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 Table of Contents  
CASE REPORT
Year : 2020  |  Volume : 14  |  Issue : 1  |  Page : 57-63

Chronic Cholelithiasis treated with Homoeopathic medicine in 50th millesimal potency: A case report


Drug Proving Unit of Central Council for Research in Homoeopathy, Dr. Abhin Chandra Homoeopathic Medical College and Hospital, Unit-3, Bhubaneswar, Odisha, India

Date of Submission02-Mar-2019
Date of Acceptance18-Feb-2020
Date of Web Publication9-Apr-2020

Correspondence Address:
Dr. Madhusmita Patnaik
Drug Proving Unit of Central Council for Research in Homoeopathy, At- Dr. Abhin Chandra Homoeopathic Medical College and Hospital, Unit-3, Bhubaneswar - 751 001, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijrh.ijrh_15_19

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  Abstract 

Introduction: Cholelithiasis or gallstone disease is a very common problem worldwide. The prevalence is more in females than males. Although cholecystectomy is considered the gold standard treatment for symptomatic cholelithiasis, it has its own limitations, risks and post-operative complications. Here, an alternative system of medicine, especially Homoeopathy, plays an important role in treating cholelithiasis. Case Summary: A 32-year-old female patient presented with the symptoms of dull pain in the right hypochondrium, sour eructations and regurgitation of food. The ultrasonography (USG) report confirmed the presence of multiple stones in the gallbladder of varying sizes, from 3 mm to 11 mm. Although she was advised for cholecystectomy, she was reluctant to undergo any surgery. Detailed case was taken, case was analysed, totality was formed, repertorization was done and Lycopodium was prescribed in fifty millesimal potency. Her symptoms were alleviated within a short span of time, and USG reports revealed that there were no stones after 3 months of treatment. Homoeopathic medicine Lycopodium, selected on the basis of totality of symptoms, was found effective in this case.

Keywords: Cholecystitis, Cholelithiasis, Gall bladder, Homoeopathy, Lycopodium


How to cite this article:
Sahoo AR, Patnaik M, Khamari N, Sahoo S. Chronic Cholelithiasis treated with Homoeopathic medicine in 50th millesimal potency: A case report. Indian J Res Homoeopathy 2020;14:57-63

How to cite this URL:
Sahoo AR, Patnaik M, Khamari N, Sahoo S. Chronic Cholelithiasis treated with Homoeopathic medicine in 50th millesimal potency: A case report. Indian J Res Homoeopathy [serial online] 2020 [cited 2020 Aug 7];14:57-63. Available from: http://www.ijrh.org/text.asp?2020/14/1/57/282111


  Introduction Top


Gallstone disease refers to the presence of stones in the gall bladder (GB) (cholelithiasis) or common bile duct (choledocholithiasis) and the symptoms and complications they cause.[1] Cholelithiasis and its associated complications such as cholecystitis, pancreatitis and cholangitis are one of the major health problems worldwide.[2] Chronic cholecystitis is almost invariably associated with gallstones.[3] The imbalance of the chemical constituents of bile results in precipitation of one or more of the components and ultimately forms gall stones. Nearly 37%–86% of gallstones are cholesterol-rich stones, 2%–27% are pigment stones and 4%–16% are mixed stones.[4],[5] Different epidemiological studies have suggested a wide variation in the overall prevalence between different populations. The prevalence of gallstones increases with age, rising markedly after the age of 40 years. Older people are 4–10 times more likely to have gall stones than younger people.[5],[6] Gallstones are frequently found in people of high socioeconomic status and in multiparous females.[7] In addition, patients with cholelithiasis have significantly higher BMI in comparison to the common population.[8] Female gender is one of the major risk factors of cholelithiasis. In comparison to men, women have two to three times higher prevalence of gallstones.[4],[9] Pregnancy is also a major risk factor for cholelithiasis. Sex hormones are mostly responsible for the increased risk as oestrogen increases biliary cholesterol secretion, causing cholesterol supersaturation in the bile.[9] Chronic calculus cholecystitis commonly presents with recurrent attacks of upper abdominal pain.[3]

Liver function tests and abdominal ultrasound are the suggested investigational procedures in suspected gallstone disease.[4] Cholecystectomy is the main choice of treatment in symptomatic gallstone cases, and laparoscopic cholecystectomy (LC) is the widely accepted operative management of gallstone disease worldwide. However, there are patients who are either reluctant to undergo surgery or are at high surgical risk.[10] In addition, LC has some disadvantages as it may lead to common bile duct and bowel injury (2.6%), post-operative bile leak (2.3%), stone spillage (2%), post-operative colonic fistula (0.3%), post-operative biliary fistula (0.3%) or post-operative haemorrhage (0.3%) in some cases.[11]

Here, Homoeopathy plays an important role in combating the sufferings due to gallstone disease. There are several medicines in the homoeopathic Materia medica which can be considered for gall stone disease; some prominent medicines are Berberis vulgaris, Calcarea carbonica, Carduus marianus, China, Chamomilla, Chionanthus, Lycopodium, Veratrum album, etc.[12] However, there are very few studies found in literature, which show positive result of well-selected individualised homoeopathic medicines in these conditions.[13],[14] In this context, the main objective of this case report is to show the effectiveness of individualised homoeopathic medicine in the treatment of this often dreaded condition, usually or considered surgical, with further stress on the necessity of more research in this field.


