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“I ask them: do you wake up with an unpleasant taste in your mouth, is your tongue discoloured or do you have any signs of an ulcer? – to work out if it’s dyspepsia, maldigestion, reflux or gastritis, etc.?” Mr Webster says many of his patients suffer from GORD. He emphasises that PPIs “commonly prescribed for GORD were designed for short-term use”. “They’re becoming more problematic as they’re more commonly used for longer periods of time,” he said. Another of the problems associated with PPIs, he says, is that they can affect the body’s absorption of nutrition from food, including vitamin B12 among other nutrients. “PPIs block the proton pumps in the stomach that secrete hydrogen and ions, which are effectively acidic compounds,” Mr Webster said. “These acidic compounds are required to assist in the breakdown of food particles into smaller blocks to allow the small intestine to absorb the nutrients more easily. For instance, vitamin B12 requires the presence of a compound called intrinsic factor, which is the compound used for vitamin B12 to be absorbed from the gut lumen. “If a person has low gut acid, they’ll have lower amounts of intrinsic factor.” To overcome a lack of intrinsic factor, Mr Webster uses a sublingual preparation, drops or tablets. “That way, they’re dissolved under the tongue and absorbed through the veins under the tongue,” he said. He adds that magnesium, iron, calcium, vitamin B3 and vitamin B6 need acidic conditions for absorption. “Sure, you could swallow more magnesium, but just because you push more magnesium down the chute doesn’t necessarily mean that you’re going to get higher amounts of absorption,” Mr Webster said. “One way around that, of course, is to find alternative ways. I’ve found that topical use of magnesium oil, gel or cream can assist with absorption.” Holistic approach for gastrointestinal wellbeing On a bigger scale, a new, world-first range of complex probiotics has been launched to support the health and function of the gastrointestinal system. Research and development from practitioner-only brand Bioclinic Naturals, part of Canada’s Factors Group of Nutritional Companies, has revealed a more holistic approach to supporting and restoring gastrointestinal homeostasis, by including not only beneficial bacteria, but also other potentially beneficial organisms and nutrients. This has led to the development of Scobiotics, a more complex form of probiotic, made up of syntrophic blends of mixed cultures of bacteria, fungi and blue-green algae. Evan Hayes, Bioclinic Naturals ANZ Managing Director and developer of Scobiotics, says the availability of a more complex probiotic is a positive GASTROESOPHAGEAL REFLUX DISEASE 39 advance for Australian healthcare practitioners and their patients. “With over half of Australia’s population experiencing gastrointestinal issues, it’s imperative that healthcare professionals have products that reflect the complexity of the microbiome and are specific to the conditions that they’re treating,” he said. “Scobiotics represent a new frontier in probiotics, based on innovative science, extensive research, and supported by strong clinical evidence. “The ingredients in Scobiotics help increase the production of secondary metabolites specific to areas such as SIBO \\\\\\\\\\\\\\\[small intestinal bacterial overgrowth\\\\\\\\\\\\\\\] or immunity, resulting in formulations that are targeted beyond just probiotic strains, for more personalised probiotic solutions. “Scobiotics’ enhanced metabolite production by synergistic symbiosis also allows probiotics to flourish and multiply faster. “The gastrointestinal tract is an extremely diverse and complicated environment and the wide scope of Bioclinic Naturals’ Scobiotics attempts to reflect this complexity.” The Scobiotics range is promoted as being able to be used to help support small intestinal health, healthy digestive function and an enhanced immune function, and to help decrease mild gastrointestinal tract inflammation. References: 1. nejm.org/doi/full/10.1056/NEJMoa1811424. Effective and lasting relief of frequent heartburn & stomach acid complaints due to gastro-oesophageal reflux disease. Available in 7 & 14 pack Available to order via all major wholesalers, your Sales Representative or call 1300 9 27769 ASK YOUR PHARMACIST – THEY MUST DECIDE IF THIS PRODUCT IS RIGHT FOR YOU. ALWAYS READ THE LABEL. FOLLOW THE DIRECTIONS FOR USE. IF SYMPTOMS PERSIST, TALK TO YOUR HEALTH PROFESSIONAL. RETAIL PHARMACY ASSISTANTS • AUG 2020