Advise Patients About Self-Care Measures to Treat Mild to Moderate GI Issues

Preserving digestive health is critical to overall well-being, and even mild to moderate gastrointestinal (GI) issues can negatively impact quality of life, disrupt sleep, and reduce daily productivity. The digestive system comprises the GI tract, liver, pancreas, and gallbladder, which collectively digest food into absorbable nutrients that are essential for energy production, cellular growth, and tissue repair.¹

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Growing clinical evidence demonstrates the significance of healthy gut microbiota in maintaining systemic health, and alterations in microbial composition, or dysbiosis, have been associated with the development or increased risk of various diseases. Examples include inflammatory bowel disease, obesity, type 2 diabetes, autoimmune conditions, neuropsychiatric disorders such as anxiety and Parkinson disease, eczema, and asthma.2 Dysbiosis is also thought to influence immune function and inflammatory responses.^2,3

Beyond its role in digestion, the gut microbiome contributes to essential physiological processes, including nutrient metabolism, immune regulation, and bidirectional communication with the central nervous system via the gut-brain axis.⁴ Proper digestive function also supports the efficient removal of metabolic waste and toxins, lessening the risk of constipation and other GI issues. Strategies to enhance digestive health, such as balanced nutrition, adequate hydration, regular physical activity, and stress management, are essential for promoting long-term wellness and disease prevention.¹

Pharmacists can be instrumental in distinguishing when self-treatment is appropriate and when referral to a health care provider is warranted, especially in cases of severe, undiagnosed, and persistent or recurrent GI complaints. Pharmacists are well-equipped to assist in the appropriate selection and use of nonprescription agents for common GI issues that are amenable to self-treatment and assist patients in navigating product choices based on symptom severity, duration, and medical and medication histories. Pharmacists can also screen for drug–drug interactions and contraindications, identify medical conditions or medications that may contribute to common GI issues, and make clinical recommendations accordingly.

The extensive selection of OTC products available for digestive health, treatment, and prevention of mild to moderate GI issues may present challenges for consumers who wish to self-manage common symptoms such as heartburn/gastroesophageal reflux disease and dyspepsia, constipation, diarrhea, nausea, vomiting, and flatulence or bloating.

Examples of frequently used OTC products include fiber supplements, laxatives, probiotics, and prebiotics for general digestive support, as well as antacids, H2-receptor antagonists, proton pump inhibitors, and antidiarrheals. Through patient-centered counseling, pharmacists can ensure that the proper selection, dosing, administration, and recommended duration of use of these products are followed. Pharmacists can also direct patients to seek further medical evaluation if there is no relief or if symptoms exacerbate.

News and Recent Clinical Studies

According to a recent report, in North America, adults aged 35 to 54 years represent the most extensive consumer base for OTC digestive products, driven by high stress levels, irregular diets, and self-medication trends. Moreover, data from the National Institutes of Health reveal that 60 million to 70 million Americans suffer from digestive diseases annually, with 40% of adults using antacids or laxatives monthly.⁵

Researchers from the University of Alabama at Birmingham Department of Microbiology have indicated that probiotics are beneficial microorganisms that support digestion and overall gut health by helping break down fiber, enhancing nutrient absorption, and regulating fat metabolism. Probiotics also generate short-chain fatty acids that strengthen the gut barrier and reduce inflammation, contributing to better immune and metabolic function. Research further highlights probiotics’ role in decreasing the risk of chronic conditions such as diabetes and cardiovascular disease by promoting a balanced microbiome. Probiotics can help alleviate various dietary issues, including bloating, irritable bowel syndrome (IBS), and even inflammatory bowel disease.⁶

Study findings published in The American Journal of Clinical Nutrition showed that following a Mediterranean diet during pregnancy notably enhances the maternal gut microbiome and promotes beneficial bacteria that produce short-chain fatty acids and decrease microbes associated with inflammation, such as Campylobacter. These modifications may support maternal health and influence the development of the child’s microbiome, although more research is necessary to confirm the long-term clinical effects.⁷

A literature review in the British Journal of Surgery highlights a substantial surge in early-onset GI cancers, which are aggressive, especially among the youngest age group. These cancers include colorectal, pancreatic, esophageal, stomach, appendiceal, biliary, and neuroendocrine cancers, most likely due to a combination of lifestyle and environmental factors.⁸

Finally, a July 2025 global study discovered a sharp postpandemic increase in gut-brain disorders such as IBS and functional dyspepsia, with IBS rates rising by 28% and dyspepsia by 44%, compared with prepandemic levels. Researchers suggest that disruptions to the gut-brain axis, altered gut motility, inflammation, and changes in microbiota, combined with psychological stress, could be the key contributors to this increase.⁹

Table | GI, gastrointestinal.

Role of the Pharmacist

Pharmacists are well-equipped to identify individuals at risk for GI disorders or those exhibiting symptoms that warrant further medical assessment. They play a crucial role in advising patients with GI concerns by helping them select suitable OTC medications and educating them on correct dosage and usage. Moreover, pharmacists can provide practical advice on diet and lifestyle changes to support digestion and reduce symptoms. They should also encourage patients to communicate any concerns or risk factors to their primary health care provider, particularly regarding preventive measures such as colon cancer screenings.

The Table includes examples of tips that pharmacists can employ when counseling patients about GI issues and OTC drugs.

Conclusion

Digestive health is vital for overall wellness, and timely treatment of GI issues prevents complications and improves daily functioning. Pharmacists play a key role by guiding patients in recommended self-care, identifying severe symptoms, and supporting early intervention.

REFERENCES

1. Dysbiosis. Cleveland Clinic. Updated April 16, 2024. Accessed August 8, 2025. https://my.clevelandclinic.org/health/diseases/dysbiosis

2. Your digestive system & how it works. National Institute of Diabetes and Digestive and Kidney Diseases. Updated December 2017. Accessed August 8, 2025. https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works

3. Belkaid Y, Hand TW. Role of the microbiota in immunity and inflammation. Cell. 2014;157(1):121-141. doi:10.1016/j.cell.2014.03.011

4. Cryan JF, O’Riordan KJ, Cowan CSM, et al. The microbiota-gut-brain axis. Physiol Rev. 2019;99(4):1877-2013. doi:10.1152/physrev.00018.2018

5. OTC digestives and intestinal remedies market. PW Consulting Health Care Research Center. May 4, 2025. Accessed August 8, 2025. https://pmarketresearch.com/hc/otc-digestives-and-intestinal-remedies-market/

6. Gut check: how probiotics impact digestion and the body’s microbiome. University of Alabama at Birmingham. August 7, 2025. Accessed August 8, 2025. https://www.uab.edu/news/news-you-can-use/gut-check-how-probiotics-impact-digestion-and-the-bodys-microbiome

7. de Souza HF. Mediterranean diet delivers gut health benefits for expectant mothers. News Medical. August 6, 2025. Accessed August 8, 2025. https://www.news-medical.net/news/20250806/Mediterranean-diet-delivers-gut-health-benefits-for-expectant-mothers.aspx

8. Char SK, O’Connor CA, Ng K. Early-onset gastrointestinal cancers: comprehensive review and future directions. Br J Surg. 2025;112(7):znaf102. doi:10.1093/bjs/znaf102

9. Palsson O, Simren M, Sperber AD, Bangdiwala S, Hreinsson JP, Aziz I. The prevalence and burden of disorders of gut-brain interaction (DGBI) before versus after the COVID-19 pandemic. Clin Gastroenterol Hepatol. Published online July 23, 2025. doi:10.1016/j.cgh.2025.07.012