Diarrhoea & Its Homoeopathic Approach
Dr. Pawan S. Chandak
Diarrhoea is defined as increase in the frequency of stool more than 3 per day or change in the consistency of stools which is usually associated with urgency or abdominal discomfort.
Diarrhoea less than 2-3 week is defined as acute disease.
The commonest cause of acute diarrhoea is infection.
Aetiology of acute Diarrhoea:
Infections (including causes of travellers diarrhoea)
Bacterial: E. coli, Campylobacter jejuni, salmonella
Parasites: Giardia, Clostridia, Aeromonas, Cryptosporidia, E. histolytica, Insospora
Viruses: Rota, Norwalk
Clostridia, Bacilus cereus, Salmonella, Staphylococcus aureus, Vibrio, Shigella, Campylobacter jejuni, E. coli, Yersinia, Liesteria
Bacteria: Mucobacterium avium intracellulare, Protozoa, Crptosporidium, Isospora belli, Microsporidia, Ilastocystis hominis.
Viruses: Cytomegaloviris, Herpes simplex, adenoviris.
Inflammatory Bowel Disease
Hospital Acxquired Diarrhoea
Medication Induced Diarrhoea: antacids, antiarrthmics, antibiotics, antineoplastic drugs, antihypertensives, cholinergic, laxatives, lactose, magnesium, theophyllin, NSAIDS, prokinetic, potassium, prostaglandins.
Mode of Transmission:
Commonest by faeco-oral route by ingesting contaminated food or water.
Person to person transmission may occur via contaminated hands, fomites or even aerosols (e. Rota Virus)
Sexual transmission oro-genital, oral-anal can cause infectious diarrhoea.
Factors affecting the prevalence of Infective Diarrhoea
Inadequate access to clean drinking water.
Inadequate sewage disposal
Lack of access to primary health care.
Uncooked, poorly refrigerated, inadequately heated prior to serving seafood especially raw shellfish.
Picnics, banquets, fast food, restaurants.
Homosexuals, Prostitutes, IV Drug Abusers.
Institutions: Hospitals, Day Care centers for children, sanitorium, mental institutions.
Recent travels, especially from developed country to developing countries.
Nausea and vomiting (toxic liberation), abdominal pain and fever.
Stools may be watery (invasion with minimal inflammation).
Bloody Stool (invasion with severe inflammation).
Vomiting occurring after a few hours of taking foods and occurring in other who have eaten the same food Food poisoning
G. lambilia: Diarrhoes with additional bloating and gurgling
Abdominal Examination: there is only mild to moderate diffuse abdominal tenderness.
In Yersinia infection: Right upper quadrant tenderness.
In Some infections: Haemolytic Uraemic Syndrome, Reiters syndrome.
Routine Blood Counts
For suspected Amoebic Infection: Giardia Antigen testing in the stool or duodenal aspirate / biopsy tissue.
Bloody Diarrhoea more than one week Sigmoidoscopy, Colonoscopy should be done.
To correct dehydration and electrolyte disturbances.
Oral Rehydration Therapy.
In mild to moderate diarrhoea ORS given in volumes of 500 to 1000 ml/kg over 4-6 hours in children.
In adults upto 1000 ml/kg.
After Rehydration 100 - 200 ml / kg of ORS is given 24 hours until diarrhoea ceases.
The addition of amino acids to Glucose based ORS or the substitutions of Rice or Grain for Glucose has been found effective.
Uncontaminated drinking water and proper sewage disposal by Public Health Authority.
Strict Personal Hygiene when handling foods.
Travelers should refrain from drinking unbolted water and other drinks, should not eat raw vegetables, raw meat or Sea food.
Infections in infants can be prevented by Breast feeding.
