If gastrointestinal problems suddenly develop, consider whether or not you have recently begun a course of medication. A change in contraception, for example, may trigger bowel problems. And many of us know from experience that antibiotics taken to cure a bacterial infection can upset the delicate balance of normal bacteria in the gut, resulting in soft stools and diarrhoea. Other common reactions to medication include constipation and nausea. Some drugs, such as aspirin and ibuprofen, can even cause gastric bleeding if taken over an extended period.
What to do about physical problems caused by essential medication presents a real quandary. The advice in Chapter 4 about foods that help control specific gastric and bowel conditions can help you live comfortably with your medication. If symptoms do not respond, you will need to seek other help. Start with your local pharmacy, but if symptoms include signs of blood, a fever or severe gastric pain, tell your doctor at once.
These drugs are often used to treat pain and inflammation caused by injury, arthritis and gout, and include aspirin, ibuprofen, fenbufen, mefenamic acid and piroxicam.
The vast majority of people experience no side-effects from these medications, but they can cause nausea, indigestion, diarrhoea and – in extreme cases – erosion of the stomach lining that may develop into an ulcer. If you are taking these products and experience digestive problems, discuss them with your doctor.
In the few decades since the discovery of the miracle of antibiotics, uncounted millions of people have been saved from deadly bacterial infections. Like all powerful drugs, however, antibiotics may cause side-effects, the most common of which are nausea, diarrhoea or a rash.
Antibiotics work by targeting and killing specific groups of bacteria; unfortunately, sometimes the normal bacteria in a healthy gut are also affected. (As discussed in Chapter 2, a balance of healthy bacteria is required for the gut to work.) When this balance is disturbed, the result can be a surge in the presence of unwanted flora in the gut and the sudden onset of symptoms. If this occurs, a good first response is to try to re-establish the presence of normal gut flora by increasing your intake of live yoghurt and probiotics products (see here).
Dangerous allergic reactions to antibiotics can occur, with symptoms of itching, facial swelling and breathing difficulties. If any of these conditions develop, seek medical help at once.
Early reactions to anti-cancer drugs include nausea, vomiting and diarrhoea. For advice about which foods can help control these symptoms, see the relevant sections in Chapter 5.
Antacids can cause gastric symptoms. For example, products containing magnesium may cause diarrhoea, while those containing aluminium may cause constipation. Some people taking sodium bicarbonate for gastric problems may experience flatulence.
The efficiency of some medications can be impaired by antacids. For this reason, always tell your doctor if you are taking them.
Excessive use of laxatives can cause diarrhoea and dependency, so only take these products when truly needed. They can also cause flatulence and abdominal pain. The best way to maintain a normal active bowel is to include high-fibre foods – such as wholegrain cereals and root vegetables – in your daily diet.
Never include laxatives as part of a weight-loss programme.
Some drugs in this category affect the way in which the gut responds to fats in the diet. They can limit the absorption of fat-soluble vitamins (see here), and vitamin supplements may be needed. Ask your local pharmacist or doctor for guidance.
As a practical approach, your local pharmacist is a good place to start seeking help when you are unwell. Choosing from a wide range of over-the-counter products can be very confusing, and if you are in doubt about which product best suits your needs, ask for help. Many people fall into the trap of selecting a product based on advertisements they have seen. Just because the manufacturer claims a product works does not mean it is the right one for you. Qualified pharmacists are highly trained members of the health-care community, and they can discuss your specific symptoms and guide you through the maze of packages and containers. They will also ask important questions about other medications you may be taking, and explain how you should best use a new product.
When talking to the pharmacist, remember to be factual about your problem. Many people are put off talking to a pharmacist because the conversation takes place in public and may be overheard, unlike the privacy of a doctor’s office. Little help can be given if the facts of your condition are not known – so be discreet but honest when you describe your problem. Always tell the pharmacist about other medications you are taking, as this will help them select the best product for you. If possible, get all your medications from the same pharmacy. Over time they will come to know your needs and specific medical problems.
Remember: if the pharmacist suggests you should see your GP, follow that advice.
Medication prescribed by your doctor will work only if taken as directed. Failure of a drug to cure a problem frequently results from three factors: a patient fails to complete the course of medication due to improvement in symptoms; there is a misunderstanding about instructions given with the drug; or the patient has a fear of adverse reactions.
Always read the patient information leaflet included in the packaging. If an information sheet is not included with your prescription, ask your pharmacist for one. Read the entire sheet, giving special attention to side-effects. Most pharmaceuticals have side-effects on occasion – most are mild, but in some cases serious conditions can result. Reading the information sheet will tell you which symptoms are common and mild, and which should be reported to your doctor. Do not panic when you read the list of side-effects! They usually include all possible conditions, including the rarest. Rest assured that the chances are you will take your medication with no ill effects.
Report all medication you take when questioned by your doctor – that includes both over-the-counter and prescribed drugs. He or she may also wish to know which dietary supplements you take, as these can have important physiological effects; for example, depending on the amount taken, fish oil may thin the blood. This would be important information if you were on blood-thinning drugs, such as warfarin.
When you get a new prescription from your doctor, make certain you know the name of the drug, why you are taking the drug, how much to take, the frequency and times of day it should be taken, if it should be taken on an empty stomach or with a meal, whether or not alcohol will lower its effectiveness, and how long you should continue the course of medication. Write this information down and put it in a handy place. This may sound a little too simple, but you would be surprised how many people are so anxious during an appointment with their doctor that they totally forget what they have been told.
It is a good idea, while you are with the doctor, to ask about possible side-effects. If you have a tendency to suffer from diarrhoea, for example, and this may result from taking your new medication, ask your doctor for a means of countering this symptom.
• Keep medications in a safe place away from children.
• Use only according to directions on the label; read these carefully.
• Always return unused medications to a pharmacy for destruction.
• Never take medicine from unlabelled containers.
• Never give your medication to someone else.
• Make certain your prescription is labelled clearly. Many people find adding a small label of their own to the packaging helps them remember what each drug is for, but never allow this to cover the label applied by the pharmacist.
• Take tablets and capsules with water when you are in a standing or upright position.
• Measure your dose carefully – keep a 5ml spoon and a measured medicine cup on hand. If you are using a dropper, count the drops carefully.
• Shake the bottle before measuring out a dose of a liquid drug.
• You may need to avoid certain foods when taking a medication – acidic fruit juice, for example, may reduce the effect of certain antibiotics; dairy products may hinder absorption of certain medications.
• Terrible-tasting medicine can be washed down with a drink of water. You cannot over-dilute a swallowed dose.
• Instructions about when you should take medication can be confusing: four times a day usually means that it should be taken four times during waking hours, but ask your doctor to be sure.
• Remember: always read the label and follow the dosage on the packaging, and never take more than is recommended.