Irritable Bowel Syndrome & its Homoeopathic Management
Introduction
Irritable Bowel Syndrome (ibs) is a functional bowel disorder characterized by periodic or chronic bowel symptoms like abdominal pain or discomfort & altered bowel habits without any detectable structural abnormalities.
Irritable bowel syndrome is the most frequently found functional bowel disorders nowadays. Approximately 20% of the general population fulfills the rome iii criteria for ibs. But only 10% among them consult for their complaints. In India prevalence of ibs is 7.5%.
Ibs affects people of all age groups but is more observed in people of 20-40 years of age. People residing in urban areas are more affected than rural. Although ibs is not life threatening, but this chronic condition reduces quality of life of the patient & imposes a significant economic burden upon them.
Precise cause of ibs is still unclear though time to time researchers try to explain it with several theories. Symptoms in ibs sometimes seem to develop or flare as a consequence of a severe intestinal infection or to be precipitated by major life events, poor dietary habits, after eating a large meal or in a period of considerable stress.
Ibs can be classified either diarrhea predominant (ibs-d), constipation predominant (ibs-c) or ibs with alternating stool pattern (ibs-a or pain-predominant).
The primary symptoms of ibs are abdominal pain or discomfort in association with frequent diarrhea or constipation with a change in bowel habits. There may also be urgency for bowel movements evacuation (tenesmus), bloating or abdominal distension.
Other symptoms may be found in association with primary symptoms such as symptoms related to genitourinary systems viz. Urinary frequency, nocturia, sense of incomplete bladder emptying etc.; psychiatric symptoms like depression, anxiety etc with other symptoms like chronic fatigue syndrome , headache & backache.
Diagnosis of IBS:
There is no specific diagnostic marker to diagnose ibs. Therefore, while assessing the patient with ibs, recognition of characteristic symptom pattern with the exclusion of organic gastrointestinal diseases is important. To diagnose a case of ibs rome iii diagnosis criteria is useful; any patient fulfilling these criteria can be labeled as suffering with ibs.
Diagnostic criteria for ibs:
- Onset of symptoms at least 6 months before diagnosis is required for diagnosis
- Recurrent abdominal pain or discomfort
- At least two of the following features:
- Improvement with defecation
- Association with a change in frequency of stool
- Association with a change in stool form.
Management:
Dietary management:
Dietary modification is an essential component of management in cases of ibs as many patients with ibs attribute their symptoms to specific food. Food that triggers this condition must be avoided. Full meal at a time or over eating must be avoided as it may flare the condition. It is better to take 4 to 6 small meals in a day. The soluble fiber supplementation is effective. Curd helps to improve digestion by enhancing growth of healthy bacterial flora in intestines. Eating food that have low fat and more carbohydrates such as whole grain breads & cereals, rice, pasta, fruits and vegetables etc. are found beneficial. Carbonated beverages such as soda must be avoided. Plenty of fluids must be taken to maintain soft, regular stools.
Stress management:
Psychotherapy also plays a vital role in management of ibs. It is helpful in reducing or coping with the stress and resulting into relief in the symptoms of ibs. Relaxation techniques like meditation, yoga, regular walk, avoidance of stressful situations and adequate sleep is also beneficial.
Treatment:
Ibs requires such lines of treatment where not only physical symptoms are to be given importance but person as a whole is to be considered for treatment that is why Homoeopathy stands high in the treatment of cases of ibs than any other streams of medicine.
Homoeopathic medicines act on the vital plane & help body’s own immune system to enhance its capability to fight illness. Perfect similimum when administered to the sick individual brings about rapid, gentle & permanent restoration of health and brings back hyper-susceptibility to normal susceptibility.
Medicines commonly used in ibs:
Nux vomica: It is one of the most common medicines for ibs mainly suited to ambitious, hard working people who cannot remain at ease till completing their work. Highly irritable, easily offended, impatient individuals who tend to get themselves indulged in rich & spicy foods and stimulants e.g. Tea, coffee, wine, tobacco etc.
Ibs is triggered from sedentary habits which include stressful lifestyle, anxiety about work / business, mental exertion, irregular food habits as well as sleep patterns, after eating rich & spicy foods and from taking conventional drugs etc.
There is alternate constipation and diarrhea, frequent ineffectual desire for stool but little amount of stool is passed in each attempts. Usually there is pain or discomfort with heaviness in abdomen after eating. Complaints get aggravated after eating and the patient feels better after passing wind or stool.
Argentum nitricum: Another very useful medicine for ibs, mainly suited to nervous, hurried impatient personalities who always have apprehension & anticipatory anxiety which triggers or aggravate the complaints.
The patient is unable to cope-up stress. Any stressful situation causes great apprehension which leads to diarrhea e.g.: facing crowd, stage performance, examination/ interview, meeting with new people or attending an engagement etc. Gastric upset gets worse from eating or drinking anything. Patient is usually fond of sweets, but sweets cause diarrhea. There is distention of abdomen from flatulence with loud, explosive belching which gives relief.
Aloes socotrina: Sudden urge for stool with great sense of insecurity in sphincter ani. Rumbling, gurgling in abdomen followed by sudden & severe urge for stool, inability to control, has to rush for closet or it will leak. Great accumulation of wind which causes distress in lower bowels. Uncertain whether stool or flatus will pass. Stool escape while passing flatus or when urinating. Diarrhea after eating and drinking. Colic before and during stool, amelioration after passing stool.
Arsenicum album:
Colocynth: Colocynth has characteristic sharp, cutting crampy, spasmodic pain in abdomen of sudden onset which compels the patient to bend over double. Pain worsens after eating or drinking.
Gelsemium: Similar to argentum nitricum, gelsemium patient is also nervous and anxious. This anxiety and anticipation leads to diarrhea. But gelsemium can be defined with characteristic 3d’s dullness, dizziness and drowsiness. Thirstlessness is also very characteristic.
Lycopodium: Gastric affections with excessive flatulence. Increased appetite but easy satiety. Eating even so little causes fullness / bloating in abdomen. Heaviness of abdomen esp. Lower abdomen. Complaints are generally aggravated in evening esp.4-8 pm, from cold food & drinks, feels better by passing wind. Patient craves everything warm which relieves the complaints.
Natrum carb: Very useful medicine for irritability of gastrointestinal tract. Digestion weak, slightest error in the diet causes upset, leading patient to remain in restricted diet ailments from milk & milk products which causes great flatulence, heartburn and diarrhea.
Sulphur: Great antipsoric medicine, useful in cases where best selected medicine fails to produce favorable effect, it frequently seems to rouse the reactive power of the system.