Friday, February 9, 2018

A Case of Paediatric Cholelithiasis treated with Homoeopathy, Prof G R Mohan

A Case of Paediatric Cholelithiasis treated with Homoeopathy

Prof G R Mohan
M D (Hom) PG dip (Env Stud)
Former ,Principal, Devs Homoeopathic Medical College,
RR District, TL, India
Introduction: Gallstones are a major public health problem in all developed countries. Although gallbladder disease had traditionally been considered an adult condition, the prevalence has been rising in the pediatric population. Baby aged 5year came with multiple Gall stones was treated successful with Lycopodium and Carduus Marianus.   Treatment was guided by ultra sound scan of abdomen before and after treatment. It is an Evidenced based Homoeopathic treatment.
Key words: Cholelithiasis, Homoeopathy,
Cholelithiasis is defined as “the presence or formation of stones in the gall bladder”. Cholelithiasis incidence ranging from 0.15% to 0.22%.. Cholelithiasis is common throughout the adult population, affecting as many as 25 million Americans and resulting in 500,000-700,000 cholecystectomies per year.
The Cholelithiasis prevalence has been rising in the pediatric population. Gallbladder disease is much rarer in children, with 1.3 pediatric cases occurring per every 1000 adult cases .A population-based study estimated that the prevalence of gallstones and biliary sludge in children is at 1.9% and 1.46%, respectively2.Pediatric patients undergo 4% of all cholecystectomies. Cholecystectomy is the procedure of choice for symptomatic children with Cholelithiasis, regardless of age 2, 3. Cholelithiasis can occur at any age, including prenatally, but is most common during puberty. Females are at significantly higher risk, with an overall 4:1 female-to-male predominance that increases to 11 to 22.1 during adolescence.
The common causes related to predisposing factors  are Hemolytic disease, hepatobiliary disease, obesity, prolonged parenteral nutrition, abdominal surgery, trauma, sepsis, and pregnancy. In children one fourth of total Cholelithiasis cases are Calcium carbonate stones, remaining 48% of gallstones in children belongs to Black pigment stones. They are formed when bile becomes supersaturated with calcium bilirubinate, the calcium salt of unconjugated bilirubin. Black pigment stones are commonly formed in hemolytic disorders and can also develop with parenteral nutrition. The complications of Cholelithiasis in children are similar to those in adults.2

A Case: Baby aged 5year came with following complaints
Complaints: Pain in the abdomen on and off, pain in the throat with recurrent fever. with multiple Gall stones.
Presenting complaints : Pain in the right hypochondria  on and off since a year shifting from right to left, fullness of abdomen, on and off pain in the throat < by eating Chocolates, she has great desire to eat.
Past history: nothing particular
Treatment history: took conventional medicine for above problem.
Family history: mother is suffering from Migraine.
Personal history:
Appetite: Normal
 Thirst:  normal
 Desires: Chocolates
 Aversions: - Nothing Particular
 Bowel movements: Normal.
 Urine: normal
 Sleep: normal
General physical examination & observations : normal built with 20 KGs; child is fussy in nature,  on examination of throat : no congestion only chronic enlargement of tonsils.
Systemic examination:

