A case of IBS managed with Homoeopathy

April 15, 2026 admin Case Presentations 0

Dr Nischitha S

 Abstract: Irritable bowel syndrome(IBS) is the most common functional gastrointestinal disorder, manifesting as abdominal pain/discomfort and altered bowel function1. IBS affects 9%-23% of the population across the world (World Gastroenterology Organization, 2009)2. .

Keywords: Irritable bowel syndrome (IBS), Homoeopathy, Individualised treatment, Holistic, gastroenterology.

Classically, IBS presents with abdominal pain or discomfort that is relieved by defecation or is associated at its onset with a change in stool frequency (either an increase or decrease) or a change in the appearance of the stool (to either loose or hard). The absence of red flag (alarm) symptoms such as gastrointestinal bleeding, weight loss, fever, anaemia or an abdominal mass support such a symptom complex as IBS rather than as structural disease3.

Clinical presentation:

  • Abdominal pain, cramping, or bloating associated with defecation.
  • Alterations in stool form or consistency.
  • Changes in bowel movement frequency.
  • Additional commonly associated symptoms include a sensation of incomplete evacuation, excessive gas, and the presence of mucus in the stool.

Causes of IBS:

  • Intestinal muscle contractions: Stronger or prolonged contractions lead to gas, bloating, and diarrhoea, while weak contractions cause slow digestion and constipation.
  • Nervous system dysfunction: Miscommunication between the brain and gut leads to heightened sensitivity, pain, and altered bowel movements.
  • Infections: IBS may develop after gastroenteritis or due to bacterial overgrowth.
  • Early-life stress: Childhood stress increases IBS susceptibility.
  • Gut microbiome changes: Altered gut bacteria, fungi, and viruses may contribute to IBS.

Triggers of IBS:

  • Food: Certain foods (e.g., wheat, dairy, citrus, beans, cabbage, carbonated drinks) can worsen symptoms.
  • Stress: Increases symptom frequency and severity but does not directly cause IBS.

Types of IBS:

  • Mostly diarrhoea and abdominal discomfort (IBS-D).
  • Mostly constipation and abdominal discomfort (IBS-C).
  • Alternating loose stools and constipation with abdominal discomfort (IBS-mixed).
  • Undefined subtype (IBS-U) — symptoms vary.

Diagnostic criteria:

The Rome IV criteria are used to diagnose Irritable Bowel Syndrome (IBS).

Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteria:

  • Related to defecation
  • Associated with a change in frequency of stool.
  • Associated with a change in form (appearance) of stool.

Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.

CASE SUMMARY:

Preliminary data:

  • Name: Mrs Patient
  • Age: 52 years
  • Sex: female
  • Education: 10th standard
  • Occupation: Homemaker

Chief complaint:

Patient came with the complaint of ineffectual urging for stool, Pain in abdomen and itching per rectum, since 10 years.

Details of Chief Complaint:

  • Onset: slow
  • Progress: gradual
  • Type of stool: soft stool, straining+++
  • Odour: Sour
  • Frequency: 3 times per day

Modalities: <after eating, sour food, meat

Itching <after stool

Pain in abdomen <before stool

Associated symptoms: Weakness+, bitter taste in mouth+, flatulence+++

Past history:

Patient had a history of uterine fibroid and underwent surgical treatment 4 years ago.

No history of diabetes mellites, hypertension, TB, and any other major illnesses.

Family History:

All family members are apparently healthy.

Personal history:

  • Diet: mixed
  • Appetite: Adequate
  • Thirst: 2-3L per day
  • Bowels: 3 times/day, ineffectual
  • Micturition: 5-6 times/day, 1/night
  • Desire: meat
  • Aversion: Nothing specific
  • Sleep: Refreshing
  • Dreams: Nothing Specific
  • Perspiration: Profuse
  • Thermals: Chilly

Mental generals:

  1. Hypochondriacal anxiety about health.
  2. Weeping, amelioration by consolation.

Vitals:

  • BP-130/88mmhg
  • Temp- 97.90F
  • Pulse- 62bpm
  • RR-14cpm

On GI Examination:

  • Inspection-boat shaped abdomen, Umbilicus centrally placed.
  • Palpation- No organomegaly or tenderness.
  • Percussion-tympanic note heard
  • Auscultation- Normal bowel sound heard, no added sound

Lab Investigation:

Abdominal USG advised – No abnormal findings found

Diagnosis:  Irritable bowel syndrome – Constipation (IBS-C)

Analysis of symptoms:

Common symptoms Uncommon symptoms
  • Constipation for soft stool, requires straining.
  • Ineffectual urging for stool.
  • Pain in abdomen <before stool.
  • Itching per rectum<after stool.
  • <after eating,
  • Flatulence.
  • Weakness.

 
  • Hypochondriacal anxiety about health.
  • Envy.
  • Cupidity.
  • Weeping, amelioration by consolation.
  • Desire for meat.
  • Profuse perspiration.
  • Chilly patient
  • Stool odour – sour.
  • <sour food, meat.
  • Bitter taste in mouth.

Totality of symptoms:

  • Hypochondriacal anxiety about health.
  • Weeping, amelioration by consolation.
  • Desire for meat.
  • Profuse perspiration.
  • Chilly patient.
  • Constipation for soft stool, requires straining.
  • Stool odour – sour.
  • Ineffectual urging for stool.
  • Pain in abdomen <before stool.
  • Itching per rectum<after stool.
  • <after eating, sour food, meat.
  • Bitter taste in mouth.

