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 Table of Contents  
CASE REPORT
Year : 2017  |  Volume : 11  |  Issue : 1  |  Page : 74-78

Homoeopathic treatment of ulcerative Colitis: A case report


1 Dr. Anjali Chatterjee Regional Research Institute (H), Kolkata, West Bengal, India
2 Regional Research Institute (H), Guwahati, Assam, India

Date of Web Publication23-Feb-2017

Correspondence Address:
Abhijit Chakma
CCRH, Ministry of AYUSH, Government of India, 1/4, Krishnanagar Main Road, Near Colonel Chowmuhani, Agartala - 799 001, Tripura
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-7168.200842

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  Abstract 

Ulcerative colitis (UC) is one of the most common inflammatory bowel diseases. As in most of the cases, the exact cause is unknown Homoeopathy, however, provides a better response in such conditions, one such case report is presented below. Patient attended out patient department (OPD) chiefly for complaints of frequent passage of bloody stool and abdominal pain. He was suffering from idiopathic UC for the past 10 years. After unsatisfactory outcome with modern medicine, patient turned to homoeopathic treatment. After detailed case-taking and repertorization, Hydrastis was given in low potency, and gradually, the potency was raised as per the response of the medicine upon patient. Within 3–4 months of homoeopathic treatment, the patient started improving and continues to be free from his complains at the time of last follow-up visit in OPD.

Keywords: Berberine, Case report, Colonoscopy, Homoeopathy, Hydrastis, Occult blood


How to cite this article:
Pal PP, Ghosh MS, Chakma A. Homoeopathic treatment of ulcerative Colitis: A case report. Indian J Res Homoeopathy 2017;11:74-8

How to cite this URL:
Pal PP, Ghosh MS, Chakma A. Homoeopathic treatment of ulcerative Colitis: A case report. Indian J Res Homoeopathy [serial online] 2017 [cited 2019 Aug 18];11:74-8. Available from: http://www.ijrh.org/text.asp?2017/11/1/74/200842


  Introduction Top


Ulcerative colitis (UC) is lapsing and remitting inflammatory disorder of the colonic mucosa. It may just affect the rectum or extend proximally to involve part of the colon or entire colon.[1] Exact cause is unknown, and there is some genetic susceptibility ( first-degree relatives of people with UC have an increased life time risk of developing the disease). It is found world wide, but common in most of Europe and Northern America.[2] The incidence/prevalence of UC varies not only to geographical region but also with race and ethnicity. For unknown reasons, an increased frequency of this condition has been observed recently in developing nations. Symptoms manifest mostly around the age of 15–30 years and are 3 times more common in non smokers.[1] There is no specific treatment for UC in modern medicine,[3] and in most cases, it is of palliative in manner.[4]

Clinical presentation and investigation

The main symptoms of UC are diarrhea, rectal bleeding, tenesmus, passage of mucus, and crampy abdominal pain. The severity of symptoms correlates with the extent of disease. Although UC can present acutely, symptoms usually have been present for weeks to months. Occasionally, diarrhea and bleeding are so intermittent and mild that the patient does not seek medical attention.[1] Patients with proctitis (just involving rectum) usually pass fresh blood or blood-stained mucus, either mixed with stool or streaked onto the surface of a normal or hard stool. They also have tenesmus or urgency with a feeling of incomplete evacuation but rarely have abdominal pain. When the disease extends beyond the rectum, blood is usually mixed with stool or grossly bloody diarrhea occurs. When the disease is severe, patients pass liquid stool containing blood, pus, and fecal matter. Diarrhea is often nocturnal or post prandial. Although severe pain is not aprominent symptom, some patients with active disease may experience vague lower abdominal discomfort or mild central abdominal cramping. Severe cramping and abdominal pain can occur with severe attacks of the disease. Other symptoms in moderate-to-severe disease category include anorexia, nausea, vomiting, fever, and weight loss. Most serious complications are perforation and bleeding. Toxic dilation of colon, venous thrombosis, and colonic cancer is also common.[5]

The disease severity is, assessed by True love and Witts' criteria which grade the disease condition as mild, moderate, and severe as per the parameters such as motions/day, rectal bleeding, temperature at 6am, pulse rate, haemoglobin, and erythrocyte sedimentation rate (ESR).[1],[6],[7] As there is no gold standard for diagnosis, the ultimate diagnosis relies on a combination of symptoms, the appearance of the coloniclining at the time of endoscopy, histological features of biopsies of the coloniclining, and studies of stool to exclude the presence of infectious agents that may becausing the inflammation. Among investigations, sigmoidoscopy, colonoscopy, bariumenema X-ray, routine blood examination, stool test for cal protect in as well as routine analysis to exclude infection, parasites, etc., are helpful in reaching to a diagnosis. Video capsule endoscopy might be useful for detection of UC with a typical features and who might be suspected of actually having Crohn's disease.[6],[7]


  Homoeopathy in Ulcerative Colitis Top


Although there are some studies carried out on irritable bowel syndrome,[8] very less work has been done exclusively on UC. In a retrospective study case analysis, Homoeopathy was found to be effective in UC.[9] Twenty-four people suffering from UC were treated in a clinical in Argentine Clinic using constitutional Homoeopathy over a period of upto 19 years. Out of these 24, 16 patients were assessed as having good outcome.


