Page 50 - RetailPharmacyAssistants-March2021-Updated

48 AS SEEN IN RETAIL PHARMACY As seen in the March issue of Retail Pharmacy magazine. IT’S NOT JUST HOT AIR By Peter Howard. Is it love ... or lunch? At least once in our lives we should all let our hearts burn with passion. We’ll become irrational, irresponsible and incredibly immature, which is a whole heap of fun. It’s also nothing like the behaviour of those with heartburn, who are irritable, in pain and incredibly inconvenienced. Professor Jane Andrews, Head of the IBD Service & Education and Department of Gastroenterology and Hepatology at the Royal Adelaide Hospital and a Clinical Professor at the University of Adelaide’s School of Medicine, spoke with Retail Pharmacy about the current best practice to identify and treat GORD. “What you’ll notice is that GORD is gastro oesophageal reflux disease,” she said. “If people present just with epigastric discomfort and indigestion, which are all felt in the abdomen, it’s usually not reflux, which is felt in the chest. Most epigastric discomfort or indigestion has no function or structural correlation with GORD.” “There are a lot of physiologically inaccurate ideas about GORD, such as it being acidic foods causing the oesophageal pain,” Professor Andrews said. “In fact, the amount of acid you produce from your stomach is far more than the amount you’re going to consume, even if you were to drink pure orange juice.” Dos and don’ts of diagnosis No one dies from reflux disease, Professor Andrews says, “but if you get it wrong, and it’s a heart attack and the patient should have gone to the emergency department, that’s a very different situation”. “I think the most important thing is that safety check at the beginning: • Is it in the right location? • Does it sound typical, looking at the person and listening to their symptoms? • Could it be cardiac? “One other thing I’d like to mention is sometimes people have dysphasia, which is difficulty swallowing or finding certain foods get stuck on the way down. It’s quite common with reflux disease to have some difficulty swallowing, with some people also having pain on swallowing, which is usually associated with inflammation.” Treatments In a range of treatment options for acid reflux and GORD, the most commonly used are antacids and PPIs. Generally, antacids are used for patients experiencing occasional symptoms of heartburn, while PPIs are for more serious ongoing cases of GORD. In addition to medicines, it’s helpful if pharmacists can advise patients as to simple lifestyle adjustments that may alleviate the onset of GORD, even when heartburn medicine is also prescribed. These include: • Losing excess weight. For those considered medically overweight, a reduction in weight may reduce acid reflux and, in some people weight loss may eliminate GORD entirely. • Avoid large meals. Acid reflux frequently occurs when patients have overindulged by eating large meals, while not being felt when smaller amounts of the same food are consumed. • A number of other lifestyle changes. While diagnosis is relatively simple, options for treatment include a range of alternatives. This gives pharmacists an opportunity to engage in meaningful patient conversations in which severity and frequency of symptoms can be discussed, leading to advice covering lifestyle changes, dietary fibre adjustments, OTC antacids and combination medicines or referrals for prescriptions including H2 receptor blocker or PPI medicines. RETAIL PHARMACY ASSISTANTS • MAR 2021 To read the full feature as it appears in the March issue of Retail Pharmacy magazine, visit: retailpharmacymagazine.com.au/magazine