Dr. Chirag Mishra 1, Dr.Seema Meena1, Dr. Shipra Singh 1
1 PG Scholar Department of Repertory, Dr. MPK Homoeopathic Medical College Hospital & Research Centre (Under Homoeopathy University), Saipura, Sanganer , Jaipur. (Raj.)
ABSTRACT : crohn’s disease is inflammation of digestive system. Patients ma be may present with pain abdomen, diaarhoea, loss of weight and malnutrition along with constitutional symptoms like restless, irritable, hasty. It is a lifestyle disorder. Management of the cases can be done using homoeopathic medicine with diet modification, lifestyle changes.
KEYWORD: IBD, Crohn’s disease, incidence, prevalence, homoeopathy,
Crohn’s disease is an inflammatory bowel disease (IBD) which causes inflammation of digestive system, and can leads to abdominal pain, severe diarrhoea, fatigue, loss of weight and malnutrition. Crohn’s disease can be both painful and debilitating, and can involve the different area of digestive tract but the most common areas affected by Crohn’s disease are the last part of the small intestine and the colon.(1)
According to previous epidemiological investigations, the incidence and prevalence of CD in industrialized country is higher as compare to the developing countries. However, from some last few years incidence of CD in developing countries is increasing and the rate of incidence in developed countries has been stabilized. The progression of CD depends upon the lifestyle of the people in countries.(2). According to study done in December 2017 The highest rate of prevalence values were reported in Europe (Crohn’s disease 322 per 100 000 in Germany) and North America (Crohn’s disease 319 per 100 000 in Canada). The rate of prevalence of inflammatory bowel disease is also increases by 0·3% in North America, Oceania, and other developing countries(3). The incidence and prevalence of inflammatory bowel disease (IBD) are lower in Asia than in the West. However, the studies from Asia (Japan, Korea, and Hong Kong) have shown that the incidence of IBD has increased over the past 2 decades.(4) Crohn’s disease occurance in India and other asian countries is increasing with high speed as it is approaching the lower limit of America and North America. The prevalence of CD in India is higher in north India as compare to the south india.(5)
Clinical features of Crohn’s disease can range from mild to severe. Symptoms develop gradually, but sometimes may appear suddenly, without any warning. The major symptoms are abdominal pain, diarrhoea and weight loss. Other signs and symptoms may include: Fever, fatigue, cramps in abdomen, bloody stool, mouth sores, reduced appetite and loss of weight. In later stages of CD may include inflammation of skin, eyes, liver, bile ducts etc. (1)
The exact cause of Crohn’s disease is unknown. Previously, it was suspected that CD is caused due to the diet disturbance and stress but from the recent studies it is cleared that diet and stress may aggravate but not the causative factor for CD. The factors which are responsible for CD is heredity and a malfunctioning of immune system, lifestyle, smoking. The Crohn’s & Colitis Foundation of America (CCFA) estimates that 1.6 million people in the United States have IBD. FACTORS
- Ethnicity– Crohn’s disease is present in all populations. Caucasians and Ashkenazi Jews have a higher risk.
- Age– Crohn’s disease can happen at any age, but in most cases, it starts at the age of 13 to 30 years.
- Family history- People with family history are at much higher risk for developing CD.
- Geographical region – People who live in urban areas and industrialized countries have a higher risk of getting Crohn’s disease.This can be partially explained by lifestyle choices and diet.
- Gender- Crohn’s disease is more common among women.
- Other factors- Diet, oral contraceptives, perinatal and childhood infections, or atypical mycobacterial infections.(6)
Pressive type of pain in abdomen with swelling of lower abdomen below the navel and hypogastrium; abdominal pain extending from abdomen to chest and shoulder, with painful respiration and great thirst, restlessness, violent headache with blurred vision.
Pain in abdomen shooting in nature which radiates from abdomen to chest during respiration during change of weather, in summer, after anger, eating fruits. Diarrhea with fever from cold exposure, every least exertion aggravates the complaint.
Pain abdomen with debility and accumulation of flatus under the ribs especially after eating eggs, abdomen feel hotter in comparision to the whole body temperaturewith marked sensitivity from least toch to the abdomen. Constipation with involuntary stool and offensive flatus.
Pain in abdomen with tenderness in epigastric region and hypochondriac region, pain aggravates while lying on right side, while sensation as if something is moving inside the abdomen as the loose stool, which is hard to evacuate bloody and slimy stool followed by faintness and trembling.
Pain in abdomen with great sensitivity even cannot bear the slight touch and pressure, with fullness sensation in abdomen with nausea and vomiting and bitter taste in mouth. short and difficult breathing followed by congestive type of headache.
Pain abdomen with accumulation of flatus and soreness in right hypochondriac region, sensation of heat in the abdomen with alternating constipation and diarrhea.
Pain and burning in abdomen as if hot coal is present inside abdomen, with violent thirst and cold perspiration on extremities, nausea with vertigo. Profuse watery greenish stool with flakes and intestinal catarrh especially in summer, suddenly at night.
Incidence and prevalence of CD increasing day by day more in developing countries and is becoming one of the commonly encountered problems in the soceity as compare to the industrialized countries. The modern lifestyle is the most common reason behind it, which includes dietary factors, lack of sleep, stress, etc. In homoeopathy medicine is prescribed on the basis of totality of symptoms which plays an vital role in CD. Although, medicine is prescribed on the basis of symptoms similarity but few medinine like Belladonna, Bryonia Alba, Colchicum Autumnale , Mercurius Corrosivus , Nux Vomica, Podophyllum ,Veratrum Album are given to be more frequently indicated for CD in homoeopathy literature. So, a large number of medicines are available in homoeopathy for treatment of CD. And being a lifestyle disease, diet management along should be advised to the patient when prescribing homoeopathic medicine.
1. Crohn’s disease – Symptoms and causes [Internet]. Mayo Clinic. 2019 [cited 8 February 2019]. Available from: https://www.mayoclinic.org/diseases-conditions/crohns-disease/symptoms-causes/syc-20353304
2. Behzadi P, Behzadi E, Ranjbar R. The Incidence and Prevalence of Crohn’s Disease in Global Scale. SOJ immunol [Internet]. 2015 [cited 7 February 2019];3(2):1-6. Available from: https://symbiosisonlinepublishing.com/immunology/immunology25.pdf
3. Ng S, Shi H, Hamidi N, Underwood F, Tang W, Benchimol E et al. The Worldwide Incidence and Prevalence of Inflammatory Bowel Disease in the 21 st Century: A Systematic Review of Population-Based Studies. Gastroenterology. 2017;152(5):S970-S971.
4. Ng S. Inflammatory Bowel Disease in Asia [Internet]. PubMed Central (PMC). 2019 [cited 8 February 2019]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3975975/
5. Ray G. Inflammatory bowel disease in India – Past, present and future. World Journal of Gastroenterology. 2016;22(36):8123.
6. Natalie A. Molodecky, Gilaad G. Kaplan Gastroenterol Hepatol (N Y) 2010 May; 6(5): 339–346.
7. Lilienthal S. Homoeopathic therapeutics. delhi: B. Jain publisher; 2003.