Irritable bowel syndrome

Homoeopathy for the layman

IRRITABLE BOWEL SYNDROME (IBS)

Introduction

Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain, distention and change in bowel habits. It’s prevalence in western countries is about 15-20% in adults with female predominance. In India its prevalence is increasing due to increased psychological stress and the westernization of the diet with a male predominance.

Causes
In most of the patients psychological conditions like anxiety, depression and fear are responsible. These conditions play a causative as well as maintaining role in IBS.
Other causes include weak vitality and poor adaptability.
This syndrome can also be triggered by acute gastrointestinal infection, irregular food habits, abuse of laxatives and other medications etc.

Symptoms
Gastrointestinal symptoms of IBS are:
1. Abdominal Pain - It is felt in lower abdomen, dull or colicky in nature and usually relieved by defecation or passing flatus. It is usually worse after meals.
2. Abdominal distension and bloating - Sense of abdominal distention or bloating is usually complained by majority. It is usually worse throughout the day but is not due to excessive intestinal gas.
3. Variable bowel habits – Most of the patients have alternate episodes of diarrhea and constipation but it is useful to classify patients as having predominantly constipation or predominantly diarrhea. The constipated type tends to pass infrequent pellet like stools, usually in association with abdominal pain. Those with diarrhea have frequent defecation but produce low volume stools and are rarely worse at night. Mucous is commonly seen with stools and no rectal bleeding is there.
4. Other symptoms associated are nausea, headaches; Pains in back, thigh or chest; frequent urination and fatigue. Despite severe symptoms, patients do not loose weight

The diagnosis of IBS is made if the symptoms are present for more than 3 months. The various type of IBS are - Diarrhea predominant (IBS-D), Constipation predominant (IBS-C), Alternating stool pattern (IBS-A).

Investigations
As it a functional problem, no structural changes are present and tests reveal nothing. Usually lab investigations are done to rule out other disease. In older patients barium enema and colonoscopy is done to exclude colorectal cancer. While younger patients with persistent diarrhea may require endoscopy to rule out ulcerative colitis.

Management
Most of the patients have a relapsing and remitting course. Aggravation of the complaints often follow stressful life events, occupational dissatisfaction and difficulties with inter personal relationships.
Along with medicines following measures are of utmost importance in the management of IBS.
1. Diet: - Increase of fibrous diet with supplementation with bulking agents as coarse wheat bran or isaphgul husk. Intake of smaller meals at frequent intervals. Avoidance of alcohol, spices, fatty meals & dietary items that aggravate the condition.
2. Other measures include relaxation techniques for stress management, regular exercise, yoga etc.

Role of Homoeopathy
As per Homoeopathic system of medicine, Disease is a total response of a patient to adverse environmental factors, external or internal; it is conditioned by constitutional factors, inherited and acquired; and it manifests itself through symptoms in the three spheres – emotional, intellectual and physical. This response is divisible into
a) Individual response – characteristic symptoms which denote the constitutional type; which vary from person to person and
b) Group response – diagnostic symptoms.

In Homoeopathic system of medicine, the individual response of the patient is much important than the group response. So, in a set of patients having the same diagnostic symptoms (group response), the medicine given to each of them is different as the individual response of each varies. As in most of patients, the condition of the mind is responsible for IBS; homoeopathy has a much greater role to play. So, while the allopathic physician may refer such patient to the psychiatrist for treatment of mind symptoms, in homoeopathy the patient is treated as a single unit and the medicine which is suited to him for his mental as well as physical state is prescribed. Thus the patient is treated in a holistic way with homoeopathy.

With an eye on the constitution, temperament, totality of symptoms, life style and diet of the patients suffering from IBS, successful results can be obtained with homoeopathic medicines.

Homoeopathic medicines for IBS: - Medicines commonly used for IBS are Abies-nigra,
Aloes, Argentum nitricum, Arsenic Album, Asafoetida, Baptisia, Belladonna, Calcarea carb, Carbo-veg, Causticum, Chamomilla, China, Colchicum, Colocynthis, Gratiola, Ignatia, Iris v, Kali Bich, Lilium tig, Lycopodium, Merc sol, Merc cor, Natrum carb, Natrum mur, Natrum phos, Nux vomica, Phosphorus, Pulsatilla, Raphanus sat, Sulphur, Veratrum alb.




