Lycopodium as a Standalone Homoeopathic Solution in Functional Dyspepsia: A Case Study

Dr Ezekiel. E. Warbah

ABSTRACT
Functional Dyspepsia (FD) is a common Gastrointestinal Disorder marked by upper abdominal discomfort without structural abnormality. Symptoms such as fullness, bloating, nausea, and early satiety can impair quality of life, affecting up to 20% of the population. Conventional treatments like acid suppression and prokinetics often provide incomplete relief, underscoring the need for individualised care. Classical Homoeopathy, through remedy selection based on the totality of symptoms, offers a holistic approach. This case report describes a 15-year-old patient with Functional Dyspepsia who achieved complete recovery with a single, individualised Homoeopathic prescription.

1. Aim

Single Individualised Homoeopathic Prescription of Lycopodium, demonstrating the effectiveness of Classical Homoeopathy in functional gastrointestinal disorders.

2. Case Details

A 15-year-old boy presented with complaints of Nausea and occasional Burping for two years, which has increased for two weeks. The complaint is worse after eating and better after walking.

3. Remedy Given

Lycopodium 200C was selected as the Constitutional Remedy and prescribed as a single dose, followed by a placebo. The selection was guided by Repertorization and Materia Medica analysis.

4. Result

The patient showed marked improvement within two weeks and complete symptom resolution by the fourth week. The remedy was not repeated; placebo was given, and progress remained stable on follow-up

5. Conclusion

This case shows that a single Individualised Homoeopathic dose can effectively manage functional dyspepsia in adolescents, highlighting the value of Classical and Constitutional prescribing.

Keywords: Functional Dyspepsia, Homoeopathy, Single Prescription, Case Report, Lycopodium, Gut-Brain Axis.

INTRODUCTION

Definition:
Functional dyspepsia (FD) is a chronic or recurrent disorder of the upper gastrointestinal tract characterised by epigastric discomfort or pain without any detectable structural or biochemical abnormality. According to the Rome IV criteria, Functional Dyspepsia is defined by one or more of the following symptoms: postprandial fullness, early satiation, epigastric pain, or epigastric burning, with symptom onset at least 6 months prior and occurring for at least 3 months. Structural diseases, including peptic ulcer or malignancy, must be excluded.

Prevalence:
Functional Dyspepsia affects approximately 10–20% of the global population, with significant prevalence in adolescents and adults. It can significantly impair quality of life, school or work performance, and social functioning.

Etiology:

The exact cause of Functional Dyspepsia is multifactorial and may include:

• Genetic predisposition
• Helicobacter pylori infection
• Dietary habits and lifestyle factors
• Psychosocial stress
• Previous gastrointestinal infections or inflammation

Pathophysiology:
Functional Dyspepsia is a multifactorial disorder, and its pathophysiology is complex, involving abnormalities in gut motility, sensory perception, and brain-gut interaction. Key mechanisms include:

1. Delayed Gastric Emptying

• Impaired gastric motility leads to postprandial fullness and early satiety.
• Food remains longer in the stomach, causing discomfort and bloating.

2. Impaired Gastric Accommodation

• The stomach fails to relax properly in response to a meal.
• Contributes to epigastric discomfort and early fullness.

3. Visceral Hypersensitivity

• Patients have heightened sensitivity to normal gastric distension.
• Even normal volumes of food can trigger pain, bloating, or nausea.

4. Altered Gut-Brain Axis / Central Sensitisation

• Dysregulation of vagal and spinal pathways leads to amplified perception of GI signals.
• Stress, anxiety, and emotional factors can exacerbate symptoms.

5. Low-Grade Inflammation

• In some cases, duodenal eosinophilia or mast cell infiltration contributes to symptom generation.

6. Helicobacter pylori Infection (in some patients)

• Can cause mild mucosal inflammation, but its role in FD is inconsistent.

7. Psychosocial Factors

• Anxiety, depression, or heightened stress levels can influence symptom severity via the brain-gut axis.

8. Altered Gastrointestinal Hormone Secretion

• Dysregulation of ghrelin, motilin, and cholecystokinin may affect motility and visceral sensitivity.

Clinical Features

• Epigastric fullness after meals
• Early satiety
• Nausea or occasional vomiting
• Bloating and belching
• Symptoms are often aggravated by meals, stress, or sedentary habits
• Absence of alarming features such as weight loss, hematemesis, or melena

Diagnosis and Differential Diagnosis

Diagnosis:

• Based on Rome IV criteria and exclusion of structural disease using imaging or endoscopy.

