Friday, October 3, 2014

Role of Homoeopathy in Irritable Bowel Syndrome

Irritable Bowel Syndrome & Homoeopathy paper was  presented at Omics Traditional and Alternative Medicine at Hyderabad on 9-11 Dec 2013

 Irritable bowel syndrome is a functional gastrointestinal disorder characterized by abdominal pain, discomfort and alteration of bowel habits in the absence of any organic disorder. Irritable Bowel Syndrome is a very common gastrointestinal dysfunction with the world wide prevalence   among general population ranges from 5.7% to 34%, the overall prevalence of IBS in western countries as reported by various studies ranges from 17-22%. However, in Asian countries a highly variable range of prevalence has been observed i.e. 2.3-34%. Many studies have reported that IBS is associated with elevated levels of emotional and psychological stress is a major contributing factor. In spite of strong evidence of a high prevalence of depression and anxiety in IBS there is very limited research on this in India. As there is no clear causes of irritable bowel syndrome, treatment focuses on the relief of symptoms.
Many sufferers seeking homeopathic, complementary and alternative medicine as a part of treatment. Homeopathic treatment is based on Individualization, Constitutional approach with lifestyle modification. In Homoeopathy, Importance is given to psyche symptoms  along with  bowel symptoms in the plan of treatment, There is quite a good number of remedies in Homoeopathy like Argentum nitricum. Sulphur, Podophyllum,Cynodin and carcinocin etc Results are quite encouraging.

Magnitude of the Problem ;
20%   Adults  in western world . More   or less same in India.
Significant impact on quality of life. 2nd common cause (after cold) of absenteeism .
Contribute to 25 - 40 % of practice of gastroenterologists
Rome II Criteria for diagnosis 2
Pain or discomfort for 12 weeks of the previous 12 months, associated with
two Of the following three:
  Relief on having a bowel movement,
Looser or more frequent stools,
Harder or less frequent stools
Symptoms 2,3
Abdominal pain associated with defecation.
Irregular pattern of defecation for at least two days a week.
Three or more of the following:
altered stool frequency; altered stool form (hard/loose);
altered stool passage (straining/urgency/ sense of incomplete evacuation);
mucus per rectum,
bloating or feeling of abdominal distension.

                  Homoeopathic Approach

·                        Case recording
·          Physical examination
·          Provisional diagnosis
·          Differential diagnosis
·          Investigations
·          Final diagnosis
·          Analysis of the symptoms
·          Evaluation of the symptoms
·          Results of repertorisation
·          Analysis of repertorial result
·          Classification of disease ( according to hahnemann)
·          Miasmatic diagnosis
·          Choice of remedy
·          Potency selected
·          Diet
My  study of 23 cases( was from june 2011 –may 2012 ) average age  was 25 years ,female gender were more, home makers  were more with large size of family, 3% were employees . DIBS was more seen then CIBS, past treatment history  majority took  conventional treatment with out any result.
every case was thoroughly investigated and came to conclusion that there   was no pathology.
          15-25 years age group males were (1) females (6)
          26-35 years age group males were (2) females (10)
          36-40 years age group males were (1) females (3)
        In  occupation out of 17 females 8 were home makers, in out of  6 males 3 were I T   professionals 2 were   teachers.
         Remedies used:
         Arsenic Alb , Gelsemium , Argenticum Nitrricum,  Mer Sol , Nux Vom , Cynodyon, Carcinocine   were the remedies              ,potency used 200 ,I M.

         Improvement was as follows
No reoccurring of symptoms three months after stopping medicines ( 6 T + 3 ST) no reoccurrence of symptoms : took it as good  improvement
reoccurring of symptoms three months after stopping medicines ( 6 T + 3 ST) no reoccurrence of symptoms, intensity of symptoms  were less , took it as  moderate   improvement
reoccurring of symptoms  very frequent with  treatment   took it as  poor   improvement

             Improvement in 23 cases  was as follows
  •            N : 23
  •            drop outs                                        :  2  ( 8.7%)
  •           cases  good  improvement             : 15 ( 65.2%)
  •           cases moderate   improvement      :  4 (17.4%)
·                             no  improvement                             : 2 (8.7%)  
        Treated case

       Patient Ms V, aged about 39 years with weight  56 KGs, consulted me on 5th June 2011 for pain abdomen > stool after, pain drawing in lumbar area, passing stools 4-5 times stool. C T Scan abdomen  was done it was WNL.  Case was diagnosed as a case of I B S by local Gastroenterologist

         Irritability, anxiety about health of his own health, pain abdomen > stool after, diarrhea anxiety after, cold water cold drinks <, cold food <., 
Ars alb 33/15 , NUX Vom 25/11, Silicia 23/15 were choice remedies 

Treatment follow up

5/06/2011          Nux Vomica 30 c  3 doses  were given
15/07/2011       case was repertorised   as shown  in next slid    Ars Alb 200, 5 doses  was given
14/08/2011       pain in abdomen  reduced ,  general condition improved,
29/09/2011      Nat sulf 200 was given  and followed by  Ars Alb
27/10/2011      general condition improved, Ars Alb 1m one dose was given
02/12/2011      was a symptomatic , with good general health , Tuberculinum  1M one dose was given as           closing remedy and treatment was stopped and advised her to see me after 4 months .

       1) Govind  K Makharia, Anil K Verma, Ritvik  Amarchand  Anil Goswami  J Neurogastroenterol Motil. 2011 January; 17(1): 82–87.Published online 2011 January 26
         2)">Irritable bowel syndrome
         3) Irritable_ bowel _syndrome paged4htm
         4) Dr GRMohan Irritable bowel syndrome challenge in medical practice, NHJ, Vol 8, no 2, March-April-2006