Management of Haemorrhoids with Homoeopathy – A case report

Dr Meenal P. Berad (Bari)

Abstract
A female patient presented with the complaints of bright red bleeding from rectum, lump in anus, constipation since childhood, she had not taken any treatment before. Considering the totality of symptoms, Aesculus Hippocastanum 30CH was prescribed which proved effective and resulted general improvement and relief was observed from first follow up.

Keywords : Homoeopathy, Hemorrhoids, Constipation, Aesculus Hippocastanum

Case Report
A 35-year-old married woman, housewife,presented with bleeding per rectum, Stitching type of pain⁺⁺ in the anal region

• Intolerable pain
• No discharge or bleeding
• Sensation as if the mass is protruding and blocking the anal canal
• Aggravated while walking⁺ and sitting
• Amelioration–none

Local examination
On inspection, there was a protrusion of a mass, possibly two with swelling around the anal orifice and blue in colour. No discharge/bleeding from the affected site [Figure 1]. she reported intense pain and tenderness

Diagnostic assessment
Complaints of the patient and local rectal examination suggested a diagnosis of external haemorrhoids. The BPRST classification was used to evaluate and grade the most frequent complaints.

Totality of symptoms

• Mass protruding from the anal canal without bleeding or discharge
• Mass protruding from the anal canal is bluish in colour
• Sensation as if a mass is protruding and blocking the anal canal
• Stitching type of pain in the anal region
• Aggravation from walking and sitting

Constipated stools were difficult to evacuate

Repertorial totality

• Rectum – Haemorrhoids – External
• Rectum – Haemorrhoids – Protruding – Prolapsed
• Rectum – Haemorrhoids – Bluish
• Rectum – Haemorrhoids – blind
• Rectum – Pain – stitching, sharp
• Rectum – Haemorrhoids – Walking – Aggravation
• Rectum – Haemorrhoids – Sitting – Aggravation
• Rectum – Constipation – Difficult stool.

Repertorial analysis was done with complete repertory using Hompath classic version 8.0

Figure 2:Repertorial sheet using hompath classic software,

Therapeutic intervention
After acute case taking and repertorial analysis, A. hippocastanum, Sulphur and Muriaticum acidum were found to cover the symptoms of the patient. The patient did not complain about itching and burning, therefore, Sulphur was ruled out. Muriaticum acidum is mostly indicated in involuntary evacuation of faeces while urinating along with itching and bleeding haemorrhoids, which were not seen in the patient. Finally, after thorough Materia Medica differentiation A. hippocastanum was prescribed as a pathological prescription considering its action on the rectal veins; the haemorrhoidal vessels become intensely congested. This leads to violent inflammation of the anus and rectum, producing haemorrhoids in their most aggravated form. Aesculus also covers most of the symptoms like large blue-coloured haemorrhoids which block up the rectum, with sharp stitching pain in the anus, and no tendency to bleed, all of which were seen in our patient.

Accordingly, in this case, 30C potency was prescribed for a day with three doses

Follow-ups and outcomes

Changeability in symptoms, BPRST classification and staging were done at every follow-up. Details are shown in [Table 3].

Table 3: Follow-ups and outcomes

S. No.	Date of visit	Symptoms	Prescription
1	First visit 29 November 2023	Intolerable stitching type of pain and tenderness in the anal region with feeling as if some mass is protruding and blocking the anal canal, aggravated by walking and sitting with constipation for a long time	Aesculus hippocastanum 30C Thrice a day
2	30 November 2023 2nd day	After two doses of medicine, pain had reduced to 50%, Bowels were satisfactory. No any new complaints were noted	Placebo 30/2 days/Thrice a day. The patient was asked to report after 2 days
3	1 December 2023 4th day	Pain in anal region still persists. No new complaints were noted	Aesculus hippocastanum 30C/3 doses/thrice a day./7d
4	10 December 2023	After taking one dose of medicine, Pain and tenderness in rectum is reduced. Feeling of protrusion of mass from anal canal only during passing stools and spontaneously reduced after passing stools. Bowels: clear	Placebo/thrice a day/1 month
5.	18 January 2024	All complaints recovered. No new complaints were noted	Placebo/1 week/Thrice a day

Discussion
External haemorrhoids are always considered to be effectively managed with surgery. However, in this case, the patient opted for homoeopathic treatment. Consideration of the patient’s most peculiar presenting symptoms and pathological changes indicated A. hippocastanum.In this case, after the third visit, the complaints had not improved further; hence, we repeated the same medicine and potency with the instructions to stop the medicine once the pain reduces. Later, a single dose of medicine helped to improve the patient’s complaints subjectively; objectively, changes were observed as well.

CONCLUSION
This case experience emphasises the role of homoeopathy in cases of haemorrhoids, preventing surgery. Consideration of pathological phenomena in the evolution of disease helped

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