Differential Diagnosis:

• Peptic ulcer disease
• Gastroesophageal reflux disease (GERD)
• Gastric or pancreatic malignancy
• Gallbladder disease
• Food intolerance (e.g., lactose intolerance)

General Management:

• Lifestyle modifications: Avoid overeating, reduce fatty/spicy foods, limit caffeine/alcohol, stop smoking, and manage stress.
• Dietary changes: Small, frequent meals; avoid trigger foods.
• Psychological support: For stress, anxiety, or associated functional GI disorders.

Investigations:

• Blood tests: CBC (anemia), LFTs, RFTs, blood glucose.
• pylori testing: Urea breath test, stool antigen, or serology.
• Upper GI endoscopy: To rule out ulcers, gastritis, or malignancy (especially if >45 years or alarm signs).
• Imaging: Abdominal ultrasound to exclude gallbladder, liver, or pancreatic issues.

Prognosis:

• Generally favourable: Most patients have chronic but non-life-threatening symptoms.
• Symptom persistence: Many experience intermittent or recurrent dyspeptic symptoms over the years.
• Quality of life: Symptoms can affect daily activities and well-being, though serious complications are rare.
• Response to treatment: Prognosis improves with appropriate management (lifestyle, dietary changes, and tailored therapy, including homoeopathy if used).
• Red flags: Development of alarm features (weight loss, GI bleeding, anemia) may indicate a worse prognosis, but these are uncommon in classic Functional Dyspepsia.

CASE PRESENTATION

PRELIMINARY DATA:

Name: Mr CCL; Age: 15 years; Sex: Male; Religion: Christian; Education: 10^th std; Occupation: Student; Marital status: Single; Address: Shakti Nagar, Mangalore; Date of Case: 05/03/25.

CHIEF COMPLAINT:

The patient came with complaints of Nausea and occasional Burping for two years, which has increased since two weeks. The complaint is aggravated after eating and better by walking.

No.	LOCATION	SENSATION & PATHOLOGY	MODALITIES	CONCOMITANTS
1)	UPPER GIT For 2 years Increased since    2weeks Sudden onset and Gradual progression.   Rx >Homoeopathy Rx>Allopathy (Nexopro 14mg, Ganaton 50mg)	Nausea2+     Burping+ (Occ)	Ailments From: Chocolate2+ < After eating (esp. Rice)2+ >Walking2+	_________

HISTORY OF CHIEF COMPLAINT: Approximately two years ago, the patient had eaten 7-8 bars of Cadbury Dairy Milk Chocolate at once and had eventually developed the symptoms of nausea and had an episode of vomiting. Ever since he eats any food, especially Rice items, he would get nauseous and occasionally burp. The complaint gets worse after eating and better by walking. The complaint increased two weeks ago. The patient had taken Homoeopathic and Allopathic Medication (Nexopro 14mg, Ganaton 50mg) for the complaint earlier.

PAST HISTORY:

• PAST MEDICAL HISTORY: Hand, foot and Mouth Disease- 2 years ago.
• PAST SURGICAL HISTORY: Nothing significant
• TREATMENT HISTORY: Treatment for the presenting complaint.
• FAMILY HISTORY: Grandparents: HTN, Father: HTN.
• ALLERGIC HISTORY: Not Allergic to Dust, Diet or Drug.

 PERSONAL HISTORY:

• Diet: Mixed
• Appetite: Decreased due to complaint, but eats 3-4 meals/day
• Thirst: Drinks 1-2 lit/D; Large quantity of cold water.
• Craving: Sweet ²⁺, spicy⁺ & fast food (Pizza, Burgers and Pastas)
• Aversion: Nil
• Bladder habits: 4-5/D. No Difficulty
• Bowel habits: Regular once daily; Satisfactory
• Perspiration: Increased in the Axilla and Back
• Sleep:
• Dreams: Unremembered
• Addictions: N/S
• Thermal state: Likes monsoon/winter season, wants fan/AC in all seasons, cover in any season till neck, likes open air, bathing in warm water, prefers loose clothing- HOT Patient

LIFE SPACE INVESTIGATION:

Patient was born and brought up in Mangalore in a middle-class nuclear family of four, comprising his Father, who works in the Gulf, his Mother as a home-maker and a younger sister (currently studying in Pre-KG).

Childhood : His upbringing was simple and peaceful. He enjoyed his childhood and educational journey, and he nurtured strong and affectionate bonds with each of his family members.

Education :He is an academically oriented student, currently studying in 10^th STD he is very much interested in studies and finds joy in studying, which eventually led him to score good grades in exams. During exams, he feels stressed as he needs to cover the portions. He recently just appeared for his exams and is on holiday till June, so in the meantime, he is planning to join some short courses. The patient’s social circle in school is comparatively small; he prefers the company of the family over friends, and he keeps a good connection to a very few friends. He talks to everyone only if he knows them well enough, but he likes having friends around. His hobbies include playing Badminton.