  Case Report Top


A40–year-old male patient attended outpatient department (OPD) in June 2015 with the following complaints:

  • Frequent passage of stool (9–10 times) with blood for 10 years, intermittently with severe exacerbations, especially after taking chewing or smoking with increased frequency mostly in the morning. During defecation, there was severe pain and burning. Urgency and tenesmus were also present
  • Pain in abdomen diffuse, cramping in nature, and ameliorated by passage of flatus, occurring empty stomach or even after eating. Everything he eats turns into gas with excessive flatulence.


History of present complaint

He was under treatment in a State General Hospital (N.R.S. Medical College and Hospital) since 2007 with complaints of frequent passage blood and mucous mixed in stool. Three consecutive reports on examination of stool revealed positive occult blood test, but endoscopy report dated September 8, 2007 showed normal study. Since the value of ESR was 45 mm (1st), he was given some antiallergic, along with antibiotic, non steroidal anti-inflammatory drug, B-complex supplementation, and acytoprotective agent. Inspite of such amultiangle prescription, there was no remarkable improvement. Patients suffering continued even after being referred to other hospital, where he was given similar treatment. In 2009, again colonoscopy was done which confirmed the diagnosis of idiopathic UC. Ultimately, he decided to start homoeopathic treatment and came to our OPD.

Colonoscopy report: Mucosa of rectum, sigmoid colon, and descending colon is erythematous with loss of vascular pattern with spontaneous bleeding (Seen up to splenicflexure); impression-Acute exacerbation of idiopathic UC (February3,2009).

Past history

Patient at the age of 15 years had anal fissure which was cured after homoeopathic treatment.

Family history

Both mother and father were diabetic.

Personal history

Patient by occupation is a businessman having his own grocery shop, belonging to middle class socio economic group with occasional habit of taking tobacco, opium, cocaine.

Generals

His appetite is good and cannot remain empty stomach for prolonged period, as it causes a sensation of weak feeling and faintness. He has desire for egg and thirst is of moderate amount, with scanty sweat. Bowel movements are irregular with urgency and tenesmus. Stool is of thin consistency. Thermal reaction of patient is hot (craves cold drinks, prefers winter, and can not tolerate heat) and seems to be always depressed with his present complaints. A general feeling of weakness accompanies the patient most of the time.

Local and systemic examination

Diffuse tenderness all over abdomen and tongue was yellowish white and moist.

Analysis of the case

After analyzing the symptoms of the case the characteristic mental and physical generals and particular symptoms were considered for framing the totality. Sadness with mental depression, lassitude in general, aggravation from tobacco, indigestion, flatulence, desire for eggs, and diarrhea in morning were the important general symptoms. Emptiness in stomach, abdominal pains, burning pain in rectum, and yellowish white discoloration of tongue, bloody stool were the particulars included in totality. Miasmatic evaluation for the presenting symptoms was done with the help of” The Chronic disease by Dr. Samuel Hahnemann” showed the predominance of psoric miasm.[10] Considering the above symptomatology, Kent's Repertory was preferred and using HOMPATH software, systemic repertorization was done.[11],[12] The Repertorization chart is given in [Table 1].
Table 1: Repertorisation Table

Click here to view


Hydrastis 6C, TDS for 7 days was prescribed on first visit (June 25, 2015) considering the reportorial totality and miasmatic background. The patient improved symptomatically although the pathology remained which was evident on comparing the colonoscopy report on December 31, 2015 which stated- “Loss of vascular pattern with friable mucos a noted from rectum to cecum. However no growth, polyp noted”. The detail of follow Up is in [Table 2].
Table 2: Timeline including follow-up of the case

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  Discussion and Conclusion Top


Homoeopathy treats the person as a whole; it eliminates the exciting and fundamental causes by annihilating the disease manifestations (signs and symptoms) In this case, important mental, physical generals and particulars, i.e., sadness with mental depression, lassitude in general, aggravation from tobacco, indigestion, flatulence, desire for eggs, diarrhea in morning, emptiness in stomach, abdominal pains, burning pain in rectum, yellowish white discoloration of tongue, and bloody stool were included for repertorization purpose. After repertorization, many medicines were competing which each other, namely, Hydrastis, Arsenic album, Sulphur, Lycopodium, Calcarea carb, etc. but after consultation with Materia Medica, Hydrastis was prescribed which remained unchanged in the subsequent follow-ups as the patient was responding well to the medicine.[13]

