A Case of Irritable Bowel Syndrome Treated by Arsenicum Album: A Case Report

Dr Kirti Patwariya

Abstract:-
Irritable bowel syndrome (IBS) is a group of symptoms that occur together, including repeated pain in abdomen and changes in bowel movements, which may be diarrhoea, constipation, or both. In IBS, these symptoms are present without any visible signs of damage or disease in digestive tract.

In functional disorders like IBS, Homoeopathy works remarkably well. IBS presents with both mental and physical symptoms, and Homoeopathy is based on principles that consider both the mind and body in treatment.

In this article, I discuss the efficacy of the homoeopathic remedy Arsenicum Album in managing IBS Type M through a case, and highlighting the effectiveness of Homoeopathy in treating IBS cases.

Introduction:-

IBS is a disorder of the intestines commonly marked by abdominal pain, bloating, and changes in a person’s bowel habits. This may include diarrhoea or constipation, or both, with one occurring after the other. Also called irritable bowel syndrome, irritable colon, mucus colitis, and spastic colon.

Irritable Bowel Syndrome (IBS) is classified as a functional gastrointestinal (GI) disorder, now referred to as a disorder of gut-brain interaction. These conditions arise due to dysregulation in the communication between the central nervous system and the enteric nervous system, leading to altered gut sensitivity and motility. Heightened visceral hypersensitivity may result in increased perception of abdominal pain and bloating, while dysregulated intestinal motility can manifest as diarrhoea, constipation, or a combination of both.

Keywords: –  Irritable bowel syndrome (IBS), Bowel movements, Homoeopathy, Stool, Similimum.

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.

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.

Types of IBS:-

There are four subcategories of IBS, each with equal prevalence:

• 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.

Case Summary:-

Mrs. A, a 35-year-old married woman, had long struggled with digestive troubles that seemed to control her life. Her symptoms were relentless, switching between constipation and diarrhoea, leaving her weak and exhausted. Emotionally, she felt trapped—desiring company yet growing restless and anxious when alone.

Mental Struggles-

She feared being alone and constantly sought reassurance, yet in company, she remained irritable and uneasy. Darkness intensified her anxiety, making nights a battle with restlessness and fear. Her perfectionist nature made her worry about her health, meals, and routines, yet no amount of control seemed to ease her suffering.

Physical Challenges-

Her digestion was unpredictable. Before passing stool, her abdomen would bloat painfully. After eating, a dull, aching pain would set in, sometimes increasing into severe cramping and gripping pain. She had an aversion to the smell of food, yet hunger made her restless. Eating often triggered diarrhoea, which left her weak and exhausted. At times, she experienced constipation, with stools alternating between lumpy and liquid.

On examination: –

• Blood pressure-120/70mmHg,
• Temperature- Afebrile 98.6-degree Fahrenheit,
• Respiratory rate- 18/min.,
• Pulse- 78/min
• Tongue- Slightly white coated
• Inspection: Mild Distended abdomen.
• Palpation: Soft
• Percussion: Tympanic sound.
• Auscultation: Bowel sound 9-10/min

Laboratory Investigations advised:-

• Abdominal USG reveal no abnormal findings.

Diagnosis :– Irritable bowel syndrome – mixed (IBS- M).

Prescribing Totality:-

• Desire for company, loneliness aggregate her symptoms.
• Aggravation in darkness.
• Anxiety about health.
• Aversion to smell of food.
• Abdominal distension before stool.
• Cramping, griping type of pain aggravated after eating.
• Alternating constipation with diarrhoea.
• Diarrhoea aggravate after eating.
• Stool lumpy and liquid type of.
• Generalised weakness after diarrhoea.
• Thirsty person.
• Thermal is chilly.

Repertorial Totality:- Repertorization through Kent’s repertory with the help of Sunerg software.