  Case Report Top


A female of moderate built, aged about 32 years, came to the outpatient department of Dr. A. C. Homoeopathic Medical College and Hospital on 24 September 2018.

She complained of dull pain in the right hypochondriac region which was aggravated about 30 min after lunch. She also complained of eructations, which were sour and were associated with regurgitation of food. The complaints started gradually about 3 months back. At first, the patient had consulted an allopathic physician who advised her for ultrasonography (USG) of the whole abdomen. On USG, multiple calculi of about 3–9 mm were seen in the GB lumen, with increased thickness of GB wall (3–5 mm) [Table 1] and [Figure 1]. The doctor advised her to undergo cholesystectomy, but the patient was reluctant to undergo any surgery and came for homoeopathic treatment, as the discomfort gradually increased. In the past, she had suffered from typhoid 1 year back. She had a family history of hypertension (father). The patient was married, had two kids and belonged to good socioeconomic background. No addictions were reported. In the physical generals, her appetite was good. She had a desire for warm and salty food. Thirst was normal. She reported profuse sour perspiration especially on the head, palms and soles. She was found to be a hot patient and generally got relief from cold. Mentally, she was irritable, afraid of being alone and had a tendency to weep easily. On local and systemic examination, no significant abnormalities were found, except mild tenderness in the right hypochondrium.
Table 1: Ultrasonography report before treatment

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Figure 1: Ultrasonography film before treatment

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While analysing the case, the general and particular symptoms were classified as per the intensity and evaluated as per their merit. Characteristic mental generals, physical generals, particulars and a few diagnostic symptoms were considered for erecting the totality of symptoms [Table 2]. Considering the totality, complete repertory was selected and repertorisation was done with HOMPATH software.[15] After repertorisation, from the list of drugs [Figure 2], Lycopodium was selected after further confirmation from Materia medica. It was prescribed in fifty millesimal potency; 0/3, followed by 0/4, 16 doses each, one dose daily in the morning on empty stomach, and the patient was asked to report after 1 month.
Table 2: Symptoms forming the totality

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Figure 2: Repertorisation chart

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The patient reported next on 1 December 2018, almost about 2 months after the first visit, and narrated that there was a gradual reduction of symptoms during this while and even after the medicine was finished, so she did not turn up for follow-up the last month. However, the pain and eructations increased recently after attending a family feast and taking fat-rich diet, but the intensity was much less than before. Lycopodium was prescribed again in 0/5 and 0/6 potency, 16 doses each, one dose daily. The patient reported next time on 4 January 2019, and at that time, she had no signs or symptoms [Table 3]. She was advised USG of the abdomen, which showed normal GB without any stones [Table 4] and [Figure 3]. She was very elated as she was completely cured. She said that she had heard that Homoeopathy cures gall stones, but had never expected complete recovery in such a short span of time and hence, she was very grateful.
Table 3: Follow up

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Table 4: Ultrasonography report after treatment

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Figure 3: Ultrasonography film after treatment

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  Discussion Top


This is the case of a 32-year-old female. As per the literature, multiparous women are more susceptible to gall stone disease and this case also substantiates it. The socioeconomic status of the patient was good, which also corroborates with the risk factors mentioned in the literature. While the moderate built of the patient contradicts the fact that cholelithiasis is mostly found in people with high BMI, there is very limited scope for conservative treatment of cholelithiasis in conventional system of medicine, and it has its own limitations. In this case, the patient was apprehensive about any surgical procedure. Hence, she opted for an alternative system of medicine, though advised for cholecystectomy by the allopathic physician.

Homoeopathy is a system of therapeutics which treats the patient, not the disease. It also aims at a rapid, gentle and permanent restoration of health.[16] Homoeopathic medicines can be selected on the basis of causation, prominent modality, organopathy, miasm, constitution, totality of the symptoms, etc.[17] In this case, there were significant mental, physical, particular and pathological symptoms. Hence, the case was approached with importance to totality of symptoms. The clarity of the symptoms in this case facilitated easy selection of the medicine. In this case, after repertorisation, Lycopodium, Natrum Muriaticum, Phosphorus, Arsenic album, Bryonia, Calcarea carbonica and Carbo Vegetabilis emerged as the leading remedies. Lycopodium was selected as it covered more number of symptoms and also was in accordance with Materia medica, which suggests its efficacy in relieving gall stone colic and in dissolving gall stones.[18] The swift relief of symptoms indicates the efficacy of Homoeopathy in the treatment of gall stone disease, without draining the patient physically, mentally and financially. Disappearance of gall stones on USG is definitely a documentary evidence of cure. Here, Lycopodium was selected on the basis of totality of symptoms. The modified Naranjo criteria score of the patient after treatment was ‘9', which indicates there is a definite relationship between the result observed and the prescribed medication [Table 5].[19],[20] A case report published earlier had also showed that well-selected individualised homoeopathic medicine prescribed on the basis of totality of symptoms was effective in treating gall stone disease.[14] This report resonates with the previous one.
Table 5: Modified Naranjo Criteria scores of the patient after treatment