Repertorial totality:

Repertorisation done using Synthesis 2.0 [Synthesis Repertory Version 2009, Edited by Dr Frederik Schroyens]

PDF – Chilly Patient

  1. Mind – Anxiety – Hypochondriacal
  2. Mind – Envy
  3. Mind – Greedy, Cupidity
  4. Mind – Weeping – Consolation – agg
  5. Generals – Food and Drinks – Meat – Desire
  6. Perspiration – Profuse
  7. Rectum – Constipation – Difficult Stool – Soft stool
  8. Rectum – Constipation – ineffectual urging and straining
  9. Rectum – Constipation – Flatulence with
  10. Rectum – Itching – Stool – after
  11. Stool – Odour – Sour
  12. Abdomen – Pain – Stool – Before
  13. Generals – Food and Drinks – Meat – agg
  14. Generals – Food and Drinks – Sour food, acids – agg
  15. Mouth – taste – Bitter

Repertorial result:

  1. Sepia – 26/13
  2. Sulphur – 24/13
  3. Natrum Muriaticum – 23/12
  4. Calcarea Carbonica – 21/12
  5. Lycopodium – 19/12

Prescription:

  1. Sepia 200 – 1Dose [EMES]
  2. Sac Lac – (4-0-4) – 1Week

Follow up: Done every 7th day

Follow up 1

  1. Flatulence present+++.
  2. Pain in abdomen present+++.
  3. Itching per rectum present+++.
  4. Ineffectual urging present+++.
  5. Straining for soft stool present+++, Bowels 3 times/day.
  6. Weakness present+++.
  7. Bitter taste in the mouth improved++.

Rx –

  1. Sepia 0 – 1Dose [EMES]
  2. Sac Lac – (4-0-4) – 1Week

Follow up 2

  1. Flatulence present+++.
  2. Pain in abdomen present+++.
  3. Itching per rectum present+++.
  4. Ineffectual urging present+++.
  5. Straining for soft stool present+++, bowels 3 times/day.
  6. Weakness present+++.
  7. Bitter taste in the mouth improved++.

Rx –

  1. Sepia 200 – 1Dose [EMES]
  2. Sac Lac – (4-0-4) – 1Week

Follow up 3

  1. Flatulence absent.
  2. Pain in abdomen reduced++.
  3. Itching per rectum reduced++.
  4. Ineffectual urging present+++.
  5. Straining for soft stool reduced++, bowels twice a day.
  6. Weakness present+++.
  7. Bitter taste in the mouth absent.

Rx –

  1. Sepia 1M – 1Dose [EMES]
  2. Sac Lac – (4-0-4) – 1Week

Follow up 4

  1. Pain in abdomen reduced+.
  2. Itching per rectum still persists++.
  3. Ineffectual urging reduced++.
  4. Straining for soft stool reduced++, bowels twice a day.
  5. Weakness reduced++.

Rx –

  1. Sepia 0 – 1Dose [EMES]
  2. Sac Lac – (4-0-4) – 1Week

Follow up 5

  1. Pain in abdomen absent.
  2. Itching per rectum still persists++.
  3. Ineffectual urging reduced; stool satisfactory.
  4. Straining for soft stool reduced+, bowels twice a day.
  5. Weakness persists++.

Rx –

  1. Sepia 1M – 1Dose [EMES]
  2. Sac Lac – (4-0-4) – 1Week

Follow up 6

  1. Pain in abdomen absent.
  2. Itching per rectum reduced+, present occasionally.
  3. Ineffectual urging for the stool reduced; stool satisfactory.
  4. Straining for soft stool reduced+, bowels once a day, twice a day occasionally.
  5. Weakness improved+.

Conclusion:
IBS is increasingly common due to sedentary lifestyle and dietary habits. IBS not only affect physical gut health but also the quality of life of an individual

Homoeopathy a Holistic system medicine, which operates based on the core principle “THEORY OF INDIVIDUALISATION AND CHRONIC DISEASES” is found to be efficient in the management of chronic illness not only by reducing the symptoms but also in improvising the quality of life of an individual. The above-mentioned remedy Sepia Officinalis is found to be beneficial in not only treating IBS but also in improvising the overall health of an individual, when administered in the proper dosage with appropriate repetition according to principles of organon of medicine.

References:

  1. Sayuk, G. S., & Gyawali, C. P. (2015). Irritable bowel syndrome: modern concepts and management options. The American Journal of Medicine, 128(8), 817–827. https://doi.org/10.1016/j.amjmed.2015.01.036
  2. Me, A. (2025, April 30). A case of irritable bowel syndrome treated by Arsenicum Album: A case report. Homeopathy Resource by Homeobook.com; Homeobook. https://www.homeobook.com/a-case-of-irritable-bowel-syndrome-treated-by-arsenicum-album/
  3. Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol. 2014 Jun 14;20(22):6759-73. doi: 10.3748/wjg.v20.i22.6759. PMID: 24944467; PMCID: PMC4051916.
  4. Rome IV criteria. (2025, May 29). The Rome Foundation. https://share.google/YMn0BelNr2sUZqumT
  5. Hahnemann S., Organon of Medicine, 5th & 6th New Delhi: B. Jain publishers (P) Ltd.; 2016.

Dr Nischitha S
Intern, BHMS
Alva’s Homoeopathic Medical College, Moodbidri
Email : Nischithasiddalingaiah409@gmail.com

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