journal of Nursing March 2008 Evans & Cotter	Avoiding Restraints in Patients with Dementia Understanding, prevention, and management are the keys to reducing restraint use.
American Family Physician December 1, 2005 Christine Hsieh	Treatment of Constipation in Older Adults Effectiveness of a variety of treatments for chronic constipation in the elderly.
American Family Physician June 1, 2003 Leung & Sigalet	Acute Abdominal Pain in Children Acute abdominal pain in children presents a diagnostic dilemma. Although many cases of acute abdominal pain are benign, some require rapid diagnosis and treatment to minimize morbidity. Numerous disorders can cause abdominal pain.
American Journal of Nursing November 2011 Christine L. Cutugno	The 'Graying' of Trauma Care: Addressing Traumatic Injury in Older Adults Evidence-based strategies for managing trauma and its complications in this population.
American Family Physician February 1, 2006 Briggs & Dery	Evaluation and Treatment of Constipation in Infants and Children Constipation in children usually is functional and the result of stool retention. However, family physicians must be alert for red flags that may indicate the presence of an uncommon but serious organic cause of constipation.
American Family Physician May 15, 2003 Holten & Wetherington	Problem-Oriented Diagnosis Diagnosing the patient with abdominal pain and altered bowel habits: is it irritable bowel syndrome?
American Family Physician November 15, 2001 Edward R. Feller	Gynecologic Aspects of Crohn's Disease This article reviews the diverse gynecologic spectrum, protean manifestations and diagnostic difficulties of pelvic Crohn's disease...
American Journal of Nursing April 2009	Understanding and Managing Burn Pain: Part 1 Despite advances in topical wound care and pharmacology, and a growing emphasis on palliative care, wound care is the main source of the pain associated with burn injury.
American Journal of Nursing April 2011	Strategies for Feeding Patients with Dementia An overview of the difficulties associated with feeding those with dementia and suggestions for caregivers to help overcome these challenges.
American Family Physician January 1, 2005 Jerry L. Old et al.	Imaging for Suspected Appendicitis Acute appendicitis is the most common reason for emergency abdominal surgery and must be distinguished from other causes of abdominal pain. Family physicians play a valuable role in the early diagnosis and management of this condition.
Nurse Practitioner May 2009 Yvonne D'Arcy	Is Low Back Pain Getting on Your Nerves? The pain and disability of low back pain are the most common reasons patients seek healthcare. Here are tools for diagnosis and treatment options.
American Family Physician February 1, 2006	Chronic Constipation in Your Child An informative patient hand-out: What is constipation?... How common is chronic constipation... Why does my child have constipation?... etc.
American Family Physician February 15, 2002 Grace Brooke Huffman	Evaluating and Treating Unintentional Weight Loss in the Elderly Unintentional weight loss in the elderly patient can be difficult to evaluate. Accurate evaluation is essential, however, because this problem is associated with increased morbidity and mortality...
Nursing April 2009 Colwell & Gordon	Helping patients combat colon cancer Colorectal cancer is the third most frequently diagnosed cancer in the United States. In 2008, about 148,810 people received this diagnosis and an estimated 49,960 died of the disease.
American Family Physician February 15, 2001 Karen S. Santacruz & Daniel Swagerty	Early Diagnosis of Dementia As more treatment options become available, it will become increasingly important to diagnose dementia early...
American Journal of Nursing June 2008 Ellen Flaherty	How to Try This: Using Pain-Rating Scales with Older Adults Pain is often undertreated and underdiagnosed in older adults. Regular use of short, simple, reliable pain-rating scales provides nurses and physicians with measurable information to establish and modify a pain management plan.
American Journal of Nursing October 2008	How to Try This: Working with Families of Hospitalized Older Adults with Dementia Families provide a considerable amount of informal care and support for older adults living with dementia. And when an older adult with dementia is hospitalized, family caregivers should be seen as important sources of information and included as valuable members of the health care team.
American Family Physician August 2001 Saud Suleiman & David E. Johnston	The Abdominal Wall: An Overlooked Source of Pain When abdominal pain is chronic and unremitting, with minimal or no relationship to eating or bowel function but often a relationship to posture (i.e., lying, sitting, standing), the abdominal wall should be suspected as the source of pain...
American Journal of Nursing March 2011 Jablonski et al.	The Use of Algorithms in Assessing and Managing Persistent Pain in Older Adults This article introduces readers to the use of algorithms in guiding the assessment and management of persistent pain in older adults, and provides an illustrative case study.
American Family Physician July 15, 2004 Robertson & Montagnini	Geriatric Failure to Thrive Some elderly patients, including those who do not have acute illness or severe chronic disease, eventually undergo a process of functional decline, progressive apathy, and a loss of willingness to eat and drink that culminates in death.
American Family Physician February 15, 2004	A New View of Occult and Obscure Gastrointestinal Bleeding Occult gastrointestinal bleeding usually is discovered when fecal occult blood test results are positive or iron deficiency anemia is detected. Fecal occult blood testing methods vary, but all have limited sensitivity and specificity.
Managed Care October 2003 Martin Sipkoff	Pain Management: Health Plans Need to Take Control Insurers have not focused much on chronic pain. They should. It presents a humanitarian and business opportunity.
Nursing March 2010 Peg Gray-Vickrey	Gathering pearls of knowledge for assessing older adults If you attended nursing school more than 10 years ago, you may have received limited education about gerontological nursing. But as baby boomers age, this is becoming an increasingly important area of nursing practice.
American Family Physician July 1, 2001 John L. Pfenninger	Common Anorectal Conditions: Part II. Lesions Patients with a wide variety of anorectal lesions present to family physicians. Most can be successfully managed in the office setting. A high index of suspicion for cancer should be maintained...
American Family Physician April 1, 2001	Flexible Sigmoidoscopy What is flexible sigmoidoscopy?... What are the benefits of flexible sigmoidoscopy?... Who should have the procedure?... How do I prepare for the procedure?...
American Family Physician November 15, 2002 Viera et al.	Management of Irritable Bowel Syndrome Irritable bowel syndrome is the most common functional disorder of the gastrointestinal tract and is frequently treated by family physicians.
Nurse Practitioner December 2008 Darlene P. Peters	Colon Cancer Screening: Recommendations and Barriers to Patient Participation Advanced practice nurses and nurse researchers can play a vital role in improving colon cancer screening among patients.
American Family Physician September 15, 2001 Douglas D. Ross & Carla S. Alexander	Management of Common Symptoms in Terminally Ill Patients: Part II. Constipation, Delirium and Dyspnea In addition to pain, patients who are approaching the end of life commonly have other symptoms...
American Family Physician April 1, 2006 Neef & Walling	Dementia with Lewy Bodies: An Emerging Disease Dementia with Lewy bodies appears to be the second most common form of dementia, accounting for about one in five cases. The condition is characterized by dementia accompanied by delirium, visual hallucinations, and parkinsonism.