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  Conclusion Top


This case shows that individualised homoeopathic treatment based on the totality of symptoms is effective in the treatment of gall stone disease. Disappearance of the signs and symptoms within a short span of time along with USG evidence of absence of stone definitely demonstrates the positive effect of Homoeopathy in the treatment of gall stone. However, this is just a single case report and research evidence in this regard is very poor. Hence, clinical trials to evaluate the efficacy of homoeopathic medicine in gall stone disease are suggested.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initial will not be published, and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

None declared.

 
  References Top

1.
Team IC. Gallstone Disease: Diagnosis and Management of Cholelithiasis, Cholecystitis and Choledocholithiasis. UK: National Institute for Health and Care Excellence; 2014.  Back to cited text no. 1
    
2.
Shaffer EA. Gallstone disease: Epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol 2006;20:981-96.  Back to cited text no. 2
    
3.
Innes JA, editor. Liver and biliary tract disease. In: Davidson's Essentials of Medicine. Edinburgh: Elsevier Limited; 2009.  Back to cited text no. 3
    
4.
Lee JY, Keane MG, Pereira S. Diagnosis and treatment of gallstone disease. Practitioner 2015;259:15-9, 2.  Back to cited text no. 4
    
5.
Njeze GE. Gallstones. Niger J Surg 2013;19:49-55.  Back to cited text no. 5
[PUBMED]  [Full text]  
6.
Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: Cholelithiasis and cancer. Gut Liver 2012;6:172-87.  Back to cited text no. 6
    
7.
Singh V, Trikha B, Nain C, Singh K, Bose S. Epidemiology of gallstone disease in Chandigarh: A community-based study. J Gastroenterol Hepatol 2001;16:560-3.  Back to cited text no. 7
    
8.
Frybova B, Drabek J, Lochmannova J, Douda L, Hlava S, Zemkova D, et al. Cholelithiasis and choledocholithiasis in children; risk factors for development. PLoS One 2018;13:e0196475.  Back to cited text no. 8
    
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Novacek G. Gender and gallstone disease. Wien Med Wochenschr 2006;156:527-33.  Back to cited text no. 9
    
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Pruthi HS, Varadarajulu R. Treatment of gallstones – What is the right choice. Med J Armed Forces India 1999;55:1-2.  Back to cited text no. 10
    
11.
Kapoor M, Yasir M, Umar A, Suri A. Complications of laparoscopic cholecystectomy, an analysis of 300 patients. JK Pract 2013;18:7-11.  Back to cited text no. 11
    
12.
Boericke W. New Mannual of Homoeopathic Materia Medica with Repertory. 3rd ed. New Delhi: B. Jain Publishers (P) Ltd.; 2011.  Back to cited text no. 12
    
13.
Pathak R. A cured case of cholelithiasis with homeopathic medicines. Clin Exp Homoeopath 2018;5:27-9.  Back to cited text no. 13
    
14.
Ghosh MS, Shil RC, Chakma A. A case of gallstone with prostatomegaly. Indian J Res Homoeopath 2014;8:231-5.  Back to cited text no. 14
    
15.
Shah JJ. Hompath Classic- Homeopathic Software. Version 8.0 Premium. Mumbai: Mind technologies private limited; 2005.  Back to cited text no. 15
    
16.
Hahnemann S, Boericke W, Dudgeon RE. Organon of Medicine. 5th, 6th ed. New Delhi: B. Jain Publishers Pvt. Ltd.; 2011.  Back to cited text no. 16
    
17.
Mathur KN, Wadia SR. Principles of Prescribing. New Delhi: B. Jain Publishers Pvt. Ltd.; 1998.  Back to cited text no. 17
    
18.
Kent JT. Lectures on Homoeopathic Materia Medica. New Delhi: B. Jain Publishers Pvt. Ltd.; 1971.  Back to cited text no. 18
    
19.
Rutten L. Prognostic factor research in Homoeopathy. Indian J Res Homoeopath 2016;10:59-65.  Back to cited text no. 19
    
20.
van Haselen RA. Homeopathic clinical case reports: Development of a supplement (HOM-CASE) to the CARE clinical case reporting guideline. Complement Ther Med 2016;25:78-85.  Back to cited text no. 20
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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