As a Person
The patient gets angry easily and suppresses his anger generally in public with others, but at home, if he gets angry, he expresses his anger by mostly shouting and sometimes beating his younger sister, and he later feels remorse about his actions. He is a part of the NSS team in school, so he likes to lend a helping hand to those around him. He aspires to become a doctor in the future, and this has also made him create an interest in helping others. Before, the patient’s confidence was shaky, and he had a fear of presenting on stage as he feels very anxious while talking, but over time, he has improved his stage fears, but currently it is slightly present whenever he has to go up on stage. He is particular about how he presents himself to others in terms of his appearance, clothing and his hygiene, but he does not mind if things around him are not in order or clean. Currently, he feels scared to try new food as it might trigger his complaint, so he usually sticks to a bland diet on most days, and once or twice a week, he would have some flavourful and rich food items.

According to the Bystander (Mother), the patient gets angry easily and tends to take it out on his sister. He is good at his studies and obeys his parents, he likes to help others, and he does not sleep or eat at a proper time, especially during holidays. He also likes to stay in his room all day. “I’m just a bit worried about his condition, whether it will be resolved or not?”

On Observation
The patient was cooperative during case taking; he answered the questions diligently, using hand gestures to express himself, and responded concisely and precisely, sticking to what was asked. He does not take time to answer the questions; he would think and then give a timely response in a clear, un-rushed tone. His clothing preference was formal with a full-sleeve buttoned-up shirt (on every visit)

GENERAL PHYSICAL EXAMINATION:

Appearance: Moderately-built & poorly nourished, dark complexion. Lean individual. Wears specs.

No signs of Pallor, Cyanosis, Clubbing, Icterus, Oedema and Lymphadenopathy.

VITAL SIGNS:

Temperature- Afebrile at the time of examination; Pulse: 66 bpm, Weight: 49 kgs, Height: 167cm

LOCAL EXAMINATION

Gastrointestinal Tract

Oral Cavity: Maintained- good, Tongue: clean and moist, Teeth: intact, no dental caries.

Inspection:

Shape- scaphoid shaped, Flanks– free, Umbilicus- centrally placed, inverted with no discolouration, Skin- no hypo/hyper pigmented patches, All Quadrants: moves equally with respiration- no visible masses, no dilated veins, no scar marks, visible pulsation seen,

Palpation:

No local rise in temperature, no tenderness,               

Liver, Spleen, Kidney- palpable.

Percussion:

Liver dullness: Liver dullness heard at the 5^th intercostal space in the right MCL.

Splenic Dullness: splenic dullness heard at 9cm below the costal margin in left MCL

Auscultation:

Normal Peristaltic/ Bowel movements heard.

SYSTEMIC EXAMINATION:

RS: Normal Vesicular Breath Sounds heard, No Added Sounds.

CVS–S1 & S2 heard, No Murmurs.

DIAGNOSIS

Provisional Diagnosis

Functional Dyspepsia

• Nausea
• Worse after food.
• Easy satiety.

MANAGEMENT- GENERAL

Diet & Regimen	Ancillary Measure	Education & Orientation
•        To opt for lactose-free milk or yoghurt. •        Choose oatmeal, brown rice, and whole-grain bread. •        Limit Trigger Foods: Identify and reduce intake of foods that exacerbate symptoms.	•        Regular Meal Times: Maintain consistent eating schedules, avoiding long gaps between meals. •        Eat slowly, chew thoroughly, and avoid distractions during meals to aid digestion.	•        To educate the patient that symptoms are manageable. •        To set realistic expectations for symptom management- eating on time. •        To be regular for follow-up visits.

MANAGEMENT- SPECIFIC

Provisional Remedy

Differential Remedy

LYCOPODIUM ü  Lyco patient is thin, withered. ü  Gets angry easily ++ (expresses to sister- shouting & beating) ü  Company- desires++ (of a few known friends) ü  Intellectually keen++ (scores well in exams) ü  Want of self-confidence++ ü  Anxiety- stage fright, presentations++ ü  Fear of taking a new task++ (in the patient, he fears trying new food) ü  Keeps a good image of himself++ ü  Apprehensive++fear of breaking down under stress. (during exams) ü  Desires: sweets++, spicy+, Fast food+ ü  Thermal: HOT pt++ ü  Nausea- > After eating++

PHOSPHROUS ü  Tall, slender, narrow-chested person. ü  Company- Desires++ (of many people) ü  Empathetic Nature++- he likes to help others around him. ü  Great tendency to start++ (giving presentations). ü  Great susceptibility to external impressions: noise, thunderstorms++ ü  Thermal: CHILLY pt ü  Belching large quantities after eating. ü  Vomiting- water is thrown up as soon as it gets warm in the stomach. R/O The mental symptoms of the patient are more inclined with Lyco, be it: anger issues, a need for company, intellectual concerns, concern of self-image. Also desires sweets, thermally Hot patient and nausea after eating is favourable to Lyco. Hence, Phos is ruled out.