The indications for few of the above remedies are as follows:-

Argentum nitricum: - Digestive upsets accompanied with Anxiety and nervousness.
Diarrhea can be sudden, greenish and may come on immediately after drinking water. Patient has great craving for sugar or salt which aggravate the complaints; meat and fat are disliked. The patient who needs this remedy is impulsive, has fear of heights, claustrophobia & anxiety about health. There is distention of abdomen with rumbling and nausea. Pain is worse when lying on right side.

Asafoetida: - This remedy is suited to hysterical persons with tendency to easy fainting. Flatulence with explosive eructation that smell like garlic. It has a hysterical rising in throat, as if a ball or large body ascended from stomach to esophagus. A feeling that food moves in a wrong way i.e. instead of going down is coming upwards. Excessive abdominal distension and sensation as if everything in the abdomen would burst through the mouth. Complaints are mostly left sided.

Colocynthis: - This remedy is suited to extremely irritable & impatient individuals. Problems start or are aggravated after anger and resentment from being slighted or humiliated especially if not expressed. Agonizing, cutting pains in abdomen causing patient to bend over double and press on the abdomen for relief. Violent, cutting, gripping, grasping, clutching or radiating, colicky. Pains, come in waves, better doubling up, hard pressure, worse least food or drink, except coffee and tobacco smoking.

Gratiola: - It is an important remedy where there is a feeling of incomplete evacuation of stool. Stool is green, yellow gushing, as if water running from a hydrant. It is aggravated in summer and by drinking water. The patient feels empty after meals. Diarrhea alternates with constipation. There is a strong craving for bread and the patient wants nothing but bread.

Lycopodium: - This remedy is suited to intellectual persons with anticipatory anxiety with extreme lack of confidence. Excessive accumulation of flatulence; constant sensation of satiety; good appetite, but a few mouthfuls fill up to the throat, and he feels bloated; fermentation in abdomen, with loud grumbling, croaking, especially lower abdomen. Rumbling with sensation as if everything turns into gas. Warm food and drinks ameliorate. Pains: aching-pressure, drawing; chiefly right-sided, worse four to eight p.m.

Natrum carbonicum: This remedy is suited to persons who are gentle and ready to serve selflessly. They have a cheerful expression even when sad. They are oversensitive to external atmospheric impressions & dietetic errors. Diarrhea from milk. Empty, gnawing, hungry sensation in stomach at 5 a.m.; must leave bed and have some biscuits. Emptiness and hungry feeling also at 10-11 a.m. and 10-11 p.m..Greedy, always nibbling.






Natrum muriaticum: This remedy is suited to persons who are vulnerable to emotional injury especially disappointment in love and do not express their emotions easily. Abdomen is hard to the touch, cramps up, and is accompanied by severe pain as if the colon were being grasped and squeezed by a tight fist. Those afflicted are compelled to double up with this acute attack, which is followed by the passage of flatus and eventually stool. The pains are often precipitated by the abdomen becoming full of gas or by constipation. Patient craves for salty things.

Raphanus sativa – This remedy is suited to hysterical persons where sadness alternates with hopefulness and a delusion that she has an unrecognized disease. Sensation of accumulation and incarceration of gas in abdomen. Colic, griping about navel. During colic, there is a pad-like swelling and movement of the intestines. Intolerance of clothing around abdomen. Post-operative gas pains and constipation. Vomiting of faecal matter.

Homoeopathic medicines should be taken under the advice of a qualified homoeopath after a thorough case taking which includes the mental & physical causes, present at the start of the IBS. The dose, potency and the repetition of the medicines should be under the supervision of a homoeopathic physician.


Dr Dushyant Kamal Dhari
M.D. (Hom)

Kidney stones and their homoeopathic treatment.

Homoeopathy for layman

Kidney stones / Nephrolithiasis

Kidney stones, one of the most painful urologic disorders, have a history of more than 7,000-years in an Egyptian mummy. Even now, statistics indicate that more than 600,000 patients went to emergency rooms for kidney stone problems and it included more men than women.

Though most of the kidney stones pass out of the body without any intervention by a physician but a few become serious surgical concern.

What is a kidney stone?

A kidney stone is a concretion formed by the deposit of one or more of the solid constituents of the urine. It may be single or multiple. All are radiopaque except for uric acid stones and are therefore visible by routine abdominal radiography.

Normally, urine contains chemicals that prevent or inhibit the crystals from forming.

Are all kidney stones alike?

There are four major types of kidney stones. The most common are Calcium oxalate, while others are struvite, uric acid and cystine stones.

