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DIGESTIVE HEALTH 51
see if live microbes are in the product,” he said. “Then there’s also confusion around strains of probiotics, some of which can cause ill health in individuals.
“We’ll often hear about Lactobacillus or even Lactobacillus acidophilus,
but it’s not meaningful unless we’re specific and state that it’s Lactobacillus acidophilus NCFM [for instance] – a strain, i.e. a critical part rather than just a species.
“So, it’s all well and good for people to try to increase the amount of good bacteria in their gut by consuming natural probiotics [live bacteria] from sources such as kefir and kombucha, as well as prebiotics.”
Mr Webster highlights, though,
that consuming these foodstuffs is beneficial as long as pharmacists
and their patients remember that the restaurant of the gut is not “by invitation only”, meaning that both bad and good bacteria can thrive in it.
“It’s always important to keep in mind that one size doesn’t fit all and that while there might be benefit for some individuals, it doesn’t mean that fermented dairy is the panacea for gut issues,” he said.
“There are many people who cannot tolerate dairy, and the problem isn’t just with the lactose, but also the casein.
I’d agree that there are some benefits to using fermented foods, but fermented dairy isn’t the only broom in the closet.”
Gut queries for all conditions
The gut can also play a part in a person being sick and listless, as the gut wall contains around 70 per cent of the cells that comprise the immune system, but there are many other reasons that could also cause these conditions.
“Chances are there will be issues with the gut wall,” Mr Webster said, adding that discerning the link can be tricky, however.
“Yes, it seems simple, but it’s so complicated, which means there must always be the inquiry as to what’s going on with the gut when it comes to any condition.
“And also remember that if somebody has an issue, it often took a long time to get there, so it might take a long time to get better, and if someone’s been in a particular frame of health, it might take a long time to reframe their health.”
He says that acne, dry and inflamed skin and eczema can be symptoms of a bacteria imbalance in the microbiota,
and that an inextricable link exists between gut health and mental health.
“We know this because we say things like, ‘I just followed my gut’, or ‘It didn’t feel right in my gut’,” Mr Webster said.
At the pharmacy level, he says, he is keen not to simply sell an OTC remedy, “which isn’t easy, as patients often just want a tablet”.
“It can also be problematic when I talk to people about sitting up at a table and chewing their food properly, because there are no teeth after their mouths,” he said.
Overall, he says the best way he can assist patients is by helping them to get a good understanding of their digestive issues and to take it from there.
“That approach is really crucial for
pharmacists – getting to the root of
the issue rather than taking the patient at their word,” he said. “That includes getting a good patient history and asking some questions, such as whether it’s the first time they’ve experienced the discomfort, what else was going on when they experienced the symptoms, whether the symptoms come and go, and what makes the gut discomfort better or worse.
“And when they think they’ve asked enough questions, they should ask a few more, such as what their symptoms are, how they started and how long they’ve had them.
“The biggest mistake a pharmacist can make is to grab something off a shelf without asking at least 10 questions.”
RETAIL PHARMACY ASSISTANTS • JUL 2020