GIT: abdomen on palpation soft, NYD
Investigations of significance: WBC: 18200, ESR: 15mm, CRP: 60mg/l, ASO: 200IU/ml,
Alkaline Phosphate: 650IU/L, SGPT 45IU/Land SGOT 37IU/L. Ultra sound Scan: Multiple stones in Gall bladder.
Provisional diagnosis: Cholelithiasis
Clinical diagnosis: Cholelithiasis, Chronic Tonsillitis,
Clinical classification: Dynamic chronic fully developed miasmatic disease
Miasmatic diagnosis: Trimiasmatic
Totality of symptoms: A shown in reportorial chart
Repertorial totality: A shown in Repertorial chart
Repertorial result:
Analysis of repertorial result:
Susceptibility: Moderate
Reasons for selecting the remedy:
Reasons for selecting the remedy:
8/9/2009: Nux Vomica 200,3doses was given and 15 days Rubrum was given.
25/09/09: no change in her complaints, 7 days Rubrum was given
09/10/09: no change in her complaints as per the Repertorisation, Lycopodium covered 7 out of six symptoms, I gave   Lycopodium 30 C 3doses were given, 15 days Rubrum was given.
24/10/09: pain in throat reduced, appetite no improvement, pain right hypochondrium was persisting, 15 days Rubrum was given
19/11/09   appetite improved. Pain right hypochondrium was persisting, fullness of abdomen was slightly better, Tuberculinum 200C, 3doses were given, 15 days Rubrum was given.
28/11 / 09 she came with pain in right upper quadrant of abdomen, bowel movement was normal, regular. Cardus M 6C, 2pill twice a day for 1O days followed by Rubrum 20 Days,
25/12/09 :  Weight has increases to 21 kgs, General condition was normal,  repeated  Cardus M 6C , 2pill twice a day for 1O days followed by Rubrum 20 Days advised them to go for  Ultra sound Scan,  Liver function Test
17/01/2010: General condition was normal Ultra sound Scan was normal as shown below.
Liver function Test Within normal limits. Advice the father of the patient to come after 2 months for review. 
Reasons for selecting the remedies:
Nux Vomica was selected as case has come from conventional system of treatment; it has covered five out of seven symptoms. Lycopodium  was selected as  it  has covered  six  out of seven symptoms. It is a right sided remedy ,Tuberculinum was prescribed  as well indicated remedies are not giving desired results, Carduus Marianus 6C was given as it is a very important remedy for Gall Stones , there was lot of pressure on me as said  patient was relative of  local Gastroenterologist , there was fear of obstruction, parents were afraid of  going for Surgery. For this reasons  I have changed the remedies frequently. But  child got desired cure.
Conclusion: estimated the prevalence of gallstones and biliary sludge in children at 1.9% and 1.46%, respectively.2 in children very common presentation will be pain in right upper quadrant of abdomen, most of the Physicians don’t dream of this Cholelithiasis condition. In majority of cases we can relive the pain by our homoeopathic remedies. Sometimes we may not get expected results, only ultra sound Scan can give us the direction to proper treatment. The above case is one example, an organopathic remedy helped to dissolve the multiple stones. In children we have to depend  only objective symptoms , as children are not in position to give their subjective symptoms.
Authors' information:
Acknowledgements   : I thank the patient for the cooperation she has extended during the time of treatment.
Repertorisation chart of Cholelithiasis case:

Scan reports before and after treatment
. Picture 007aPicture 006aa
Picture 005a

(for full-length article ref : Hpathy.ezine, nov 2011 & Wonders of Homoeopathy an evidence based study )


Wednesday, June 8, 2016

Irritable Bowel syndrome & Homoeopathy

Irritable Bowel syndrome - a challenge in medical practice
Prof G R Mohan
(NHJ, Vol 8, no 2, March/April-2006
full length article in Wonders of Homoeopathy an evidence based study
Irritable bowel syndrome a motility disorder involving the entire GI tract, it is a challenge to treat Irritable Bowel Syndrome in clinical practice with high prevalence of one in four. The cause of irritable bowel syndrome is unknown. No anatomic cause is seen. Emotional factors, diet, drugs, or hormones may precipitate or aggravate GI motility. Some patients of IBS have anxiety disorders, particularly panic disorder; major depressive disorder; and somatization disorder. However, stress and emotional conflict do not always coincide with symptom onset and recurrence. This clinical condition, which has long been misunderstood and misdiagnosed, may represent a complex interaction of altered neurochemical mediators in the enteric nervous system with psychosocial and environmental influences. (2).
The pathogenesis of IBS is poorly understood although roles for abnormal gut motor and sensory activity, central neural dysfunction, psychological disturbances, stress and other factors have been proposed.
            Abnormal psychiatric features are recorded in upto 80% of IBS patients, however no single psychiatric diagnosis predominates. An association between prior sexual or physical abuse and development of IBS has been reported.  Forms of sexual abuse associated with IBS include verbal aggression, exhibitionism, sexual harassment, sexual touching and rape. The pathophysiologic relationship between IBS and sexual and physical abuse is unknown. However physical and sexual abuse may result in hyper vigilance to body sensations at CNS level and visceral hypersensitivity at the gut level.
Gender, race, and age all play a role in the prevalence of IBS. Recent studies suggest that in the United States the incidence of IBS is 10% and its prevalence 20%. These numbers are dependent on the diagnostic criteria used as well as on the population studied. Approximately 70% of patients who meet the diagnostic criteria for IBS do not seek medical care; the remaining patients account for 12% of primary care visits. Community-based estimates suggest that up to 30% of patients with a gastrointestinal complaint will have IBS but only a minority of patients diagnosed by a gastroenterologist.
There are two major clinical types of IBS, constipation predominate IBS, and Diarrhea predominate IBS.
In constipation-predominant IBS, constipation is common, but bowel habits vary. Most patients have pain over at least one area of the colon, associated with periodic constipation alternating with a more normal stool frequency. Stool often contains clear or white mucus. The pain is either colicky, coming in bouts, or a continuous dull ache; it may be relieved by a bowel movement. Eating commonly triggers symptoms. Bloating, flatulence, nausea, dyspepsia, and pyrosis can also occur.
Diarrhea-predominant IBS is characterized by precipitous diarrhea that occurs immediately on rising or during or immediately after eating. Nocturnal diarrhea is unusual. Pain, bloating, and rectal urgency are common, and incontinence may occur. Painless diarrhea is not typical and should lead to consider other diagnostic possibilities e.g., malabsorption, osmotic diarrhea, and etc.

