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Case Study
MB is a 35 year-old white female who presents to the pharmacy looking for “something to help her stomach.” She is complaining of occasional digestive upset that usually begins shortly after meals. On some mornings she suffers from gas, bloating, and stomach discomfort immediately relieved following a bowel movement. MB also suffers from diarrhea and constipation on a regular basis. She states that her symptoms occur once or twice a week and began about 2 months ago. They primarily occur after lunch or dinner, sometimes both and she doesn’t notice any certain foods that trigger her episodes. She has discussed her symptoms with her health care provider, who advised her to use anti-diarrheal medications and incorporate fiber into her diet. MB has tried Pepto-Bismol® and Imodium-AD® but they did not relieve the persistent bloating or discomfort; fiber supplements make her symptoms worse. She wants to take something that will prevent her symptoms from occurring rather than treat them after they have started. She also quietly tells you that she experiences frequent episodes of gas that can be embarrassing considering she is an elementary teacher surrounded by children that love to laugh at any bodily noise.
PmHx: None
ALL: NKDA
Current medications, including OTC and herbals: Yasmin®, Pepto-Bismol and Immodium-AC as needed.
- Using the QuEST method, quickly and accurately assess MB
- Using the SCHOLAR-MAC method, classify the pertinent information illustrated in this case
|
Symptoms |
Gas, bloating, abdominal discomfort, diarrhea, constipation |
|
Characteristics |
Stomach discomfort relieved following a bowel movement |
|
History |
Has tried Pepto-Bismol and Imodium-AD for as needed relief and fiber for symptom prevention |
|
Onset |
Occurs once or twice each week, started approximately 2 months ago |
|
Location |
Abdominal region |
|
Aggravating factors |
Eating lunch and/or dinner |
|
Remitting factors |
Fiber |
|
Medications |
Yasmin, Pepto-Bismol and Imodium-AD |
|
ALL |
NKDA |
|
Comorbidities |
none |
Using the QuEST method, establish if this patient is an appropriate self care candidate. Provide a rationale:
- No severe symptoms
- Not self-treating to avoid medical care
If this patient is a self care candidate, suggest appropriate strategies (QuEST) for MB. Include supportive measures with your recommendations:
- MB is experiencing many symptoms that can be attributed to digestive imbalance.
- An appropriate treatment option is a probiotic that will help restore a healthy, natural normal flora in the digestive tract
- Align® contains the probiotic Bifantis® that builds and maintains a healthy digestive system that prevents against occasional digestive upsets.
- General care measures:
- Create and keep a food journal to identify any foods that aggravate symptoms.
- Drink plenty of water and get regular exercise.
- Eat slowly and have meals in a quiet, relaxing environment.
If recommending self care, talk with MB regarding 2-3 counseling points (QuEST)
- Take one capsule every day with or without food.
- Align® can be taken any time of the day.
- Store at room temperature. Align® must be stored in the original blister package to protect the active ingredient from moisture and oxygen. (If Bifantis® is exposed to moisture; it can activate the freeze-dried bacteria).
When can the patient expect relief from symptoms?
- It may take up to 8 weeks to obtain the full benefit of Align®. Continue to take Align® daily to maintain results.
When should MB seek her primary care provider?
- If symptoms worsen, do not get any better, or become intolerable.
- If MB experiences weight loss, rectal bleeding, fever, night pain, bloody or black tarry stools, menstrual irregularities or changes in your cycle, heartburn, nausea, or vomiting.
Miscellaneous
Questions? Call 1-800-208-0112 or visit our website at www.aligngi.com