SPOTLIGHT: Managing digestive health

Naresh Rallmil shares his insights into how pharmacy teams can support patients who have problems with their digestive system health…

Maintaining a healthy digestive system is a vital component of a customer’s overall health. Gut health affects how food is processed and digested, in turn affecting how and what vitamins and minerals are absorbed from the food that is ingested. It also impacts immune system efficiencies which can lead to allergies and autoimmune conditions.

As such, supporting customers with their digestive health should be a key focus for community pharmacists. Alongside offering a range of over-the-counter products, pharmacists are well placed to offer one-to-one guidance for customers concerned about their digestive health. Top tips that pharmacists should provide their customers with, include:

Eating well

Having a balanced diet that features plenty of fruit, vegetables and fiber should not be underestimated as a tool to promote good gut health. Pharmacists should encourage customers to eat less animal-based protein, less fat, and less refined sugars.

What’s more, eating starchier carbohydrates, such as potatoes, whole wheat bread, rice or pasta which are high in fiber, should be recommended. These complex carbohydrates release sugars slowly and can keep customers feeling full for longer, therefore helping prevent individuals from snacking and potentially eating unhealthy food that damages good digestive motility.

For customers struggling to maintain a healthy balance, community pharmacists should advise that between a third of a person’s daily dietary intake should be made up of fruit and vegetables, another third should be made up of carbohydrates and the rest should be made up of protein and dairy.

Pre and probiotics

Ingesting foods with pre and probiotics can be very useful for customers dealing with poor gut health. The terms prebiotics and probiotics can be confusing for patients, so pharmacists should aim to demystify what their offering entails. Prebiotics help feed out digestive bacteria and maintain good gut flora.

Whilst probiotics can be found in food that has been fermented or in supplements containing these bacteria, which can then be ingested to promote the levels of good healthy bacteria in the digestive system. Probiotics can be found in certain yogurts, fermented tea, and fermented cabbage – foods that pharmacists should recommend to patients suffering with poor gut health.

Water intake

Drinking plenty of water is imperative for positive digestive health. Fluids help maintain healthy gut motility, prevent constipation, and assist the body in absorbing all the right nutrients. Additionally, consuming lots of water has the benefit of maintaining a normal blood pressure. Pharmacists should remind customers that adults should be drinking around two litres of water per day, which translates to approximately six to eight glasses of water.

Smoking cessation

Cutting out smoking can help improve digestive health and should be recommended to patients requiring support with their gut health. The nicotine found in cigarettes can relax the lower oesophageal sphincter causing food to pass back up the oesophagus from the stomach, resulting in pain and poor digestion of food.

Nicotine can also cause additional acid to be released by the stomach and can cause the gut to become irritated, leading to ulcers. This provides pharmacists with an opportunity to offer guidance on smoking cessation, including products that are available to help support customers who are seeking to quit smoking.

Alcohol Intake

Excessive alcohol intake can also cause lots of problems for the digestive system. Like smoking, alcohol can relax the oesophageal sphincter causing reflux which results in heartburn. Additionally, alcohol can damage the mucous lining of the stomach which protects against stomach acid.

This can damage the stomach wall and can lead to an ulcer. As such, pharmacists should offer guidance on cutting down on alcohol intake. Whilst pharmacists can offer practical lifestyle tips such as these to customers seeking support, often customers might not be aware of their poor digestive health and will require assistance with diagnosing and identifying their gut health issues.

In order to best support their communities, pharmacists should look out for symptoms such as bloating, discomfort and gas, constipation and diarrhoea, and heartburn. These symptoms can indicate that the body is having trouble digesting food and eliminating it from the body, due to something that has been ingested.

Other symptoms community pharmacists should look out for include poor sleeping patterns and skin irritation. Poor sleeping patterns, night-time waking and not feeling refreshed in the morning can suggest poor gut health, whilst skin irritations, such as dry skin or eczema, are symptomatic of a poor diet, not enough fluids, or an intolerance to certain food.

Once digestive health issues have been identified, community pharmacists should offer the above lifestyle guidance, as well as suggesting medicines that can support with the relevant issue. Since the category holds approximately 10 per cent of the total medicines category for Numark pharmacies, there are a wide variety of products available for selection, particularly within the heartburn and indigestion subcategory.

Community pharmacists can provide customers with guidance on which medicines are best suited to their health conditions and lifestyle, helping them navigate the category. Since indigestion products have moved from prescription-only (POM) to general sale list (GSL) medicines, self-selection is also available for customers. As such, pharmacists should keep this in mind when organizing their fixtures.

Leading brands, such as Gaviscon, Senokot, Imodium, Anusol and Buscopan, are all well-known and instantly recognizable, so customers will use these brands to locate and navigate the category. Therefore, it is important that these take prominent position within a pharmacy’s fixtures.

Pharmacists should also keep in mind that in 2020 there were some significant changes to the stimulant laxatives category, moving a range of products from being available on the shop floor to only being available from behind the counter. This offers pharmacy the opportunity to provide a product range that is not on offer to customers at other retailers.

Pharmacies wide product offering, when combined with the bespoke guidance community pharmacists can provide, makes community pharmacies a first port of call for customers suffering with poor digestive health.

Furthermore, when dealing with sensitive health issues like gut health, the value of welcoming, accessible and customer-focused support cannot be underestimated. And that friendly service is what community pharmacy is, and will continue to be, renowned for.

(Naresh Rallmil is the lead information pharmacist at Numark.)