The key to diagnosis of IBS is effective history taking, which requires attention to directed, but not controlled, elaboration of the presenting symptoms, history of present illness, past medical history, family history, familial interrelationships, and drug and dietary histories. Equally important are the patient's interpretation of personal problems and overall emotional state. The quality of patient-physician interaction is key to diagnostic and therapeutic efficacy. Patients with IBS generally appear to be healthy. Palpation of the abdomen may reveal tenderness, particularly in the left lower quadrant, (4)
Rome II Criteria for diagnosis of Irritable Bowel Syndrome
Abdominal discomfort or pain with two of the following three features for at least 12 weeks, not necessarily consecutive, during the previous 12 months:

 • Relief with defecation

 • Onset associated with change in stool frequency.

 • Onset associated with change in stool formation.

Supportive Symptoms-
1. Fewer than three bowel movements per week.

2. More than three bowel movements per day.

3. Hard or lumpy stools.

4. Loose or watery stools.

5. Straining during bowel movements.

6. Fecal urgency.

7. Feelings of incomplete evacuation.

8. Passage of mucus during bowel movement.

9. Sensation of abdominal fullness or bloating

Diarrhea-predominant irritable bowel syndrome = one or more of 2, 4, and 6 and none of 1, 3, and 5
Constipation-predominant irritable bowel syndrome = one or more of 1, 3, and 5 and none of 2, 4, and 6 (4)
Symptoms can be triggered by stress or the ingestion of food is 50% higher than for patients who do not fit the diagnostic criteria. These patients undergo more surgical procedures (such as hysterectomy, appendectomy, and cholecystectomy) and have a higher rate of work absenteeism and an increased number of physician visits per year. Moreover, these patients have significantly impaired quality of life even when compared with chronic disease such as diabetes. Upto 40% of referrals to gastroenterologists are IBS. (2,3).
Lactase intolerance is another common condition that can mimic diarrhea-predominant IBS, antecedent event such as a viral gastroenteritis or food-borne illness is important because there is evidence that up to 30% of patients will develop IBS-like symptoms after experiencing Salmonella enteritis,

Laboratory examination:
  • Physical exam.
  • Blood tests.
  • X ray of the bowel: This x-ray test is called a barium enema or lower GI (gastrointestinal) series. Barium is a thick liquid that makes the bowel show up better on the x-ray. Before taking the x ray, the doctor will put barium into your bowel through the anus.
  • Endoscopy: The doctor inserts a thin tube into your bowel. The tube has a camera in it, so the doctor can look at the inside of the bowel to check for problems.

The approach by conventional system in the treatment of IBS is without consideration of person as a whole but in Homoeopathic system the successes rate is more due to holistic approach, in considering the mental and physical aspects of the individual. Giving importance to mind in treatment is the need of the hour in IBS; so homoeopathic treatment has edge over other systems
A high-fiber diet should be advised to reduce digestive system irritation. Alcohol, caffeine, and fatty, gassy, or spicy foods should be avoided. Recommended stress management techniques include yoga, meditation, hypnosis, biofeedback, and reflexology. Reflexology is a technique of foot massage that is thought to relieve diarrhea, constipation, and other IBS symptoms.
The following two interesting cases of IBS treated in OPD
C A S E S:
NAME- Mr.G, 35years. Male-Sex, 

Religion- Hindu. Married.