Investigations
No specific laboratory or imaging investigations were undertaken in this case. The diagnosis of functional dyspepsia was made clinically, based on the characteristic symptomatology and the absence of alarming features such as weight loss, hematemesis, or melena. The case was evaluated according to the Rome IV clinical criteria.

Case Analysis

Mental Generals	Physical Generals	Characteristic Particulars
– Gets angry easily++ – Anxiety- having stage fright while giving presentations++ – Likes company++ – Lack of self-confidence+	-Craving: Sweets++; Spicy+ -Perspiration: increased on the Axilla and Back++ -Thermally: Hot patient++	Nausea2+ Burping+ (Occ) A/F Chocolate2+ < After eating (esp. Rice)2+ >Walking2+

Repertorial Analysis                                                       

Repertory used: Synthesis Repertory

List of Rubrics:

• MIND- Anger- easily.
• MIND- Anticipatory- stage fright.
• MIND- Company- desires.
• MIND- Confidence- want of self.
• MIND- Emotions- suppressed.
• STOMACH- Nausea.
• STOMACH- Nausea- Chocolate after.
• NAUSEA- eating after- agg.
• NAUSEA- walking.
• GENERALS- Food & Drinks- Desire-sweets.
• GENERALS- Food & Drinks- Desire-spicy.

Remedy Selection:
Based on the totality of symptoms and individual characteristics, Lycopodium was selected as the similimum. The prescription was confirmed through repertorial analysis and verified with the Homoeopathic Materia Medica.

PRESCRIPTION

DATE: 05/03/2025

Rx

1. LYCO 200 1P (STAT)
2. NO 40 PILLS (4-4-4) x 2 weeks

• Dose: Single dose, followed by a Placebo
• Basis of selection: Totality and Constitutional Similarity.

FOLLOW-UPS

DATE: 19/03/2025

• C/O Nausea- Better (1 Episode in 1 week)

< Maida content food items + (had Samosa)

< Paneer +

• C/o Burping- Same
• Appetite- Increased towards evening
• No new complaint
• All other generals are good.

 DATE: 02/04/2025                                                         

• C/O Nausea- Better

< Maida content food items+ (too much)

• C/o Burping- better
• No new complaint
• All generals are good.

DATE: 16/04/25

• C/O Nausea- REDUCED
• C/o Burping- BETTER
• No new complaints
• All generals are good.

DISCUSSION
Functional Dyspepsia is a common gastrointestinal complaint often difficult to manage due to its multifactorial nature and lack of structural findings. In this case, individualised Homoeopathic treatment with a single dose of Lycopodium 200C was selected for symptoms such as epigastric fullness, flatulence, post-meal aggravation, craving for warm food, irritability, and anticipatory anxiety, which led to complete and lasting recovery. Placebos were given subsequently to support the remedy’s action. The outcome illustrates Homoeopathy’s ability to restore balance by addressing internal disharmony and reaffirms the effectiveness of Classical, constitutional prescribing in functional gastrointestinal disorders.

LIMITATIONS:

• Single case: Findings cannot be generalised to a larger population.
• No objective tests: Lack of diagnostic or follow-up investigations.
• No comparison: Absence of control or comparative treatment.
• Subjective assessment: Based mainly on the patient’s self-reported improvement.

RECOMMENDATIONS

• Further studies: Larger clinical trials and case series are needed to validate Lycopodium’s efficacy.
• Objective assessment: Future cases should include diagnostic tools for stronger clinical evidence.

CONCLUSION
This case demonstrates the effectiveness of Individualised Homoeopathic Management in treating Functional Dyspepsia. A single dose of Lycopodium 200C, selected based on the totality of symptoms, resulted in complete and sustained recovery without recurrence. The outcome highlights the importance of Constitutional Prescribing and supports the potential role of Homoeopathy as a safe and holistic approach in functional gastrointestinal disorders.

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 Dr Ezekiel. E. Warbah.
MD Part II
Department of Homoeopathic Materia Medica, Father Muller Homoeopathic Medical College and Hospital,
Deralakatte, Mangalore-575018
Email: ezekielew13@gmail.com
Guided by: Professor Dr Mini I.V.