What causes kidney stones?

Causes

1. Over –saturation of urine which may be due to

Too little urinary output.

Increased amount of stone constituents excreted over a period of time such as calcium, oxalates, urates etc.

Altered urine ph: Below ph of 5.5, uric acid crystals predominate as it decreases

the solubility of uric acid.

High urinary ph favours formation of calcium phosphate & struvite stones.

Dietic :-

a. Vitamin A & B6 deficiency predisposes for stone formation.

b. Increased intake of foods rich in calcium, oxalates & purines.

Hereditary.

Chronic urinary tract infection.

Prolonged immobilisation from any cause.

Hot weather.

What are the symptoms?

Many stones are asymptomatic until they begin to move down the ureter, causing pain due to obstruction. Pain is the main complaint. Typically, a person feels a sharp, cramping pain in the back and side in the area of the kidney or in the lower abdomen. Some times nausea and vomiting occur. As a stone grows or moves, blood may appear in the urine. If fever and chills accompany any of these symptoms, an infection may be present.

How are kidney stones diagnosed?

They are diagnosed by their presence in the X-ray or Sonography or an IVP.

Recurring stones also warrant an investigation into possible parathyroid gland disease.

Management

Diet for kidney stone patients:

Not- Advisable:- Palak, Tomato, Amla, Chickoo, Cashew nut, cucumber, black grapes strawberries increase oxalates.

Advisable: - Coconut water, barley, corn silk tea, pineapple juice, bananas, almonds, carrots, Karela, kulthi dal.

Other Preventive measures:-

1. Increasing fluid intake: Patients should try to drink enough liquids throughout the day to produce at least 1200 ml of urine in every 24- hour period.

2. Avoid dairy products: If you are on calcium supplements in hopes of strengthening your bones, you may actually be increasing your risk of stone formation. Dairy products are the greatest dietary source of calcium.

3. Vitamins - "B" fortified. Vitamin B6 reduces the risk of stone formation.

"C" less. People prone to kidney stones should stay away from vitamin C supplements.

Exercise: Regular exercise also lessens the risk of stone formation

Role of Homoeopathy

In homoeopathy there are many medicines which can relieve pain, break the kidney stones and flush them out side kidney also. In addition to this, homeopathy also removes the tendency of formation of kidney stones in an individual. So, homoeopathic treatment is recommended even after surgical removal of stone.

Remedies

1.Berberis vulgaris

Excellent remedy for left sided renal calculi. Pains shooting, radiate from a point. Least motion aggravates. Sits over to painful side for relief. Pains run up into kidneys and down into bladder.

2. Nux vomica

It is indicated for pains caused by a stone in the ureter. It relaxes the circular fibres of ureter causing the relief in pain and passage of calculi. Indicated in renal colic when one kidney (especially the right) is the seat of the disease. Pains extend down the leg, with nausea and vomiting.

3. Tabacum:

Left sided stones. Pains down the ureter, with deathly sickness and cold sweat. Nausea with burning heat in abdomen, the rest of the body being cold. Patient persists in uncovering the abdomen.

4. Benzoicum acidum

Constitutions with a predisposition to develop kidney stones. This remedy should be considered for people who are careful with their diet yet develop stones in the kidneys all the time, accompanied by frequent kidney colic. There is frequent vomiting during the kidney colic which is usually left sided. Urine deep-red, of strong odour.

5. Hydrangea arborescens

It has a traditional reputation as a "Stone-breaking" remedy. It is particularly useful for profuse deposits of white amorphous salts in the urine; and has arrested the tendency to formation of calculi; relieves distress from renal calculus, with soreness over region of kidneys and bloody urine.

6. Cantharis vesicatoria

Dull, heavy distensive pain in region of kidney, either side, no relief in any position; continued rolling and twisting of body, with groans and cries, resulting in nausea, retching and vomiting, unless the stomach is empty; no great desire to urinate. Burning pain, with intolerable urging to urinate.

7. Pareira brava

Excessive pain in kidneys shoots down left ureter; urine passes drop by drop with violent tenesmus, nausea. Constant urging to urinate: pain extorts screams. Must go down on all fours to urinate. Copious sediment of uric acid and blood.

