By Linden Pirrone, Guild Trainer / Assessor
The countdown to Christmas has begun! Tis the season to start preparing the ham, turkey, prawns, an abundance of salads, Christmas pudding and Pavlova (wow, I am hungry just thinking about it). But as pharmacy assistants ‘tis the season for overeating, heartburn and indigestion!
Many of us, including our customers, overindulge at Christmas time and suffer from the symptoms of indigestion or heartburn. Firstly, let’s look at some of the key symptoms and causes of indigestion and heartburn so we know what we need to treat.
So what are we treating: indigestion or heartburn?
Let’s start with the symptoms and causes of indigestion.
Indigestion (dyspepsia) can be rather painful, uncomfortable, inconvenient and at times embarrassing.
Common symptoms of indigestion may include:
- Bloated stomach – pain in the upper abdomen and the feeling of extra fullness for a long period of time.
The reason we feel this way is because after eating more then we should, we produce too much acid in our stomach. This acid disturbs the mucus gel barrier which protects the lining of our stomach, the stomach then becomes irritated, even swollen, leading to indigestion or heartburn.
Heartburn is felt higher in the chest area rather than the stomach and upper abdomen. The pain is described more as a burning sensation in the chest and/or heart area. Some customers may even complain that heartburn often leaves an acid taste in the mouth.
The contents of the stomach is controlled by a one-way valve called a sphincter, which prevents the acid from rising. If there is too much pressure in the stomach, then the digestive juices can bubble up and leak from the stomach up into the oesophagus. Unlike the stomach, the lining of the oesophagus is just like skin and does not have the mucus gel barrier as protection from the acids of the stomach. Symptoms of heartburn should be carefully examined, to avoid misdiagnosed of a heartburn, when someone may be suffering from a heart attack.
Common symptoms of a heart attack include chest pain or discomfort, pain in your arm(s), back, neck or jaw, stomach pain, shortness of breath, nausea or lightheadedness, sweating or fatigue. If our customers have any concerns about their symptoms refer them to your pharmacist or call 000.
Lifestyle tips and solutions
In recent months the widely used proton pump inhibitor (PPI), Esomeprazole has been rescheduled by the Advisory Committee on Medicines. The purpose of the reschedule is to provide our customers with more access to these products under certain conditions.
The Committee has decided that medications containing 20 mg or less of Esomeprazole for the relief of heartburn and other symptoms of gastro-oesophageal reflux disease, in packs containing not more than 14 days’ supply should be available as a Schedule 3 product, therefore only under the recommendation of the pharmacist. The decision was based on overseas data demonstrating the safety and effectiveness of 14 days’ therapy compared with just seven days. There was also a consideration with the fact that the less effective H2RA alternative ranitidine which is already unscheduled (seven days’ supply) or Schedule 2 (14 days) can be subject to patient tolerance issues and is not as effective. The use of 14 days’ therapy with Esomeprazole has also been demonstrated to provide improved sleep quality, work productivity and improvement in everyday functionality because of the effective relief of the heartburn and acid reflux symptoms. The best news for our customers is the fact that having access to a 14-day pack was also more cost-effective. For more information visit: https://www.tga.gov.au/publication/poisons-standard-susmp
Medication can help relieve the symptoms however it is important that customers embrace lifestyle tips to minimise the effects and symptoms of indigestion and heartburn. Here are some examples:
- Don’t go to bed with a full stomach (leave at least three hours)
- Don’t overeat.
- Eat slowly with smaller portions.
- Avoid foods and drinks that can bring on heartburn symptoms. For example onions, peppermint, chocolate, beverages with caffeine or alcohol, citrus fruits or juices, tomatoes, high-fat or spicy foods.
- Avoid tight-fitting clothing which may put pressure on the symptoms
- Avoid smoking
- Maintain healthy weight and diet
Wishing you a safe and healthy Christmas, and not too much overeating, please!