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PHARMACY UPDATE: A gut reaction.

Article Excerpt
This article can help in the following CPD competencies: G1a, G1c, C1f, C1c. A list is available at www.uptodate.org.uk/home/PlanRecord.shtml

Objectives

* To understand the causes of indigestion symptoms

* To know which types of indigestion may be treated by pharmacists and when to refer

* To distinguish between different types of indigestion

* To be aware of the drugs and foods that may precipitate indigestion

THE COLLEGE OF PHARMACY PRACTICE

This course (module 1344), in association with multiple choice questions being published in C&D August 6, provides one hour's continuing education

In the first of two articles, Derek Balon considers which symptoms can be treated OTC

Abdominal pain may result from more than 280 possible underlying pathologies and thus represents a considerable diagnostic challenge to healthcare professionals.

Symptoms can range from harmless to extremely severe, life-threatening conditions. Relatively few cases presented to pharmacists need prompt professional medical advice, but sudden and very severe pain should be treated as a medical emergency.

Indigestion is a common complaint. Surveys in general practice have suggested a prevalence of 40 per cent, with up to a quarter of sufferers consulting their GP.1,2,3 It is estimated that about 4 per cent of general practice consultations are for indigestion, with 10 per cent of patients being referred to secondary care for further consultation or investigation.

This article considers only the presentation of pain and discomfort in the epigastric and oesophageal region. This type of pain may be referred to as "indigestion" or perhaps "heartburn" and represents a symptom, not a condition. It includes bloating, a feeling of fullness, nausea and anorexia.4

The term heartburn is usually reserved to define pain in the heart region (retrosternal). People with heartburn or acid regurgitation alone, and those in whom reflux symptoms are dominant (with epigastric pain or discomfort being minor), should be defined as having symptomatic gastro-oesophageal reflux disease (GORD).

Pain in the areas described may be the result of many conditions that must be taken into account when making a diagnosis (working hypothesis) and deciding whether...