30 WORLD GASTROENTEROLOGY NEWS JANUARY 2015 Editorial | Expert Point of View | Gastro 2015: AGW/WGO | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events Lutz (USA), a member of the execu-tive committee of the FIP community pharmacy section (CPS), who further discussed the “impact of guidelines in pharmacy practice,” emphasizing the role of community pharmacists in the treatment of common GI symptoms. The application of daily pharmacy practice was presented by Paul Sinclair (CPS, Australia) using a couple of case studies. Reflux and heartburn as a self-care model was another topic of discussion as a part of an industry sponsored satellite symposium on self-care in the 21st century. Different issues of self-care were discussed by experts in the field, including the role of pharmacists, a health care economic perspective, with reflux/ heartburn used as a self-care model. In dealing with heartburn, which is the hallmark of gastroesophageal reflux disease (GERD), it is important to recognize the alarm symptoms which should prompt further investigations. Treat-ment includes lifestyle modification and acid reducing agents. The use of prokinetic agents has been limited by their unproven efficacy and side ef-fects. As far as self-care is concerned in heartburn/GERD, the relief of symp-toms is the main goal. In the pres-ence of alarm features, self-treatment should be avoided and patients should be referred to GI specialists for further investigation. There is increasing public interest in self-medication for common GI symptoms with OTC medications which have become readily available. The WGO Global Guideline was de-veloped with a joint effort among GI specialists, primary care experts, and FIP representatives to guide in the management of common GI symp-toms, including: heartburn, abdomi-nal pain/ discomfort, bloating and constipation. The guideline provides diagnostic and treatment cascades, with resource-sensitive recommenda-tions mainly focusing on self-care to the role of pharmacists in the utilization of the OTC medications. Pharmacists could serve as frontline healthcare professionals in self-care, recognizing problems and providing consultations related to therapy (such as drug side-effects, drug interactions, and timely referrals to primary care providers or GI specialists). The main concerns of the self-care approach using OTC medications are the possi-bilities of misdiagnosis or under-treat-ment of the underlying conditions, although it is unlikely as they are of mild severity. It is important to iden-tify patients with a high likelihood of a serious condition in the presence of alarm features and failed therapy so that they can be referred for proper investigation and management.
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