Homoeopathic therapeutics of dyspepsia

Dr  Dharanni V

ABSTRACT
In recent times, dyspepsia has become a more prevalent condition. It refers to pain or discomfort centered in the upper abdomen. It may be caused by anything from mild indigestion due to dietary and lifestyle choices to chronic conditions of the gastrointestinal tract resulting from various medications and other systemic illnesses. Understanding the root cause of dyspepsia is essential for selecting the appropriate management and selection of homeopathic similimum.

KEY WORDS : Dyspepsia, Classification, Homeo therapeutics, Management

DYSPEPSIA

Dyspepsia is a condition of impaired digestion or Indigestion or stomach upset.

• RISK FACTORS
  • Indigestion is related to lifestyle and may be triggered by food, drink or medication
  • Overeating or eating too quickly
  • Fatty, greasy or spicy foods
  • Too much caffeine, alcohol, chocolate or carbonated beverages
  • Smoking
  • Anxiety
  • Certain antibiotics, pain relievers and iron supplements
  • Other systemic diseases
  • Presented with conditions of

Upper GI Tract

• Alcohol following heavy meals
• Aerophagia
• Hiatus hernia
• GERD
• Peptic Ulcer disease
• Gastritis
• Drugs – NSAIDs, anti depressants etc

Lower GI Tract

• Intestinal Parasites
• Food intolerance
• Irritable bowel syndrome
• Increased intraluminal gas

Hepato biliary

• Cholecystitis
• Cholelithiasis
• Pancreatitis

• CLASSIFICATION

1. Organic Causes
   • Esophagitis
   • Gastritis
   • Peptic ulcer disease
   • Infection
   • Pancreato – Biliary disease

1. Functional Causes / Non– Ulcer Dyspepsia

• Epigastric pain syndrome(EPS)
• Post prandial distress syndrome (PDS)

Drug Related

• NSAIDs
• Aspirin
• Anti-Biotics
• Steroids
• Digoxin
• Iron , Potassium supplements

Extra–Intestinal Systemic Disease

• Diabetes mellitus
• Hypothyroidism
• Hyper Parathyroidism
• Addison’s disease
• Uremia

• CLINICAL FEATURES

Symptoms

• Upper abdominal discomfort /fullness / pain
• Heartburn
• Easy satiety
• Anorexia
• Nausea, belching
• Regurgitation

Signs

• On palpation- abdominal tenderness

• SYMPTOM CLASSIFICATION
  • Reflux type – Retrosternal burning, Regurgitation
  • Ulcer type – Epigastric pain < empty stomach > bland food & antacids
  • Dysmotility type – Post prandial fullness ,Distension, Early satiety Nausea
• Alarming Symptoms
  • Persistent vomiting
  • Progressive difficulty swallowing
  • Chronic GI bleeding
  • Iron deficiency, Vit B12 deficiency anemia
  • Progressive unintentional weight loss
  • Epigastric mass
• INVESTIGATIONS

Non-Invasive Tests

• Serology:
• Complete blood picture
• Hb & MCV – rule out iron deficiency anemias
• Vit B12 (160- 950pg/ml) – reduced in case of Type A gastritis
• Fasting plasma gastrin concentration (<150pg/ml) – elevated in ZE syndrome à peptic ulcers
• Urea breath test – H pylori infection
• Stool antigen test – H pylori antigens shed in feces

Invasive Tests

• Upper GI Endoscopy
• Esophagitis
• Erosive gastritis
• Peptic ulcer – appears like apthous ulcer with creamy base
• GERD
• Antrum Biopsy – H Pylori
• Biopsy urease test
• Histology
• Culture
• X ray chest – large sliding hernias – retro cardiac shadow
• Barium meal studies
• Size of hernias
• Peptic ulcer – acute / healing stage

