Pharmacists can identify risks and talk to patient about them.

By Kajal Mistry

Gastrointestinal discomfort is a very common complaint and although most of the time it’s easy to manage and short-lived, some people will experience regular discomfort.

It’s a really broad spectrum and there are a range of different symptoms and ways to treat them. Some conditions can lead to further complications or become worse over time, so it’s really important that patients can access advice and support when they need it. That’s where community pharmacy comes in.

Most digestive problems can be tackled by changes to lifestyle habits like diet and exercise. There are some more complex conditions that require patients to receive repeat prescriptions which brings its own challenges for pharmacy teams.

Minor symptoms

Most gastrointestinal symptoms are relatively minor and easily treated with over-the-counter (OTC) medicines. For example, indigestion and acid reflux can be treated with antacid products.

Things like heartburn or constipation might appear straightforward to resolve, but they can cause a lot of discomfort and even pain when left untreated.

Patients with this kind of indigestion may be dealing with a variety of symptoms, especially while lying down; excessive burping; flatulence, and a painful burning sensation in the chest, especially after eating.

This can affect their mood, sleeping patterns and general wellbeing. As pharmacists, we have an opportunity to talk to patients about how they manage these symptoms, especially to those who experience them more frequently.

We can use these conversations to provide advice and suggest various OTC products that might be useful, depending on the situation and the patient’s condition or their existing medication. It’s always worth checking what else they’re taking before suggesting something new.

Patients presenting with symptoms of IBS (Irritable Bowel Syndrome) are likely to be in a lot of discomfort and may ask their pharmacist for help. Not everyone with IBS needs treatment, but some can be relieved using medicines like mebeverine or hyoscine. It’s important to work out what the best course of action is for each individual patient – you can’t take a one size fits all approach.

Complex cases

When dealing with patients that have more complicated gastrointestinal issues, it’s vital to listen and try to understand the full picture of their condition. In the past I have found that it is even necessary to take on more of a counselling role for some patients who are coming to terms with having a serious illness.

This is a good way of building relationships with patients and ensuring that they come back to your pharmacy for help and advice when they need it. There are some patients that feel like they have to cope on their own or just get over the discomfort, but that can lead to further complications. So, it’s important that people understand where they can go for help.

Pharmacy teams interact with patients every single day and when some people are coming in regularly with the same complaints, it’s easy to spot patterns. If someone is constantly struggling with heartburn or IBS then it could be a sign of something else and pharmacists are ideally placed to identify these risks and talk to the patient about them.

From a clinical perspective, it can be quite a stimulating challenge to work out how best to support patients with more serious cases. As well as understanding their medicines regime and identifying any possible interactions, you may need to speak with their GP to discuss the best course of treatment and help with monitoring the progression of the illness.

More severe conditions like ulcerative colitis and Crohn’s disease can be treated with medicines such as budesonide, prednisolone and mesalazine.

Facts

  • One in 5 people in the UK experience IBS at some point in their lives
  • Four in 10 will have at least one digestive symptom in their lives
  • One in every 650 in the UK have Crohn’s disease

Role of pharmacies

Pharmacists should be seen as the go-to place for most gastrointestinal issues. Some of the symptoms can be quite vague and most of the time it isn’t necessary to visit a GP.

As professionals, we can advise and provide guidance on the use of OTC products for gastrointestinal discomfort, and we can spot when the condition is getting worse and needs further attention. For example, if any gastrointestinal symptoms are worrying or last longer than about two weeks, the patient should make an appointment to see their doctor.

Being healthcare hubs within the community, pharmacies and their teams are there to help raise awareness and understanding of digestive health and how to manage gastro discomfort.

Kajal Mistry is with Healthcare and NHS Pharmacy Services at McKesson UK.

This article also appears in the November issue of Pharmacy Business.

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