Page 37 - Retail Pharmacy March 2021

and chocolate. Maintaining a note of what you eat and the effect on your digestion helps planning ahead to avoid those trigger items. • Body position. Avoid lying down, bending or straining to lift heavy items too soon after meals. Raising the top end of the mattress can help those who get acid reflux at night. Certain medicines, including some used for depression and high blood pressure, are known to make acid reflux worse in some patients. Other medicines prescribed to treat arthritis can also cause acid reflux as a side effect. Check with patients to see if they’re on any regular medicines likely to increase symptoms of acid reflux or GORD. Don’t dismiss healthy diet As we’ve heard, GORD and acid reflux are very dependent on what we eat, so, other than medicines, diet is a major factor for both prevention and treatment. Speciality health food supplier Health Food Symmetry (HFS) has a research focus on human microbiome modulation. The company has developed Kfibre, involving the removal of almost all the sugar from sugarcane, claiming the product is a unique prebiotic with its plant cell wall structure comparable to other fruit and vegetable cellular material but without the levels of accompanying carbohydrate sugars or lipids that are generally present. Fruits and vegetables typically have dry weight/wet weight fibre content of one per cent/1.8 per cent, so, according to HFS, a 3g dose of Kfibre has about the same fibre content of 166-300g of fruit or vegetable. Application of Kfibre therefore allows variation of the levels of cellular fibre in the diet independent of any significant change in energy content, HFS says, which is a significant benefit for those trying to cut back on carbs while aiming to increase their fibre intake. “All HFS do is take the sugar out of sugarcane in such a way that all the policosanols, the flavonoids, the vitamins and so on, are still in there,” HFS CEO Gordon Edwards said. “We do it using no chemicals and we do it using minimal heat, so we barely change the constitution at all. “Essentially, we take what is classed as the bad elements and keep all of the good elements. Mother nature was very kind to sugarcane. It’s like a mini rainforest and full of good things. “We started out looking at a product for dietary fibre and, as we progressed, we started getting anecdotal evidence for systemic inflammation and reflux. “We then directed our research to what the anecdotal evidence was telling us, and that led to a GORD reflux trial with Professor Roger Stanley and the University of Tasmania.” Professor Stanley is Foundation Director of the Centre for Food Innovation, based at Launceston. He also works as a joint appointment with the Defence Science and Technology Group’s food and nutrition research laboratory at Scottsdale and links local research to the national CSIRO food research network. His research focus includes the development of improved nutritional and performance (functional) foods. The GORD trial looked at specific prebiotic dietary fibre from sugarcane in relation to acid reflux and short chain fatty acid synthesis. “The study was a double blind, randomised, placebo controlled study, with 40 subjects divided into two groups of 20, with the treatment group prescribed Kfibre for a period of three weeks,” Mr Edwards said. “Mother nature was very kind to sugarcane. It’s like a mini rainforest and full of good things.” HEALTH GORD 35 According to HFS, the results show a considerable clinical benefit in reducing acid reflux/GORD symptoms compared with placebo intervention. “We believe the results show an excellent reduction and trend towards symptom alleviation in the Kfibre treated subjects compared with the placebo group.” Time to cut the GORD With acid reflux or GORD experienced by a high proportion of Australian adults at some point in their lives, and estimates suggesting 60-70 per cent of the population suffer from reflux in any 12-month period, it’s a condition pharmacists are going to see regularly among their patients. 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. The Expand Your Range options on the following page offer some additions to existing products, while keeping up with the latest developments and alternative treatments. RETAIL PHARMACY • MAR 2021