Hydrastis was found not only homoeopathically most specific remedy for this particular case of disease but also chemical similarity was found when chemical analysis was made. The main alkaloid constituent of golden sealisberberine (others are hydrastine, palmatine, canadine, and hydrastinine).[14] Studies reveal that incases of pro-inflammatory cytokines induced intestinal epithelial tight junction damage in vitro berberine may be one of the targeted therapeutic agents that can restore barrier function in intestinal disease states, and it is observed in the pathogenesis of UC that the immune response is indicated by marked increase in interleukin (IL)-4, IL-5, and IL-10 and IL-13 levels which are different types of cytokines only. Hence, the alkaloids of Hydrastis also strongly correlate with the simillimum.[15]

Financial support and sponsorship

Nil.

Conflict of interest

None declared.

 
  References Top

1.
Longmore M, Wilkinson IB, Davidson EH, Foulkes A, Mafi AR. Gastroenterology. Oxford Handbook of Clinical Medicine. 8th ed. London: Oxford University Press; 2010. p. 272.2.  Back to cited text no. 1
    
2.
Lakatos PL. Recent trends in the epidemiology of inflammatory bowel disease. World J Gastroenterol 2006; 12(38): 6102-08. Available from: http://www.ncbi.nlm.nih.gov.[Last accessed on 2015 Dec 26].  Back to cited text no. 2
    
3.
Shearman DJ, Crean GP. Diseases of the alimentary tract and pancreas. Davidson's Principles and Practice of Medicine. 16th ed. Edinburgh: ELBS Publication; 1991. p. 470.  Back to cited text no. 3
    
4.
Walsch ND. Question and Answers on conversation with God. Charlottesville: Hampton Roads Publishing Company, Inc.; 1999.  Back to cited text no. 4
    
5.
Friedman S, Blumberg RS. Inflammatory bowel disease. In: Kasper DL, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL, et al., editors. Harrison's Principles of Internal Medicine. Vol. II. 17th ed., New Delhi: McGraw Hill; 2008. p. 1886.  Back to cited text no. 5
    
6.
Khan A. Ulcerative Colitis Imaging. Available from: http://www.emedicine.medscape.com. [Last accessed on 2013 Jul 19].  Back to cited text no. 6
    
7.
Kumar P, Cark M. Kumar and Clark's Medicine. 7th ed. New Delhi; Saunders Elsevier, A Division of Reed Elsevier India Private Limited; 2008. p. 291.  Back to cited text no. 7
    
8.
Mass HP. Ulcerative colitis treated with homoeopathy. Br Homoeopath J 1993;82:179-85. Available from: http://www.homeopathyjournal.net. [Last accessed on 2015 Dec 25].  Back to cited text no. 8
    
9.
McLeod S. Irritable Bowel Syndrome and Ulcerative Colitis; 08 November, 2012. Available from: http://www.littlemountainhomeopathy.com. [Last accessed on 2015 Dec 25].  Back to cited text no. 9
    
10.
Hahnemann S. The Chronic Diseases Their Peculiar Nature and Their Homoeopathic Cure. Low Price Edition. New Delhi: B. Jain Publishers Pvt. Ltd.; 2002. p. 46, 61-2.  Back to cited text no. 10
    
11.
Kent JT. Repertory of the Homoeopathic MateriaMedica. Enriched Indian Edition Reprinted from 6th American edition. New Delhi: B. Jain Publishers (P) Ltd.; 2000. p. 75, 403, 485, 487, 503, 548, 575, 609, 626, 636, 1370, 1407.  Back to cited text no. 11
    
12.
Shah J. Hompath Classic-Homeopathic Software. Version 8.0 Premium. Mumbai; 2005.  Back to cited text no. 12
    
13.
Boericke W. New Manual of Homoeopathic MateriaMedica and Repertory. Augmented Edition Based on Ninth Edition. New Delhi: B. Jain Publishers (P) Ltd.; 2000. p. 332.  Back to cited text no. 13
    
14.
Randhawa PK, Singh K, Singh N, Jaggi AS. A review on chemical-induced inflammatory bowel disease models in rodents. Korean J PhysiolPharmacol 2014;18:279-88.  Back to cited text no. 14
    
15.
Inbaraj JJ, Kukielczak BM, Bilski P, Sandvik SL, Chignell CF. Photochemistry and photocytotoxicity of alkaloids from Goldenseal (Hydrastis canadensis) 1. Berberine. Chem Res Toxicol 2001;14:1529-34.  Back to cited text no. 15
    



 
 
    Tables

  [Table 1], [Table 2]



 

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