• MANAGEMENT
  • Mild indigestion can often be helped with lifestyle changes.
    • Eating smaller, more-frequent meals
    • Chew your food slowly and thoroughly.
  • Avoiding triggers
    • Fatty and spicy foods, processed foods, carbonated beverages, caffeine, alcohol, and smoking can trigger indigestion.
  • Maintaining a healthy weight
    • Exercising regularly- helps you keep off extra weight, reduces abdominal pressure and promotes better digestion.
  • Managing stress
    • Practice relaxation techniques, such as deep breathing, meditation or yoga.
    • Get plenty of sleep
  • Preventing reflux
    • Avoid lying down after meal – at least gap of 2- 3hrs
    • Elevate head – raising head with extra pillows
    • Lying on left side
  • HOMOEOPATHIC THERAPEUTICS

ALFALFA

• The appetite is impaired and here is much flatulence and distension.
• It should be thought of in retarded digestion, when the appetite is impaired, the patient is emaciated, weak and complains of fermentation and flatulence
• Disorders characterized by malnutrition are mainly within its therapeutic range
• Appetite impaired, but chiefly increased even to bulimia.
• He must eat frequently, so that he cannot wait for regular meals; hungry in forenoon
• Much nibbling of food and craving for sweets

DIOSCOREA VILLOSA

• As a remedy for many kinds of pain, especially colic, and in severe, painful affections of abdominal and pelvic viscera; it ranks with the polychrests of the Materia Medica.
• Persons of feeble digestive powers; tea-drinkers, with much flatulence.
• Gall stone colic. Violent twisting colic, occurring in regular paroxysms, as if intestines were grasped and twisted by a powerful hand.
• Colic pains < from bending forward and while lying; > on standing erect or bending backwards (rev. of Col.)

ABIES NIGRA

• In dyspeptic troubles of the aged, with functional heart symptoms; also after tea or tobacco
• Pain in stomach always comes on after eating.
• Sensation of a lump that hurts, as if a hard-boiled egg had lodged in cardiac end of stomach; continual distressing constriction just above the pit of the stomach, as if everything were knotted up.
• Total loss of appetite in morning, but great craving for food at noon and night

ROBINIA PSEUDACACIA

• The remedy for hyperchlorhydria
• In cases where albuminoid digestion is too rapid and starch digestion is perverted.
• The acidity of Robinia is accompanied by frontal headache
• Intensely acrid eructations.
• Acidity of children.
• Acrid and greenish vomiting, colic and flatulence, nightly burning pains in stomach and constipation with urgent desire.
• Eructations and vomiting of intensively sour fluid, setting the teeth on edge

LAUROCERASUS

• Drink rolls audibly through oesophagus and intestines
• Violent pain in stomach with loss of speech
• Spasm of facial muscles and oesophagus
• Persistent hiccough
• Vomiting of food during cough
• Gurgling flatulence
• Disgust for food during pregnancy
• Nausea near hot stove

BISMUTHUM

• Irritation & catarrhal inflammation of alimentary canal
• Vomits, with convulsive gagging and pain.
• Vomits all fluids.Water is vomited as soon as it reaches the stomach.
• Slow digestion, with fetid eructations
• Will eat for several days; then vomit.
• Gastralgia; pain from stomach through to spine.
• Better, cold drinks, but vomiting when stomach becomes full.
• Tongue coated white; sweetish, metallic taste.
• Pressure as from a load in one spot, alternating with burning, crampy pain and pyrosis

EUPHORBIA COROLLATA

• Irritation & catarrhal inflammation of alimentary canal
• Vomits, with convulsive gagging and pain.
• Vomits all fluids.Water is vomited as soon as it reaches the stomach.
• Slow digestion, with fetid eructations
• Will eat for several days; then vomit.
• Gastralgia; pain from stomach through to spine.
• Better, cold drinks, but vomiting when stomach becomes full.
• Tongue coated white; sweetish, metallic taste.
• Pressure as from a load in one spot, alternating with burning, crampy pain and pyrosis

IPECACUANHA

• The chief action is on the ramifications of the pneumogastric nerve, producing spasmodic irritation in chest and stomach
• Adapted to cases where the gastric symptoms predominate (Ant. c., Puls.); tongue clean or slightly coated
• The principal feature of Ipecacuanha is its persistent nausea and vomiting
• Indicated after indigestible food, raisins, cakes, etc.
• Intermittent dyspepsia, every other day at same hour;
• Stomach: feels relaxed, as if hanging down, clutching, squeezing, griping, as from a hand, each finger sharply pressing into intestines; worse from motion.
• Flatulent, cutting colic about umbilicus.