8. Sarsaparilla officinalis

This medicine is indicated for a stone in the bladder; it so changes the character of the urine that it is no longer possible for the stone to build up and it grows smaller by continually dissolving off from the surface. Extreme pain at conclusion of urination: yells with pain

As in Homoeopathic system, each patient is regarded as a unique individual the selection of medicine, dose, potency & repetition should be under the supervision of a Homoeopathic physician so that benefit is derived at the earliest.

Dr. Dushyant Kamal Dhari. M.D. (Hom)

Steroids – Do Homoeopaths use them ?

Steroids is a shortened term used for corticosteroids. Corticosteroids are man made drugs that closely resemble cortisol, a hormone produced by adrenal glands in our body.

When inflammation occurs due to foreign substances in our body, chemicals from the body are released to protect us from foreign bodies.

Sometimes, however, the wbc`s and the inflammatory chemicals cause damage to the body`s tissues.

How they work

Steroids work by decreasing inflammation & reducing the activity of immune system. Inflammation is a process in which the body`s white blood cells and chemicals protect us from infection and foreign substances such as bacteria and viruses.

In certain diseases, however, the body`s defense system does not work properly. This may cause inflammation to work against the body`s tissues and cause damage. Inflammation is characterized by redness, warmth, swelling & pain.

Steroids reduce the production of inflammatory chemicals in order to minimize tissue damage. Steroids also reduce the activity of immune system by affecting the function of wbc`s.

When inflammation threatens to damage critical body organs, steroids can be organ saving and in many cases life saving.

If prolonged and high doses of steroids are used; side effects may occur.

Common side effects of steroids include :-

Increased appetite, weight gain.

Sudden mood swings.

Muscle weakness.

Blurred vision.

Increased growth of body hair.

Low resistance to infection.

Swollen puffy face

Acne.

Osteoporosis (Brittle bones).

Water retention, swelling.

For their proper use, their dose, repetititon and withdrawal should be done properly.

“ Doctor, I have heard that homoeopaths use steroids. Do you also use them? This question is often posed by some patients during the course of a consultation with a Homoeopathic physician.

The answer to this question is a definite “NO”. Homoeopathic physicians of integrity and commitment to their profession do not use steroids.

Further more the following points also add up to clear the doubts:

If one has been on long term steroids, one would show some side effects like “MOON FACE”, Excessive Body hair, Osteoporosis, Diabetes etc.

Steroids are not all “CURE ALL” for all the ills of the world. If that had been the case then all diseases would have vanished.

There are around 4000 medicines in the homoeopathic armamentarium, each having its own sphere of action, symptomalogy & individuality. So where is the need for steroids?

Using steroids causes SUPPRESSION of disease i.e. the act of driving a disease deeper inwards so that it attacks more important organs than previously affected and in a more serious form. No conscientious physician would like to do that.

How steroids are tested in medicines?

The routine method for testing steroids is the “Calorimetric Method” using Tetrazolium Blue salts. In this test, the reaction depends upon the reduction of Tetrazolium Blue salts to a highly coloured compound known as

“Farmazan”. Under controlled conditions the amount of “Farmazan” developed is proportional to the quality of steroids or any other Reducing sugars present in the material being tested.

The dispensing materials used in homoeopathic medicines are: Lactose

(Milk sugar), Pills made of cane sugar. Both of these materials are reducing sugars, so they give a false test for steroids even when they are

UN-medicated!

Another dispensing material used is Alcohol. If the alcohol used is not completely free from Aldehyde, it will interfere with the reaction and will impart some characteristic colour in the reaction that may again give a false positive impression of steroid. So this method is not at all advisable to determine the presence of steroids in a homoeopathic medicines.

Other methods used t

UV method: This is another method for the testing of steroids. All steroids shoe UV absorption between 235 to 240 NM in dehydrated alcohol or methanol in a clear solution. This is a reliable method for testing steroids in homoeopathic medicines.

Conclusion: So, before accepting a claim that the tested medicine does contain a steroid, one must find out what testing procedures were used to eliminate the possibility of a false positive result.

If tests conclusively prove that the medicine given is indeed a steroid under the guise of a homoeopathic remedy then one must seek an explanation or complain to homoeopathic council or consumer forum so that a disciplinary action can be taken against the erring doctor.

Unsubstantiated allegations against any doctor or system of medicine are most unfair and damaging to the professional integrity and indeed to the profession.

The curative properties of homoeopathic medicines prescribed strictly on the principles of homoeopathy extend much farther than contemporary system of medicine. This might be the reason that our contemporaries have the misconception that homoeopaths use steroids.