Irritable Bowel Syndrome-a few cases
NATIONAL JOURNAL OF HOMOEOPATHY 2004 Mar / Apr VOL VI NO 2.
Dr Adil Chimthanawala
'Aloe / Sulp / Lil-tig / Podo / Puls / Lil-tig
"Irritable Bowel Syndrome", brings to mind a host of successes for this so-called vague syndrome. It is a Psychosomatic disorder manifesting primarily via GIT in the form of recurrent episodes of loose motions. The signs & symptoms are wide, vague and vivid. The Symptom syndrome is diagnosed by the process of elimination of other differential disorders as amoebiasis, giardiasis, Ulcerative colitis, Koch’s abodmen etc. The Miasmatic Diagnosis of this disorder is obviously Tubercular - Psorosyphilitic due to its characteristic features viz. recurrence, erraticity of symptoms, changibility and restlessness.
In my practice, patient age group-50 years. Predisposition to psychiatric
problems and health care seeking behaviour.
Pathophysiology: "Body mind" interactions results in altered motility
of the gut- hyper responsiveness of the gut to minor stimuli (similar to
bronchioles in Asthma).
Certain life events which leave a deep emotional impact as a sense of "loss" or "injustice", threat to one’s own identity, sexual or physical abuse, unwanted / unhappy marriage, unwanted child birth, etc act as exciting and maintaining factors. The patient has difficulty in coping with the loss and this starts the cascade of events that ultimately leads to IBS.
I am citing 3 atypical cases of IBS with varied clinical presentations. All had come to different OPD’s (Paediatric, Gynaecology and cardiology) but had IBS. They all responded to a single remedy (although lesser used). By such a workup one can study 3 different states of disposition as well as 3 varied aspects of a single remedy. The constitutional remedy so selected was after the apparently indicated remedy had failed to yield expected results.
Cardiophobia with Chronic Loose Stools
48 yr Male- Sales executive presented on 4/8/02 with
1. Systemic Hypertension - 8 years
AF Death younger Br of MI.
Patient was constantly worried about having a heart attack > when occupied.
Occ Palpitation + burning palms & soles.
Chest Pain extending to Rt Arm
2. GIT complaints - 12 years
Stools loose, 3-4/ day, mucus+++, unsatisfactory, occasionally passage of blood.
Bloating < meals occasionally involuntary. Urge > urination.
Temperament: soft spoken, apprehensive, mild, worrying nature. Perception
good, short tempered, Anxious about his complaints.
Physicals Generals
Thirst +++; > fresh air
Past History: T cruris, roundworms
Family History: Mother - died of pleurisy.
Father: IHD, HT.
Had taken Nux-vom, Carbo-veg, Lyco, China etc.
Investigations - Repeated Stool examinations - Nil.
Colonoscopy - N.
ECG & 2D ECHO - N.
O/E - P-80/min, reg, B.P- 120/90mmHg, No Pallor/ Icterus. Heart Sounds-N, RS
clear, CNS-NAD.
Per Abdomen- soft, Vague tenderness +.
Liver/Spleen/Kidneys - Not Palpable;
Management
4/8/02 Aloes 200 TDS x 3 d
14/8 Stools invol on passing flatus. ++ Aloes 1M TDS x 3 d
Early morning urge to stool >
25/9 Stools - mucus ++. invol Sulph 200 TDSx1 d
Early morning urge >. Burn palms
++ SL x 1 mth
3/10 Partial > all complaints. Sulph
1M TDS x 1 d
Anxiety +++, Itching groins ++ SL x 1 mth
P reg 90/min, BP 130/80 mmHg
P/A - soft, NT, L/S NP
4/3/03 Reported after 4 mnths.
Nux-vom 1M/ TDS x 1d
All abd comp +++ SL x 1 mth
H/o Hosp for HT + U. angina Amyl-n Q sos
ECG: Anterior Wall ischemia, ECHO-N, Coronary Angiography-N Aspirin Omit
On Sorb, ASA. GI symp < Aspirin
Anti-Hypertensives contd
10/4 Rec. Angina ++ > sorbitate Lil-t 200 TDS x1 d
Bloating, Stools loose; mucus+++. SL x 15 d
Involuntary on passing flatus+.
Case reviewed in clinical meet:
Apprehensiveness ++, worry +,
Constant dwelling on brothers death +
Anxiety of his own life after death. Religiousness ++.
27/4 Mental calmness ++, anxiety about his health> SLx15 d
Religiousness > Borborygmi / Eructation/ Flatulence ++++, Stools
N, No Angina.
22/5 Pt > in all respects Anti Anginals Omit
Calm, No rec thoughts about salvation SL x 1 mnth
Stools N. Flatulence >>
Eructation>> BP 130/84mmHg. Amlopres 2.5mg
4/7/03 P -92/min. Reg good vol BP 130/84
PA - soft non tender, L/S NP. HS pure, RS clear
S. creat- 0.9mg/dl. Bl. sugar(R) 105 mg/dl.
ECG - WNL, 2D ECHO - normal study
Pt under follow up and is well settled.