CAPSICUM ANNUM

• A/F : Alcohol
• Prostration & feeble digestion of alcoholics
• Desire for coffee, with inclination to vomit before or after taking it
• Pain in stomach which is inflated
• Sour taste in mouth, also taste of broth
• Unnaturally increased appetite, alternated with aversion to food
• Shootings in epigastrium, on breathing rapidly & deeply ,on speaking, part being touched

KALI BICHROMICUM

• The special affinities of this drug are the mucous membrane of stomach, bowels, and air-passages; bones and fibrous tissues
• Nausea and vomiting after beer
• Feels as if digestion had stopped. Dilatation of stomach.
• Round ulcer of stomach.
• Stitches in region of liver and spleen and through to spine.
• Cannot digest meat.
• Desire for beer and acids.
• Gastric symptoms are relieved after eating, and the rheumatic symptoms reappear
• Vomiting of bright yellow water.

CINCHONA OFFICINALIS

• Post operative gas pains, not relief from passing it
• Slow digestion. Weight after eating. Vomiting of undigested food.
• Ill effects of tea. Milk disagrees.
• Hungry without appetite.
• Darting pain crosswise in hypogastric region.
• Hungry longing for food, which lies undigested.
• Flatulence; belching of bitter fluid or regurgitation of food gives no relief; worse eating fruit

PTELEA TRIFOLIATA

• Remarkable remedy in stomach & liver sffections
• Atonic state of stomach
• Stomach & liver symptoms < lying on left side; associated with pain in limbs
• Excess of saliva, with bitter taste
• Gripping in epigastric region, with dryness of mouth
• Constant sensation of corrosion, heat & burning in stomach
• Aversion to fats & rich food, cheese

ANACARDIUM ORIENTALE

• Anacardium patient is found mostly among the neurasthenics; such have a type of nervous dyspepsia, relieved by food
• Weak digestion, with fullness and distention
• Empty feeling in stomach.
• Eructation, nausea, vomiting.
• Eating relieves the Anacardium dyspepsia.
• Apt to choke when eating or drinking.
• Swallows food and drinks hastily.

ASAFOETIDA

• Flatulence & spasmodic contraction of stomach with reverse peristalisis – Marked symptoms
• Hysterical flatulence. Great difficulty in bringing up wind
• Pulsation in pit of stomach
• Violent gastralgia; cutting & burning in stomach & region of diaphragm
• Flatulence & regurgitation of liquids
• Gurgling & rolling of wind, which escapes afterwards with loud & difficult eructation