Occupation – Works in a Private Bank.
Date of first visit-13.03.03 (OPD)

Presenting complaints-

·         Burning in throat since 3 years.
·         Irregular bowel habits since 10 months.

History of presenting complaints-

Patient was well before 3-4 years; to start with he developed symptoms of pain in the right hypochondrium, burning pain in throat, sour eructations, regurgitation of food after eating. he was diagnosed as having cholelithiasis and he was operated for it. He was very well up to 5/6 months of operation, but gradually he developed following symptoms.   
Burning in throat since 3 years < Afternoon 2-3 p.m., taking spicy food, excess quantity of food and after any anxiety or tension.
Regurgitation of food and water
Irregular bowel habit-morning at least gets 3 times urgency before 9 a.m. (before going to office, in holidays also he gets for 3 times.)
First –just after raising from bed.
2nd- mostly after breakfast.
3rd- commonly before starting for office.
Itching in scalp since 4-5years.

Past history-

Chickenpox in childhood.
Treatment history.
2.Homoeopathic-a) Ars.alb200.b) Arg.Nit 200.

Personal history-

Appetite-good, now taking food in small quanties.
Thirst- normal.
Desires –cold drinks.
Bowels-3/4 times daily. (3times before 9 a.m.).
Sweat- on exertion, offensive odour.
Sleep –sound.
Dreams –not specific.
Thermal reactions- Likes open air. Likes winter.
Life space investigation- He hails from one middle class family. Now works in a private bank. Happy with his work. Married and having a son of two year. Relationship with family members and others is good. Can’t concentrate in one thing for a long time, low in confidence.
Physical examination- Well nourished, moderate built.
No signs of pallor, icterus, cyanosis, clubbing and edema.
B.P-120/80 mm of Hg.
Pulse rate-75/min, regular, full, and no spl. character.
Heart rate –75/min regular, full, no spl. character
Systemic examination-
GIT- No relevant sign found.
Investigations- Within the normal range.
Clinical diagnosis- Irritable bowel syndrome.
Disease classification: Dynamic chronic fully developed miasmatic disease.
Miasmatic Diagnosis: Mixed miasmatic disease (Predominantly Psoric)
Repertorial totality.
Complete Repertory Selected
Mind- Anxiety.
            Ailments from anxiety.
            Confidence want of self.
            Concentration difficult.
Male genital-   Sexual; Desire increased
Generalities-    Food and drinks sweets aversion.
                        Food and drinks, cold drinks water desires.
Perspiration- Odor- offensive.
Stool-  Frequent.
Throat-            Pain – Burning.
Stomach-Eructations-food of, regurgitation.
Result of repertorisation.
1.      Lyco-26/11.                                               6.Ars.alb-20/10.
2.      Phosp-25/10.                                             7.Caust-20/10.
3.      Merc-22/10.                                               8.Puls-20/10.
4.      Sil-22/10.                                                   9.Sulph-20/10.
Remedy selected.
Lyco 200/ 1 dose on 20/03/2003

Follow up-

No change in symptoms.
Placebo- 1 dose
No change in symptoms.
Along with previous mental symptoms patient now have a marked aversion to do the official work.
As before he has a strong desire for cold drinks,
Basing upon these symptoms and as before also Phos. was in the 2nd position in repertorization , Phos 200 planned to be prescribed. 
Phosphorus 200C / 1 dose.
Feels better.
Bowel habit reduced to 2 times in morning.
Placebo/1 dose.
Feels better.
Bowel habit once in the morning.
Burning pain and regurgitation reduced.
Placebo /1 dose
Case Summary: In this case due importance was given to the mental symptoms of the patient and the case was marked improved after Phos 200 may be due to its highest similarity to the case and as it covering more prominent mental symptoms. 
Mr. K, 51yrs/M, Hindu, Married, illiterate, Agricultural laborer, admitted in our IPD, Bed no.31 with the complaints of sensation of fullness of abdomen < after eating, stool >flatus; aching pain in the abdomen on and off with urging to stool < during urging to stool >flatus; constipation, frequent, ineffectual, urging and burning sensation in both soles

