From heartburn to constipation, community pharmacists are well placed to address patients’ gastro issues…


When a patient walks into a community pharmacy complaining about a gastrointestinal-related problem, it is likely they will have one or more than one of the following; abdominal pain, constipation, diarrhoea, indigestion, heartburn.

Pharmacists can offer lifestyle advice or over-the-counter remedies having held a conversation with a patient. About 40% of people have at least one digestive symptom at any one time. There is an opportunity for community pharmacy to have an impact.

According to Euromonitor the UK digestive remedies market last year “recorded moderate current value growth as very different trends were witnessed within the various categories in digestive remedies.”

The laxatives category enjoyed the strongest growth, recording sales of £55 million last year. As a caveat Euromonitor said: “It continued to suffer from a negative reputation linked to the adverse side-effects of people using these products for slimming.”

Some types of laxatives are not suitable for people who have conditions such as Crohn’s disease or ulcerative colitis.There are four main types of laxative; bulk-forming laxatives (ispaghula husk and methylcellulose), osmotic laxatives (lactulose and polyethylene glycol), stimulant laxatives (bisacodyl, senna and sodium picosulfate) and stool softener laxatives (arachis oil and docusate sodium).

The National Institute for Health and Care Excellence however cautioned: “Laxatives should generally be avoided except where straining will exacerbate a condition (such as angina) or increase the risk of rectal bleeding as in haemorrhoids.”

Last year research from Mintel revealed that 86% of adults in the UK had experienced a gastrointestinal problem in the 12 months to February 2016. The biggest trigger factor for gastro ailments appeared to be stress, with 30% of adults citing that as the reason.

Poor diet was offered as a reason by 26% of adults followed by lack of sleep (17%), alcohol consumption (14%) and viruses (14%).

And it is women more than men who appear to suffer from gastro problems – 88% of women compared to 83% of men. The most common symptom was wind, bloating and flatulence, then indigestion and diarrhoea.

“A high proportion of consumers experience gastrointestinal issues and the spike in stomach ailments amongst women can be partly attributed to their experience of menstrual cycle-related symptoms,” said Jack Duckett, senior consumer lifestyles analyst at Mintel.

“However, it is also linked to women largely remaining the main care providers for children, with the increased exposure to children consequently rendering women more susceptible to germs they may be carrying.”

Mintel’s research also uncovered the extent to which patients fail to act when they experience symptoms, 40% doing nothing and hoping their wind, bloating and flatulence disappears by itself and 27% sitting back and waiting for their diarrhoea to go of its own accord.

Those statistics present an opportunity for community pharmacy because those people who slip through the net in all probability regularly visit their local pharmacy.

“With a number of people experiencing gastrointestinal ailments indicating that they do not treat their symptoms, there remain opportunities for brands to encourage usage,” Duckett said.

“Focusing messaging on being prepared could help drive usage in the category, with brands using campaigns to show how having remedies in the home can make it easier to treat GI ailments as soon as they strike, helping to reduce any impact on busy schedules.”

In terms of digestive remedies, the prospects looks good. Euromonitor anticipates sales will reach £333 million by 2021, largely because of the growth in antacids and irritable bowel syndrome (IBS) treatments.

“There is widening awareness of IBS, which is also becoming an increasingly common diagnosis in doctors’ surgeries and pharmacies. Many of the symptoms associated with IBS are, furthermore, those that are targeted by other digestive remedies, such as flatulence, diarrhoea, cramping and constipation,” Euromonitor says, adding that IBS treatments is “expected to pose growing competition to many other categories within digestive remedies.”

Duckett had a word of warning for the gastrointestinal remedies market which he believes will find it increasingly difficult to engage with patients who are increasingly likely to opt for healthier living rather than medicinal solutions to their tummy troubles.

“Sales of gastrointestinal remedies have surged in recent years as consumers have become increasingly aware of their diet and digestive health. However, along with a growing awareness of health issues comes a greater desire to treat illness through dietary changes rather than reaching for medications, which is a challenge for the market in years to come,” he said.

“Falling investment in NPD (new product development) is also likely to impact consumer engagement, which could in turn lead to a downturn in sales, highlighting the importance of innovation to the category.”