Talking about bowel health can feel a little embarrassing… to say the least.
“We know that it can be hard for people to talk about their bowels,” says Dr Rachel Ainley, head of research at Crohn’s & Colitis UK. “Pharmacy staff can help make it easier by finding a private consulting space to discuss symptoms and offer reassurance that these could be signs of a wide-ranging number of conditions… We need your help to get people an early diagnosis and started on treatment when it can do most good.”
Interventions from simple conversations in the pharmacy could be vital in spotting something serious. So let’s take a look at some of the most common bowel health concerns…
Good gut health
The gut is home to 100 trillion microbes, which make up the gut microbiome. These microorganisms are important for normal gut function and digestion as well as for supporting the immune system.
“Although there is no definition of what constitutes a healthy gut microbiome, many health conditions have been linked to an altered gut microbiome,” says Dr Linda Thomas, secretary of the British Gastroenterology Gut Microbiota for Health expert panel. “IBS and constipation are common conditions that may be associated with adverse changes in the gut microbiome.”
Studies have shown that probiotics can help to maintain good gut health. It’s important to recommend that customers try a good quality product. “Quality can be assessed by checking the label. The full name of any probiotic strain should be printed, but as well as the species, there should be a code or name that exactly identifies the strain,” says Dr Thomas. She advises that customers should try a probiotic for at least eight weeks as they can take a while to be effective.
Bowel cancer is the country’s second biggest cancer killer, with 43,000 cases diagnosed in the UK every year. Detecting it at an early stage is vital, as nine in 10 will survive if it’s picked up early. The good news is that more people are being urgently referred for key tests that can diagnose it, which indicates that more are seeking help after noticing changes, according to charity Bowel Cancer UK.
“At the forefront of healthcare, pharmacy teams are ideally placed to raise awareness of bowel cancer,” says Claire Coughlan, clinical lead at Bowel Cancer UK. “In particular about the symptoms and the NHS screening programme. The advice of pharmacy teams can really help by informing and reminding patients that it is best to get checked out.”
Symptoms customers need to be alerted to include:
- Bleeding from the anus and/or in faeces
- Persistent and unexplained change in bowel habits
- Unexplained weight loss
- A pain or lump in the abdominal region
- Extreme fatigue.
“It’s important to know that most people with these symptoms won’t have bowel cancer. But if a customer has any of these, they should be encouraged to see their GP,” says Claire.
Risk factors include being over the age of 50, a strong family history, history of polyps, longstanding inflammatory bowel disease (IBD), type 2 diabetes and living an unhealthy lifestyle. “Scientists believe 54 per cent of all bowel cancers could be prevented by having a healthier lifestyle,” explains Claire. “Risk can be reduced by taking some simple steps to improve diet. Avoid processed meat and red meat; eat plenty of fibre; be a healthy body weight.”
Bowel cancer screening reduces cancer deaths by 25 per cent, says Public Health England (PHE). In England, screening is offered every two years to people aged 60-74, and this is gradually being rolled out over the next four years to people aged 50-59 as well. In Scotland, screening starts from age 50; in Wales, it’s 55-74 and in Northern Ireland, it’s 60-74.
“Make sure that you and your colleagues understand the importance of screening. It can detect bowel cancer early before any symptoms appear, when it is easier to treat,” says Claire.
Pancreatic cancer has the lowest five-year survival rate of all of the 22 most common cancers in the UK, at 7.3 per cent. Whilst this number is low, it has improved steadily over the last few years and Pancreatic Cancer Action (PCA) is aiming to raise it to 13 per cent by 2030.
As with most cancers, early diagnosis is key, with survival odds increasing by 30 per cent. Currently, 43 per cent of all cases are diagnosed in A&E, when the cancer is more likely to be at a later stage.
Symptoms customers need to be aware of include:
- Indigestion that doesn’t respond to treatment
- New onset type 2 diabetes in patients of normal or under weight
- Mid-back pain
- New onset of IBS-like symptoms in people over the age of 45
- Change in bowel habits
- Unexplained weight loss
- Nausea and vomiting
- Loss of appetite.