Dr Nitesh Jangid
Abstract: Acid peptic disorder includes gastric ulcers, duodenal ulcers, dyspepsia, gastritis and gastro esophageal reflux disease. It is due to imbalance between acid secretion and gastric mucosal defenses. It is manifested by pain, abdominal discomfort, nausea, vomiting, heart burn and regurgitation. A combination of homoeopathic medicines and life style changes may bring relief in Acid peptic disorder.
Keywords: Gastric and duodenal ulcer, Dyspepsia, Gastritis, Gastro esophageal reflux disease, Homoeopathic medicines.
Introduction: Acid peptic diseases result from distinctive but overlapping pathogenic mechanisms which involve diminished mucosal defense due to acid effects. Glands in the stomach produces acid and an enzyme called as pepsin that helps the body to digest food in the process of digestion.1 Normally, the stomach and the duodenum also produce mucus that protects the inner lining of the wall of these organs from the effect of acid secreted during the process. But sometimes excessive gastric acid secretion occurs and so, due to repeated attack of this acid, there is decreased mucosal defense activity of the wall lining of these organs, due to which various symptoms of Acid Peptic Disorder develops.4
Acid peptic disorder includes:-
- Dyspepsia: Dyspepsia describe an inability to digest food. It include epigastric pain, heartburn, distension, nausea or an acid feeling occur after eating and drinking. It is caused by Helicobacter pylori, psychological, neurological and gut peptide factors which are implicated in the genesis.2 There are no diagnostic signs, apart perhaps from inappropriate tenderness on abdominal palpation. Patients often appear anxious.3
- Gastritis: Inflammation of gastric mucosa is called gastritis. The two types of gastritis are known i. e. acute and chronic. Aetiological factors may include Helicobacter pylori, excessive consumption of alcohol, NSAIDs, constant physical and emotional stress, spicy food, smoking and decreased mucin content in gastric juice or decreased protective activity
in stomach and duodenum.4
- Gastro esophageal reflux diseases: Several mechanisms operate into esophagus to prevent the reflux of gastric contents. When these mechanisms fails to prevent, gastric content reflux into the lower esophagus.3 The reduced lower esophageal sphincter (LES) tone is an important cause of reflux. This is called as gastro-esophageal reflux disease (GERD).5
- Abnormalities of the lower esophageal sphincter.
- Hiatus hernia
- Delayed esophageal clearance
- Gastric contents
- Dietary and environmental factors3
- Heartburn and regurgitation, provoked by bending, straining or lying down.
- ‘Water brash’, which is salivation due to reflex salivary gland stimulation as acid enters the gullet.
- Patients are woken at night by choking as refluxed fluid irritates the larynx.
- Odynophagia or dysphagia.
- Chest pain.3
- Peptic Ulcers: Peptic ulcer refers to an ulcer in the lower esophagus, stomach or duodenum, in the jejunum after surgical anastomosis to stomach, and in the ileum adjacent to a Meckel’s diverticulum. It’s incidence is 10% of all adult males. There are following two types:3
Acute peptic ulcer: Acute peptic ulcers present with gastrointestinal bleeding. Sometimes it may occurs following stress than they termed as ‘stress ulcer’. The main aetiological factor is sepsis. It may be seen after cerebral trauma or neurological operations.6
Chronic peptic ulcer: Gastric ulcer and Duodenal ulcer are the two types of chronic peptic ulcer. Gastric ulcer occurs at the age more than 40 years. It is equal in both sexes while duodenal ulcer occur between 20-50 years of age and more common in females.3
|Causal factors||Gastric ulcer||Duodenal ulcer|
|Helicobector pylori||Important||Very important|
|NSAIDs and aspirin||Important||Important|
|Acids||Normal or low acid output||High or normal acid output|
|Stress||Evidence of head injuries and burns only|
- Epigastric pain with localised at the site of one finger. It is burning in character.
- Pain occurs in episodes, lasting 1-3 weeks every time, 3-4 times a year. Hunger pain occur on empty stomach.
- Pain increased at night around 3 A.M. and relieved by food, milk or antacids.
- Waterbrash, heart burn, loss of appetite and vomiting .
- Anorexia, nausea and dyspepsia.3
Lesser Known Homoeopathic Medicines for APD
- Euphorbium officinalis: Ulcers in stomach, burn like coal fire. Great hunger. Sialorrhea.8 Waterbrash. Thirst for cold drinks.9
- Gratiola officinalis: Dyspepsia with distention of abdomen. Cramps and colic after supper and during night with swelling of abdomen.9
- Nyctanthes arbor tristis: Burning in stomach with nausea and vomiting8 better by cold application. Thirst, Better vomiting.9
- Ornithogalum umbellatum: Ulceration of pylorus and caecum with distention of abdomen. Belching, offensive flatus, agonizing pain must loosen clothes. Gastric and duodenal ulcers.8 Painful sinking across epigastrium.9
- Ptelea: Chronic gastritis.8 Weight and fullness of abdomen. Gripping in epigastric region. Eructation, nausea and vomiting. Constant sensation of corrosion, heat and burning in stomach.9
- Salicylic acid: Dyspepsia with putrid eructations, excessive accumulation of flatus. Acidity of stomach, nausea gagging and waterbrash.8
- Uranium nitricum: Pyloric and gastric ulcer.8 Boring pain in pyloric region. Gastric and duodenal ulcers. Burning pain. Abdomen bloated.9
- Valeriana officinalis: Heartburn with gulping of rancid fluid. Hunger and nausea. Eructations foul. Abdomen bloated.9
- Accepted Diet: Milk, low-fat cheese, yogurt, fermented milk, Walnuts, Vegetable oils, olive oil, Apple, papaya, melon, banana, Leafy dark green vegetables, carrot, beet, green bean, spinach, kale, radish, zucchini, leek Bean soup, lentils, chickpeas, soybean, Lean meat (beef, pork, chicken, fish) and natural juices.
- Restricted Diet: Small volume but frequent meals, alcohol, fatty food, caffeine, mint, orange juice.
- Minimum use of NSAIDs drugs.
- Avoid weight lifting, stooping and bending at waist.
- Avoid smoking.
- Hot or cold compress to the epigastrium.3
- Mejia A, Kraft W. Acid peptic diseases: pharmacological approach to treatment. Expert Review of Clinical Pharmacology. 2009;2(3):295-314.
- Swash M. Hutchison’s clinical methods. Edinburgh: W.B. Saunders; 2002.
- Aggarwal P, Mathew K. MEDICINE. 3rd ed. [S.l.]: ELSEVIER INDIA; 2010.
- Sembulingum K, Sembulingam P. Essentials of medical physiology.6th ed. Jaypee Brothers Medical Publishers (P) Ltd.: 2012.
- Kasper D, Braunwald E. Harrison’s Principles of internal medicine. 16th ed. New York: McGraw- Hill Medical Publishing Division; 2005.
- D as S. A Concise Textbook of Surgery. 5th ed. Calcutta, India: Dr. S. Das; 2008.
- Khanna M. Self Assessment & Review Medicine. 10th ed. New Delhi, India Jaypee The Healtth Science Publisher; 2017
- Bishambar Das R. Select your remedy. 16th ed. New Delhi, India.: Bishambar Free Homoeo Dispensary; 1994.
- Boericke D. Pocket manual of homoeopathic materia medica. New Delhi: B. Jain publisher (P) Ltd; 2008.