Past History

No significant past history.  Took allopathic treatment for the presenting complaints for the last 6 months with only temporary relief

Personal History:
Appetite: reduced                                          Thirst: 5-6 glasses/day.
Desires: Sweets                                               Aversions: sour things
Urine: (D/N): 6-7/0-1                                     Perspiration: only on exertion 
Bowels: Constipated, frequent, ineffectual, urging.
Sleep: refreshed
Thermal state: Ambithermal

Mental generals: Ailments from silent grief, cannot bear contradiction.
Investigations: On 24/06/2004, CBP: Hb%- 13.5gm%, T.RBC-4.8 milli/cu mm, T.WBC-8,000cells, ESR-5mm/1st hr, 9/2nd hr; DC-L.60%, L.33%, E.5%, M.2%: Stool analysis-No cyst, No ova, No occult blood, No parasite. FBS, LPT – with in normal limits
Diagnosis: Irritable Bowel Syndrome.
Disease classification: Dynamic chronic fully developed miasmatic disease
Miasmatic Diagnosis: Predominant Psora - Syphilis
Repertorial Totality:
[KT] [Stomach] Desire: Sweets:
[KT] [Stomach] Desire: Sour:
[KT][Abdomen] Fullness, sensation of: Eating: after:
[KT][Abdomen] Fullness, sensation of: Flatus, passing: amel:
[KT][Abdomen] Pain: Aching: Flatus, passing: amel:
 [KT][Abdomen] Pain: Aching: Stool: Urging, during.
[KT][Abdomen] Pain: Aching: Stool: Before:
[KT][Rectum] Constipation: Ineffectual urging and straining
[KT][Extremities Pain] Pain: Burning: Hand: Palm: Night:
[KT][Extremities Pain] Pain: Burning: Foot: Sole: Night:
Repertorial Result: Sulph 20/9, Lyc 17/7, Carb.veg 16/8, Sep 15/8, Calc.carb 12/6
Previous Homoeopathic Treatment: Initially Nux vom 200C and Lyco 1M prescribed based upon the prominent physical generals and gastric symptoms but there has been no relief for 15 days, but after careful interrogoration about his life space investigation, he revealed the death of his son 6 months back, after that he was constantly brooding over that matter without expressing outwards and from then onwards started his complaints gradually and cannot bear contradiction 
Follow Ups:

Observation and progress


First prescription (Based on acute emotional causative modality)
Ign 200C/1D
Complaints slightly reduced.  General’s normal.
S.L / 2 weeks
Complaints completely reduced. Generals’ normal.  Patient was discharged and advised to attend OP every Thursday.
S.L/ 1 month
Recurrence of complaints since 3 days. App-reduced, thirst- more, H/o of grief
Nat.m 1M/1D
S.L / 2 weeks
No recurrence of complaints.  Burning pain in the soles reduced completely.
S.L/2 weeks
No recurrence of complaints.
S.L / 2 weeks
No recurrence of complaints.  Patient feels better
S.L / 2 weeks
No recurrence of complaints. 
S.L/2 weeks

Case Summary: Mr. K, aged 51 years, developed fullness and aching pain in the abdomen after stool and burning sensation in the soles following his son’s death. He was treated initially with Ign 200C/1D and later Natr.mur 1M/1D as per the case required.  This led to marked improvement as there was no recurrence of complaints and the patient is still under observation and further results awaited.
1) Lynn, Richard B., and Lawrence S. Friedman. Irritable bowel Syndrome In Harrison's  Principles of Internal Medicine, edited by Anthony S. Fauci, et al. New York: McGraw-Hill, 1998
2) By Rebecca C. Dunphy, MD, and G. Nicholas Verne, MD, Malcom Randall Veterans Affairs Medical Center and the University of Florida College of Medicine in Gainesville.
3)  Manning AP, et al: Towards a positive diagnosis of the irritable bowel syndrome. BMJ 2:653, 1978.

4) Thompson WG, et al.Functional bowel disorders and Functional abdominal pain. Gut 45(suppl II):1143, 1999.