1. Mind, Company: Desire for: Alone, while agg :
2. Mind, Darkness agg ( see anger):
3. Stomach, Aversion: Food: Smell of:
4. Abdomen, Distension: Stool: Before:
5. Abdomen, Pain: Aching, dull pain (see boring, Gnawing etc): Eating: After:
6. Stomach, Pain: Cramping, griping, constricting:
7. Rectum, Constipation: alternating with diarrhoea:
8. Rectum, Diarrhoea: Eating: After:
9. Stool, Lumpy and liquid:
10. Generalities, Weakness, enervation: Diarrhoea, from:

Repertorial Result:-

• Arsenicum Album- 22/10
• Lycopodium- 17/7
• Phosphorus – 16/7
• Conium- 11/7
• Podophyllum- 15/6

Prescription:-

Rx-  Arsenicum album 200 /Single Dose (Empty stomach)

Sac lac /BD/7days

Repertorial Analysis:-

According to reportorial totality Arsenicum album cover maximum rubrics with maximum marks with characteristics symptoms of presenting case like fastidious, anxiety about health, constipation alternate with diarrhoea, abdominal distension, physical generals.

Follow ups:-

Follow up 1 – After a single dose of Arsenicum Album 200, the patient experienced slight relief in abdominal pain, though not as much as expected, while other symptoms remained unchanged.

Rx- Sac lac /BD/7days

Follow up 2 :- The patient has experienced relief from abdominal distension and significant improvement in abdominal pain, but the alternation between constipation and diarrhoea remains unchanged.

Rx- Sac lac /BD/7days

Follow up 3:- No further progress has been observed, no new complains have surfaced, and irregular bowel habits continue.

Rx- Arsenicum album 200 /Single dose (Empty stomach)

Sac lac /BD/7days

Follow up 4:- Abdominal pain has improved, and the alternation in bowel habits is no longer as before. There is improvement in post-meal diarrhea, but weakness after diarrhea persists.

Rx- Sac lac /BD/7days

Follow up 5:- The patient has shown mental improvement, experienced relief from generalized weakness, and is satisfied with the treatment.

Conclusion:-
Extensive research has been conducted on the management and treatment of IBS, as it has become increasingly common due to sedentary lifestyles and dietary habits. Homoeopathy provides highly effective treatment for IBS, as demonstrated by the preceding case. It yields the most satisfactory results through individualization, considering each patient’s unique signs and symptoms as a whole. The mentioned remedy has proven beneficial in treating IBS based on individualization and repertorial totality, ensuring the selection of the specific remedy for the specific case, administered in the proper dosage with appropriate repetition according to principles of organon of medicine.

References:-

1. Davidson’s Principles and Practice of Medicine 24th Edition.
2. National Institute of Diabetes and Digestive and Kidney Diseases. Irritable Bowel Syndrome (IBS) [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; [updated 2021 Dec; cited 2025 Mar 11]. Available from: https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/definition-facts
3. National Cancer Institute. Irritable bowel syndrome (IBS) [Internet]. Bethesda (MD): National Cancer Institute; [cited 2025 Mar 11]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/ibs
4. Rome Foundation. Rome IV criteria [Internet]. Available from: https://theromefoundation.org/rome-iv/rome-iv-criteria/
5. Hahnemann S., Organon of Medicine, 5^th & 6^th New Delhi: B. Jain publishers (P) Ltd.; 2016.
6. Kent JT. Repertory of the Homoeopathic Materia Medica. Originally published in parts (1897) and compiled (1899). Subsequent editions followed until the 7^th edition in 1961 (India) and Blended edition by P. Schmith
7. Kent JT. Lectures on Homoeopathic Materia Medica. New Delhi: B. Jain Publishers; 1990
8. Johns Hopkins Medicine. Irritable Bowel Syndrome (IBS) [Internet]. Baltimore (MD): Johns Hopkins Medicine; [cited 2025 Mar 11]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/irritable-bowel-syndrome-ibs

Dr. Kirti Patwariya                                                                                                                                                                                                                 MD Scholar, Department of Homoeopathic Repertory & Case Taking.    
UGO of Dr. Gyanesh Shakya
Govt. Homoeopathic Medical College & Hospital, Bhopal (M.P.).