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
Abstract:
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,
Introduction:
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:
CVS: NYD
RESP: NYD
CNS: NYD
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.
Acknowledgements : I thank the patient for the cooperation she has extended during the time
of treatment.
References:
3)
http://pedsinreview.aappublications.org/content/11/9/268.
Repertorisation chart of Cholelithiasis
case:
. 
(for full-length
article ref : Hpathy.ezine, nov 2011 & Wonders of Homoeopathy an evidence
based study )