5) Phlip M Bailey, Homoeopathic psychology,B.Jain publications

6) Weatherall D.J, Ledingham G.G and Wavell D.A : Oxford textbook of medicine.  Oxford medical publishers, Oxford, 3rd edition – 1996.
  Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of which they know nothing”           - VOLTAIRE, 1694-1778

Prof. G. R. Mohan,     H.O.D, P.G. Dept. of Organon and Phil.                                                                               Dr. Ch.v.Kishore kumar, P.G. Final year.                                                                                                   Dr Amulya Ratna Sahoo, P.G. Final year.

Sunday, October 25, 2015





(Health ACTION, April 2008)

key words : respiratory allergy Homoeopathy
Allergies are a common and significant cause of morbidity, lost-productivity and increased health care.  It is not uncommon to see children on antibiotics, antihistamine cough syrups, tonic and off-and-on bronchodilators for years together without any referral to a specialist.  This irrational treatment not only results in disease and economic burden on the family but also lost opportunities of growth and development for the child.  A respiratory allergy is a specific immunologic response to a normally harmless allergen.  Some people with allergy develop asthma and some allergic rhinitis.

Homoeopathy offers very effective treatment for all allergic diseases such as various skin diseases like urticaria, eczema, and contact dermatitis, as well as given unbelievably miraculous results in asthmatic bronchitis etc.  Allergic rhinitis is defined as an allergen-induced inflammation of the membranes lining the nose and the sinus, often due to an allergic reaction to pollen, dust or other airborne substances.  The various types of allergic rhinitis include Atopic Rhinitis, Seasonal Allergic Rhinitis (also known as hay fever) and Perennial Rhinitis (year round).

Of these, allergic rhinitis remains the common cause of morbidity and social embarrassment.  Recent surveys revealed a four-fold increase in the number of consultations with general practitioners, although the reasons are unclear.

RAPID increase
A rapid increase in allergic diseases like asthma, allergic rhinitis, atopic dermatitis and food allergies has been observed worldwide.  Globally, it has been noted that allergic rhinitis affects 24% of the population n the United Kingdom, 20.6% in Norway, and 19.6% in Germany and 26% of the population in India.  Today, the incidence of asthma-related cases is 10-12 percent.  In terms of the age-groups affected, about 70 per cent of patients develop allergic rhinitis before they are 30 years of age and, the adolescent children have greater incidence with allergic rhinitis occurring between 8-11 years of age.  Over $600 million is spent annually in the management of this disease by United States which does not include the costs of the 2 million lost workdays, 3 million lost school days and 28 million days of decreased productivity from the symptoms of the disease and/or side-effects of the medications used to treat them.

Heredity plays a role in the development of allergies.  The risk of the developing allergies is 18% if neither parent is a topic, 20% if one parent is atopic and 50%, if both parents are atopic.

Common Causes
Irritants like smoke, perfumes, strong smells, air pollutants and temperature changes, dust mites (see figure), polluted areas having high levels of sulphur dioxide and nitrogen diospets, moulds growing on wallpaper, upholstery, carping and plants within the house are found to cause allergic rhinitis.  Grasses and trees that release minute pollen grains are also known to cause allergies.  Allergies contracted from grass are experienced more in the late afternoon while that from mould spores may peak on dry windy afternoons or on damp or rainy days in the early morning.  Intake of alcoholic drinks like wines and beer, sea foods, chlorine in swimming pool water, drugs like birth control pills and female hormones, some drugs used for blood pressure control, aspirin and chronic use of decongestants in the nose can also produce rhinitis.

Perennial rhinitis:  common causes are dust mite found in many homes, and domestic pets.  Salivary protein of cat, allergens from cockroaches etc. also cause perennial rhinitis.  Occupational rhinitis is caused by an agent inhaled at the work place.

When an allergen such as pollen or dust is inhaled by a person with a sensitized immune system, it triggers antibody production.  These antibodies mostly bind to mast cells, which contain histamine and when the mast cells are stimulated by pollen and dust, histamine and other chemicals are released.  This results in itching, swelling, and mucus production.  Symptoms vary in severity from person to person with very sensitive individuals experiencing hives or other rashes.

Symptoms of allergic rhinitis include frequent or repetitive sneezing (it is an allergic reaction to something in the air); a runny or congested nose; itching in the nose, eyes, throat, or roof of the mouth; plugged-up ear canals; sore throat; occasional nose-bleeds; impaired smell and wheezing.  Sometimes, cross-reactive allergy to some fruits such as the skin of apples or potatoes occurs because of similarities in the proteins of the pollen and the food.  Additional symptoms include fever, fatigue, flushing and irritability.  Many patients develop watering, itching and redness of the eyes, collectively known as allergic rhino conjunctivitis.