RUBRICS FROM DIFFERENT REPERTORIES

MURPHY REPERTORY

• Stomach-INDIGESTION, general
• Stomach-INDIGESTION, general-digestion, weak, from
• Stomach – INDIGESTION, general-pregnancy, during
• Stomach-INDIGESTION, general – simplest food, from
• Stomach – INDIGESTION, general-fat food, from
• Stomach – INDIGESTION, diet, indiscretions in
• Stomach – INDIGESTION, drugs, abuse of, after
• Stomach – INDIGESTION, gastric juice, scanty
• Stomach – DIGESTION, slow
• Stomach – DIGESTION, weak
• Stomach – DISAGREEABLE, sensation
• Stomach – DISORDERED, stomach
• Stomach – DISTENTION
• Stomach-EMPTINESS, weak, hungry feeling
• Stomach – ESOPHAGITIS, inflammation, esophagus
• Stomach – FERMENTATION
• Stomach – FULLNESS, sensation 66. Stomach – GASTRITIS, inflammation
• Stomach-HEARTBURN, general
• Stomach – INDURATION, of the walls
• Stomach- LUMP, sensation of
• Stomach-NAUSEA, general
• Stomach – PAIN, stomach
• Stomach – PAIN, esophagus
• Stomach – PRESSING, pain, esophagus
• Stomach – REGURGITATION of food
• Stomach – RELAXATION, of pylorus
• Stomach – RETCHING, general
• Stomach – SHARP, pain
• Stomach – REVERSE, esophagus, peristaltic action of
• Stomach-RETCHING, general
• Stomach – TOBACCO, stomach, sensitive to
• Stomach – ULCERATIVE, pain
• Stomach – ULCERS
• Emergency – NAUSEA, severe
• Emergency-FOOD, poisoning
• Emergency – VOMITING, violent relief, without
• Diseases-AEROPHAGIA, excessive swallowing of air
• Diseases-ACID, diseases – children suffering from excess of lactic acid, resulting from overfeeding of milk or sugar
• Diseases – ACIDITY, diseases from excess of acid
• Diseases – ACIDOSIS
• Diseases – ESOPHAGITIS
• Diseases – GASTRITIS, stomach
• Diseases – GASTROENTERITIS, acute
• Diseases – HEPATITIS, liver
• Diseases – PYLORIC stenosis
• Toxicity-ARTIFICIAL, food, agg
• Toxicity-ACIDS, foods, agg
• Toxicity- Alcoholic, Constitutions, dyspepsia & debility
• Atonic
• Beer- drinkers, in
• Toxicity- Drugs, indigestion, from
• Toxicity- Indigestion, from
• Toxicity- Tobacco, dyspepsia, from smoking
• Toxicity- Tobacco, nausea, smoking, after
• Toxicity- Tobacco, stomach, gastro-intestinal symptoms worse after chewing
• Toxicity – MAGNESIA, abuse of
• Toxicity-IRON, poisoning or abuse
• Toxicity – IODINE, poisoning or abuse
• Toxicity – COD liver oil, abuse
• Toxicity – FOOD, poisoning
• Toxicity – SALT, abuse of
• Toxicity – STIMULANTS, agg

SYNTHESIS REPERTORY

• STOMACH-ACIDITY
• STOMACH-COMPLAINTS of the stomach
• STOMACH – DISORDERED
• STOMACH-ERUCTATIONS; TYPE OF – acrid
• STOMACH – ERUCTATIONS; TYPE OF – empty
• STOMACH-ERUCTATIONS, TYPE OF – nauseous
• STOMACH- ERUCTATIONS, TYPE OF – sour
• STOMACH – ERUCTATIONS; TYPE OF – water brash
• STOMACH – ERUCTATIONS; TYPE OF – pungent
• STOMACH – FERMENTATION
• STOMACH – HEARTBURN
• STOMACH – HERNIA, HIATUS
• STOMACH – HYPERCHLORHYDRIA
• STOMACH – INFLAMMATION
• STOMACH – IRRITATION
• STOMACH – LOATHING of food
• GENERALS – HISTORY, personal – antibiotics, of use of
• GENERALS HISTORY, personal-medicine, of abuse of allopathic

BOGER C., BOENNINGHAUSEN’S REPERTORY

• STOMACH – Digestion – weak
• aged, in the
• alcoholics, in
• coffee addicts, in
• fluids, from loss of vital
• food, improper, overeating, etc.
• hysteria, in
• mental exertion, from
• mercury, from abuse of
• pregnancy, during
• quinine, abuse of
• sleep, loss of
• tea, abuse of

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Dr. Dharanni. V
PG Scholar, Department of Materia Medica
Father Muller Homoeopathic Medical College
Under the guidance of Dr Mini. I.V
Associate Professor, Department of Homoeopathic Materia Medica