Gastro-oesophageal reflux disease (GERD) is a common, global disorder with retrosternal burning as a predominant symptom. GERD is a condition, which develops when the reflux of stomach contents causes troublesome symptoms and or complication. GERD has an impact on the daily lives of affected individuals, interfering with physical activity, disturbing sleep, impairing social functioning, mental well-being, and reducing productivity at work and reducing the quality of life. Homoeopathy has great scope in GERD and the Homeopathic medicine ROBINIA helps in improving the quality of life.
Keywords: Gastro oesophageal disease, Improving quality of life of GERD, Homoeopathic medicine-Robinia pseudacacia.
Gastro oesophageal reflux disease (GERD) is defined as “a chronic disorder related to the retrograde flow of gastro-duodenal contents into the oesophagus and adjacent organs, producing a group of symptoms, with or without tissue damage”. It is characterized by regurgitation of gastric contents into the esophagus .
In recent study report it has shown that its prevalence in India is between 8-20% which is comparable to that in the West. About 16.2-18% peoples were affected in India according to questionnaire-based cross-sectional multi centre studies by Sharma et al. and Kumar et al2. GERD affects both sexes, all age groups and all races.
- Older age,
- Family history,
- Socioeconomic status,
- Increased body mass index,
- Alcohol use,
- Hiatus hernia
This physiological reflux occurs as heart burn especially after a meal and remains asymptomatic and neutralized by rapid clearance from distal oesophagus. Oesophageal peristalsis is an essential phenomenon for the anti-reflux mechanism of GERD. Patients with GERD had abnormal peristalsis (40%50%), had frequent and prolonged transient lower oesophageal sphincter relaxation (40%). 50% of patients with erosive esophagitis are associated with GERD. Hiatal hernia is considered as an independent factor for GERD as it disrupts natural anti-reflux mechanisms and also decreases transdiaphragmatic pressure. The pathophysiology of GERD seems to be multifactorial.
Typical and classical symptoms of GERD are heartburn and regurgitation7,8. The diagnosis of GERD can be made when presented with both the symptoms7. Atypical symptoms include dysphagia, Globus sensation, non-cardiac chest pain, dyspepsia or abdominal pain. Extra oesophageal symptoms include hoarseness, laryngitis, pharyngitis, chronic sinusitis, dental erosion and chronic cough
- Oesophageal erosions and ulcerations
- Stricture formation
- Barrett‟s oesophagus, and
- adenocarcinoma of the oesophagus.
Life style modification and avoidance of exacerbating factors can be helpful in the treatment of GERD for individual patients.
- Avoid caffeine, nicotine, alcohol, chocolate, mints, carbonated beverages, high-fat foods, tomato or citrus based products.
- Abstain from eating within two hours of bed time.
iii. Sleep in left lateral decubitus position.
- Elevated head of bed by 6 inches.
- If obese, weight loss should be done.
HOMOEOPATHY AND GERD:
Homoeopathy has great scope in treatment of GERD than any other system of medicine, because it is the only system of treatment that considers the symptom as a whole and remove the disease as a whole. Homoeopathy can also be beneficial for those who cannot show much improvement in GERD after lifestyle modification
Robinia was named by Linnaeus after Jean Robin, herbalist to Henry IV of France. The true acacia is the Egyptian tree, Acacia Arabica. Robinia is prepared from the bark of „Locust Tress‟ that grows plentifully in the united states. It is otherwise known as North American Locust, common or false acacia. Its family belongs to Leguminosae. Medicine is prepared from fresh root of bark, fresh bark of young twigs and the beans. It was first proved in a fragmentary way by Dr Burt in 1864. Robinia is one of the best remedy for GERD. It is having a sphere of action on gastrointestinal system and symptoms similar to GERD.
ACCORDING TO ALEXANDER L.BLACKWOOD:
- This remedy is indicated in hyperchlorhydria when there is an excessive acidity of the stomach with constant eructation and vomiting of a sour fluid that sets the teeth upon edges.
- There is a pain and distress in the gastric region which is worsen while the stomach is empty, but is relieved by taking food.
- Accompanying these gastric symptoms the patient is low spirited and irritable, and there is a dull headache which is made worse from motion
ACCORDING TO C.M BOGER:
- Robinia is indicated in gastric complaints of acridity; sour taste; sour stomach; acid belching; acid dyspepsia. Water brash.
- It is also indicated in burning in stomach and between scapulae. Squeezing in stomach. Sick headache.
- Complaints are worse on eating, night, fats.
ACCORDING TO N.M.CHOUDHURI:
- Robinia is frequently a remedy for one of the most fashionable complaints of the present time that is dyspepsia, especially when acidity is the characteristic features.
- Acidity with sourness.
- Everything smells sour, sweat, stool.
- Dyspepsia; flatulence and vomiting of liquid, sour ingesta; even water is vomited as green, sour, ropy mucus.
- Acid vomiting, acid eructation, rumbling, gurgling and heartburn, worry him all night and disturb his rest.
- It is useful in a peculiar kind of sick headache associated with gastric symptoms and is caused by fat, cabbages, meat, turnips, warm bread and pastry.
ACCORDING TO WILLIAM BOERICKE
- Acidity of children. Stools and perspiration sour. Incarcerated flatus .
- Burning distress in stomach and region of gall bladder.
- Diarrhoeic stools, yellow, green, burning with nervous agitation, weakness, cold sweat, dyspnoea.
- Acrid and greenish vomiting, colic and flatulence, nightly burning pains in stomach.
- Sudden attacks of purging and vomiting.
- Bowels costive, with frequent ineffectual desire for stool.
- Aggravation: motion, pressure; afternoon and at night.
- Amelioration: quiet and in the morning.
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PG Scholar, Fr Muller Homoeopathic Medical College