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Digestion and bowels probably cause people more complaints than any other part of the body

We provide a digest of the latest product news for stomach and bowel problems

Many digestive symptoms are triggered by lifestyle changes, poor diet or stress. At this time of year, festive season overindulgence and bingeing on stodgy foods are often to blame. When it’s cold outdoors, people often exercise less and eat more, which can play havoc with their digestive system.

“Digestion and bowels probably cause people more complaints than any other part of the body,” says Dr Nick Read, gastroenterologist, nutritionist and psychotherapist, chair of trustees and medical adviser to the IBS Network. Heartburn, indigestion, abdominal pain, bloating, constipation or diarrhoea affect about half of the population frequently, some on a daily basis.

“But look at the way people treat their digestive system and bowels. They either starve them into submission or stuff them so full of food they threaten to burst at the seams. They eat the wrong things, drink too much alcohol and never give them the time to relax and get on with their job in peace.”

Many common digestive ailments can be eased with OTC medicines. But some people are turning to lifestyle changes and natural products to ease their digestive symptoms and keep their digestion and bowels in good shape.

“It’s all about self-regulation and balance, food and mood,” says Dr Read. “Natural products can play a role in managing the symptoms of irritable bowel syndrome to help make every day living more comfortable.”

Irritable bowel syndrome

Irritable bowel syndrome (IBS) affects up to one in five people in the UK. The exact cause is unknown, but most experts think that IBS is related to increased gut sensitivity. The symptoms vary from person to person, but include abdominal pain, diarrhoea and/or constipation, and bloating. The pain is caused by muscle spasms in the bowel.

A recent survey for Buscopan IBS Relief revealed that 50 per cent of IBS sufferers felt better after they identified their triggers. “It’s so important to keep a diary to record foods eaten, along with other potential triggers such as stress and hormones,” says Helen Bond, consultant dietician and nutritionist. “It’s also a good idea to keep an IBS treatment handy for times when a flare-up does occur.”

Many IBS sufferers try probiotics to ease their symptoms. But some products contain relatively few viable bacteria or are inactivated by the stomach’s acidic environment, so customers need to choose products carefully. Symprove was recently shown to relieve IBS symptoms in 60 per cent of sufferers within 12 weeks. Independent research at University College London found that Symprove’s live bacteria were proven to arrive in sufficient numbers, survive the transit through the stomach, and to thrive in the intestines.

“Many people find the winter months, and the run-up to Christmas in particular, a time of increased stress and anxieties,” says gastroenterologist Dr Guy Sisson. “These stresses in combination with richer, seasonal diets and higher alcohol consumption may lead to an exacerbation of IBS symptoms. Probiotics are live bacterial products, some of which have been shown in clinical trials to improve the symptoms of IBS. Taking one as part of a daily routine may help to relieve symptoms.”

Constipation

Constipation affects around one in seven adults in the UK. Many people who experience irregular bowel movements try laxatives first. But pharmacy customers should be advised to increase their fibre intake first, as most people in the UK don’t eat enough fibre-rich foods. Other useful advice includes drinking more fluids and taking more exercise.

If customers can’t get enough fibre in their diet, a natural fibre remedy (eg, Fybogel) or a fibre supplement (eg, Lepicol) may help. Lepicol is a three-in-one supplement containing probiotics, prebiotic and psyllium husk fibre. Research shows that it can increase bowel movements and reduce the intensity of constipation symptoms.

“Up to 40 per cent of the general population will resort to using laxatives at some stage in their lives, despite conventional advice to only use laxatives intermittently,” says Dr Mayur Joshi, medical advisor at Probiotics International (Protexin). “The use of laxatives over a prolonged period of time can have significant consequences. Lepicol can significantly improve symptoms and quality of life in people with functional constipation. It also significantly reduces the need for laxatives.”

Diarrhoea

When customers have diarrhoea, oral rehydration sachets are important to prevent or treat dehydration, especially in babies and older people. Antidiarrhoeal remedies, such as Imodium, can help to treat diarrhoea early on, but only in adults and children over 12 years. Recent launches mean that pharmacists can now offer a wider range of diarrhoea-relieving products to suit customers’ different needs.

Dioclear is made from diosmectite, a natural clay that adsorbs toxins, bacteria and rotavirus. “Dioclear treats diarrhoea fast from the first sachet,” says Juliette Holmes, marketing manager at Kent Pharmaceuticals. “It works on the cause of the problem, whatever it is (from bacteria to a chronic condition). It doesn’t have any nasty side effects and can be used by all, even pregnant women, babies from one year and people suffering from IBS or Crohn’s disease.”

Enterosgel is a silicone-based product with dual action. “Enterosgel is a unique formulation of adsorbent with a new twist,” says pharmacist Derek Evans. “It protects the gut lining by coating the gut mucosa and also adsorbs toxins produced after overindulgence. This in turn will help reduce the symptoms often presented at the pharmacy counter of bloating, indigestion, nausea and diarrhoea.”

There is also some evidence that probiotics can help in diarrhoea management. “Supplementation with probiotics such as Pharma Nord’s Bio-Culture increases the number of beneficial bacteria in the gastrointestinal tract,” says Dr David Mantle, medical adviser to Pharma Nord UK. “These compete with pathogenic bacteria for nutrient resources, as well as bacterial binding sites on the intestinal mucosal lining. Probiotics also produce substances called bacteriocins, which inhibit the growth of a wide range of undesirable bacteria, as well as secreting enzymes that are capable of degrading bacterial toxins.”

Indigestion, wind and bloating

Indigestion often causes wind and bloating, as well as pain or discomfort in the upper abdomen. Common triggers include rushed meals, fizzy drinks, beans, onions, cabbage and cauliflower. Customers with occasional symptoms can try an antacid/alginate combination for symptom relief, or as a preventative measure.

Maalox Plus, which contains simeticone as well as antacids, may also help with wind and bloating. If customers have persistent or recurring symptoms, pharmacists can recommend an H2 antagonist or proton pump inhibitor, but not for longer than two weeks.

Some customers may prefer to try a natural approach, such as Potter’s Slippery Elm tablets or Silicol gel, which is distributed by FW Medical and is a commercial partner of the IBS Network. A single tablespoonful of Silicol gel, taken three times a day, has been shown to normalise the function of the stomach and bowel quickly and without side effects. Used regularly, Silicol gel can also reduce excess acidity and gases to reduce bloating and discomfort.

Alflorex probiotic supplement was launched in the UK in July after success in Ireland. It contains the PrecisionBiotic 35624 culture, which has been studied in IBS patients and proven to be effective at reducing abdominal discomfort, passage of gas, and bloating/distention. “While everyone’s gut microbiota is different, research has shown that many digestive complaints, including IBS, can be linked to a bacterial imbalance in the gut,” says Dr Eileen Murphy, research director at Alimentary Health. “Maintaining and enhancing gut microbiota is important, not only to digestive health, but can also have beneficial effects on general health.”

Acti-Biotic ActiMint tablets also contain live bacteria to improve overall gut health and wellbeing. A new improved coating and increased fructo-oligosaccharide (FOS) content create a synergistic effect that ensures higher levels of beneficial microflora reach the gut.

Digestion problems in infants

Functional gastrointestinal disorders (FGIDs) are common in infancy, affecting around half of infants in their first year. Nutricia has worked closely with Communications International Group to develop an educational booklet for pharmacy staff on ‘Management of Infant Feeding Problems’. This covers issues such as functional gastrointestinal disorders, cows’ milk allergy (CMA) and lactose intolerance, discussing causes, symptoms and management.