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Effectively relieving multiple symptoms of reflux

Managing reflux
Treatments for reflux
Customer scenario
MCQs

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CUSTOMER SCENARIO

32-year-old Gabby, who is pregnant, has rushed to the pharmacy this afternoon to make it in time for her annual flu jab, with a can of cola in her hand. She’s looks tired and tells you that she’s been quite stressed recently as she is trying to get everything ready in time for the baby’s arrival. She says that she has been so busy that she missed her lunch, so she quickly ate a big bowl of spicy noodles and a bar of chocolate on her way in.

Think about factors that could make it more likely for Gabby to suffer from reflux

Contributing factors may include:

  • Pregnancy

  • Stress

  • Rushing food

  • Eating a large meal

  • Eating fatty, spicy food

  • Eating certain foods like chocolate

  • Drinking fizzy drinks

REVEAL ANSWERS

She tells you that she has some STOMACH DISCOMFORT and is feeling a BURNING SENSATION TRAVELLING UP HER CHEST TO HER THROAT, leaving a SOUR TASTE IN HER MOUTH.

From her bag she produces a small bottle of bismuth subsalicylate liquid, some omeprazole capsules and some Gaviscon Double Action liquid sachets. Gabby asks: “Which of these will work quickly to relieve my symptoms, and is still safe to use considering I am pregnant?”.

WHICH PRODUCT WOULD YOU RECOMMEND, THAT IS BOTH FAST-ACTING AND SUITABLE FOR USE IN PREGNANCY, WHILST ALSO CONSIDERING THAT SHE HAS JUST EATEN?

BISMUTH SUBSALICYLATE LIQUID
GAVISCON DOUBLE ACTION LIQUID SACHETS
OMEPRAZOLE CAPSULES

INCORRECT!Gabby is pregnant and bismuth subsalicylate should not be used during pregnancy or breastfeeding.20

INCORRECT!PPIs are typically taken prior to food to prevent symptoms from occurring.1 Gabby needs fast-acting relief and omeprazole can take up to 2-3 days for effects to be seen.21

CORRECT!Gaviscon Double Action is best taken with or after food and is suitable for use in pregnancy.10 It also provides a soothing effect in 3 minutes.8

Gabby takes your advice and feels much better by the end of the conversation. You offer her lifestyle advice which she says she will try to implement to reduce the likelihood of her symptoms recurring.

REFERENCES

1. GUTS UK. Heartburn and reflux. 2024. Available at: https://gutscharity.org.uk/wp-content/uploads/2023/06/Heartburn-Guts-UK.pdf

2. NHS Inform. Gastro-oesophageal reflux disease (GORD). 2023. Available at: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/gastro-oesophageal-reflux-disease-gord/#causes-of-gord

3. NHS. Heartburn and acid reflux. 2023. Available at: https://www.nhs.uk/conditions/heartburn-and-acid-reflux/

4. NHS. Indigestion. 2023. Available at: https://www.nhs.uk/conditions/indigestion/

5. Patient. McKechnie D. Acid reflux and oesophagitis. 2024.
Available at: https://patient.info/digestive-health/acid-reflux-and-oesophagitis#treatments-for-acid-reflux-and-oesophagitis

6. NHS. Antacids. 2023. Available at: https://www.nhs.uk/medicines/antacids/

7. NHS. About Pepto-bismol. 2022. Available at: https://www.nhs.uk/medicines/pepto-bismol/about-pepto-bismol/

8. Strugala V, et al. J Int Med Res. 2010;38:449–57.

9. Hampson FC, et al. Drug Develop Industr Pharm. 2010;36(5):614–23.

10. SmPC. Gaviscon Double Action Mint Suspension. 2024. Available at: https://www.medicines.org.uk/emc/product/5609/smpc/print

11. Rohof, WO, et al. Clin Gastroenterol Hepatol. 2013;11:1585– 1591.

12. Dettmar PW, et al. Drug Develop Indust Pharm. 2018; 44(1):30-9

13. Decktor, DL, et al. AM J Ther.1995;2:546-552.

14. Heading RC, et al. Eur J Gastroenterol Hepatol. 2016;28:455–62.

15. Broderick R, et al. Dig Dis. 2020; 38.188-195 (n=1031)

16. Watanabe M, et al. BMC Gastroenterol. 2017;17:92.

17. Giannini EG, et al. Dig Dis Sci. 2006;51(11):1904–9.

18. Chevrel B. J Int Med Res. 1980;8(4):300–2.

19. Bor S, et al. Turk J Gastroenterol. 2019;30(Suppl 2):109–36.

20. NHS. Who can and cannot take Pepto-Bismol. 2022.
Available at: https://www.nhs.uk/medicines/pepto-bismol/who-can-and-cannot-take-pepto-bismol/

21. NHS. About omeprazole. 2021. Available at: https://www.nhs.uk/medicines/omeprazole/about-omeprazole/

References last accessed November 2025.

ESSENTIAL INFORMATION

GAVISCON DOUBLE ACTION MINT ORAL SUSPENSION: Each 10 ml dose contains sodium alginate 500 mg, sodium bicarbonate 213 mg and calcium carbonate 325 mg (GSL). Indications: Treatment of symptoms resulting from the reflux of acid, bile and pepsin into the oesophagus such as acid regurgitation, heartburn and indigestion, for example following meals or during pregnancy, and for symptoms of excess stomach acid (hyperacidity). Can also be used to treat the symptoms of gastro-oesophageal reflux during concomitant treatment with or following withdrawal of acid suppressing therapy. MAH: Reckitt Benckiser Healthcare (UK) Ltd, HU8 7DS, United Kingdom. Information about this product including adverse reactions, precautions, contra-indications and method of use can be found at: https://www.medicines.org.uk/emc/product/5609.

GAVISCON DOUBLE ACTION MINT FLAVOUR CHEWABLE TABLETS: Each tablet contains sodium alginate 250 mg, sodium bicarbonate 106.5 mg and calcium carbonate 187.5 mg (GSL). Indications: Treatment of symptoms resulting from the reflux of acid, bile and pepsin into the oesophagus such as acid regurgitation, heartburn and indigestion, for example following meals or during pregnancy, and for symptoms of excess stomach acid (hyperacidity). Can also be used to treat the symptoms of gastro-oesophageal reflux during concomitant treatment with or following withdrawal of acid suppressing therapy. MAH: Reckitt Benckiser Healthcare (UK) Ltd, HU8 7DS, United Kingdom. Information about this product including adverse reactions, precautions, contraindications and method of use can be found at: https://www.medicines.org.uk/emc/product/5329.

GAVISCON DOUBLE ACTION MINT LIQUID SACHETS: Each 10 ml dose contains sodium alginate 500 mg, sodium bicarbonate 213mg and calcium carbonate 325 mg. Indications: Treatment of symptoms resulting from the reflux of acid, bile and pepsin into the oesophagus such as acid regurgitation, heartburn and indigestion, for example following meals or during pregnancy, and for symptoms of excess stomach acid (hyperacidity). Can also be used to treat the symptoms of gastro-oesophageal reflux during concomitant treatment with or following withdrawal of acid suppressing therapy. MAH: Reckitt Benckiser Healthcare (UK) Ltd, HU8 7DS, United Kingdom. Information about this product including adverse reactions, precautions, contra-indications and method of use can be found at: https://www.medicines.org.uk/emc/product/3959.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard, or search for the MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to Reckitt Benckiser Healthcare (UK) Ltd on: 0333 200 5345.

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