Almost 20-50 percent of patients with allergic rhinitis go on to develop asthma as allergic rhinitis is a risk factor for developing asthma.  A large number of children who start with asthma also develop allergic rhinitis.

The most important diagnostic tool is the history of the illness.  The timing of symptoms also helps in making the diagnosis.  Allergic rhinitis that appears seasonally is almost always due to pollen; and outdoor allergens can be detected by conducting a skin test when the patient is not taking antihistamines. Skin-testing should also be avoided in patients with extensive eczema.  For such patients, ELISA and RAST are two commonly used methods that measure the presence of food-specific IgE I the blood of the patients.  However, they are more costly than skin tests and also take more time and a simple method for detecting common allergens.

Complications of allergic rhinitis lead to ear infections due to blockage of the Eustachian tube, recurring headaches, reduced concentration, reduced hearing, appetite, and growth.

Symptoms of Asthma
Asthma is a chronic disease in which the airways of the lungs become inflamed or narrowed, resulting in disruptions to normal breathing patterns, often called attacks’ or “episodes’.  The level of severity of asthma suffered by each individual, and further, the severity of each attack, varies greatly.  Genetic predisposition toward developing asthma and environmental factors play a role in the actual development of the disease.  Symptoms of asthma include wheezing, shortness of breath, a feeling of tightness in the chest, and coughing, which are due to a narrowing of the bronchial passages in the lungs, and to excess mucus production and inflammation.  Asthma can be disabling and sometimes fatal.

Treatment: A detailed clinical history of the patient’s illness will identify the likely cause of rhinitis.

Medical philosophy is increasingly coming to the conclusion that the mere treatment of symptoms and organs can only help temporarily and that it is the healing power of the body as a whole that has to be enhanced.  Homoeopathy believes in a holistic, totalistic and individualistic approach which provides relief, free of side-effects.

Clinical trials conducted on allergic disorders like atopic dermatitis and childhood asthma in Hyderabad showed encouraging results with homoeopathic remedies.  The same was published in an international journal Homoeo Links.

A few homoeopathic remedies with their indications

Arsenicum album: sneezing (with every change in the weather), watery discharge from the nostrils, excoriation of the upper lip, itching, burning and watering from eyes.

Allium Cepa: Prepared from red onion has this excoriating nasal discharge, there is more lachrynation which is bland.  The discharge ceases when the patiehnt goes into the open air, but returns when entering a warm room again.

Euphrasia: is similar to Allium cepa, but it has profuse lachrymation, while having bland nasal discharge.

Arum triphyllum: all the seretions are acrid, the nostrils and lips are sore.  There is thirst, but drinking causes pain.  The nostrils are sore, and there is contant desire to bore the finger into the nose.

Lemna Minor: A catarrhal remedy.  Nasal polyps, swollen turbinates.  Atrophic rhinitis asthma from nasal obstruction, wrose in wet weather.

Kali lod.  Constitutional remedy, starts with sneezing, pfofuse watry acrid coryza with pain in frontal sinus, cold travels downward to chest, laynhx feel raw, violent cough

Sulphur – found to be helpful in asthma alternating with recurrent skin eruption, fluent burning coryza, worse when outdoors, stops when indoors.  Frequent sneezing.

Teucr ham marum: Catarrhal condition of both anterior and posterior nostrils.  Mucous polyps.  Chronic catarrh, crawling in nostrils with lachrymation and sneezing.  Coryza with stoppage of nostrils.

Solidago: Hay fever.  Spasmodic sneezing with runny nose.  Copious, watery nasal discharge, worse from the odour of flowers, even thinking of flowers increases the discharge.  Oversensitiveness to odours.

Sanguinaria nitrate: Acute clods with sneezing, profuse discharge, burning and rawness in posterior nares, husky voice (must clear throat before speaking).

Pothos: Asthma fromdust exposure (Kalic, Batta, O\, Solanum)

Asthma relieved by stool.

Psorinum: nose dry, coryza, with stoppage of nose, chronic catarrh; dropping from posterior nares, Asthma, with dysponea; worse, while sitting up; better, on lying down.