Repertorial Approach of Diarrhoea:
RECTUM - DIARRHEA - alternating with headache
RECTUM - DIARRHEA - alternating with rheumatism
RECTUM - FLATUS - diarrhea, during
RECTUM - PAIN diarrhea
RECTUM - PAIN - burning diarrhea
RECTUM - PAIN - soreness - stool - diarrheic, after
RECTUM - PAIN - tenesmus diarrhea
RECTUM - URGING - diarrhea, with
RECTUM - DIARRHEA - autumn, in
RECTUM - DIARRHEA - cholera - epidemic; during
RECTUM - DIARRHEA - damp ground; after standing on
RECTUM - DIARRHEA - dentition, during
RECTUM - DIARRHEA - diet - change of diet; least
RECTUM - DIARRHEA - eating after
RECTUM - DIARRHEA - fever typhoid
RECTUM - DIARRHEA - fruit after
RECTUM - DIARRHEA - jaundice, during
RECTUM - DIARRHEA - magnesia, after
RECTUM - DIARRHEA - milk, after
RECTUM - DIARRHEA painless
RECTUM - DIARRHEA - periodical - day alternate
RECTUM - DIARRHEA - septic conditions, from
RECTUM - DIARRHEA summer
RECTUM - DIARRHEA - weather wet
RECTUM - DIARRHEA - wet; getting
RECTUM - DIARRHEA - weather - change of
RECTUM - DIARRHEA winter
RECTUM - DIARRHEA - autumn, in
RECTUM - DIARRHEA bilious
RECTUM - CHOLERA infantum
RECTUM - CHOLERA morbus
RECTUM - PROLAPSUS - diarrhea, during
STOOL - FORCIBLE, sudden, gushing
STOOL - ODOR offensive
STOOL - ODOR putrid
STOOL - THIN, liquid
STOOL - YELLOW
ABDOMEN - RUMBLING - diarrhea would come on; as if
ABDOMEN - RUMBLING - stool diarrheic
ABDOMEN - WEAKNESS, sense of - diarrhea would come on; as if
ABDOMEN - PAIN diarrhea
ABDOMEN - DIARRHEA - sensation as if diarrhea would come on
STOMACH - VOMITING diarrhea
GENERALS - WEAKNESS - sudden - diarrhea, with
GENERALS - WEARINESS - diarrhea, after
Merc Cor: Indicated for Dysentery with scanty stools with blood and incessant straining, not relived by stool.
Podophyllum: Commonest medicine for Diarrhoeas with profuse, watery, painless, offensive, gushing, seems to drain the infant dry. Stools are larger than expected from food taken. Patient desire for much water, none for food. There is marked gurgling in abdomen. Retching; vomits green froth or food. Diarrhoeas worse in the morning, teething baby. Prolapse of rectum with soft stool.
China: Indicated for painless and undigested, copious & putrid stools.
Merc Sol: Indicated for slimy, even bloody diarrhoea, with straining followed by chilliness. There is profuse perspiration which does not relieve. Mouth is offensive. Salivation with intense thirst. Tongue is large, flabby, tooth-notched.
< at night, from warmth of bed.
Thighs and legs are cold and clammy especially at night.
Veratrum: Useful for Diarrhoea with vomiting in which vomit, stools, swear are very profuse. Thirst for much cold water, acid drinks. Patient feels exhausted after each spell.
Cold sweat on forehead from least movements.
Dulcamara: Diarrhoeas from every change of weather to cool. Ailments from exposure to cold, or damp. Changeability of stools. Nausea with desire for stool. Colic before and during stool. Prostration. Weakness from Stools.
Croton Tig: Useful for Diarrhoeas with yellow, watery stool, come out like a shot, while nursing or immediately after nursing babies. Any food or drink starts this sudden stool. A hand pressing on umbilicus produced protrusion of rectum.
Aloes: Diarrhoes in which hurry to stool after eating or drinking. Inability to retain or to evacuate stool.
Kreosote: Useful for Cholera infantum in teething infants with very painful dentition, gums painful, spongy. Severe cases with incessant vomiting and stools cadaveric smelling. Patient is intensely irritable.
Chamomilla: Indicated for Diarrhoeas with watery, greenish stools, excoriating, smell like rotten eggs. Baby is very cross, must be carried. Useful for Diarrhoea in teething babies.
Arsenicum: Diarrhoea worse at night from 1 to 3 am. There is rapid emaciation with exhaustion and collapse. Intense restlessness. Painless, watery, offensive stools. There may be simultaneous vomiting and diarrhoea. Diarrhoea worse after cold drinks when heated, in older persons after ices. Thirst for cold water, but it is immediately vomited. Face looks pale, cadaverous. Skin is dry, wrinkled, toneless.
Gelsemium: Useful medicine for epidemic dysentery of malarial or catarrhal type. Indicated for acute catarrhal enteritis, mucous diarrhoea. Discharges are almost involuntary, intense spasmodic colic and tenesmus. Fright, emotion, anticipation will produce diarrhoea. Gelsemium has chills up and down back with trembling, heaviness of limbs and eyelids.
API Practice of Medicine
Pointers to the Common Remedies by Dr. M.L. Tyler.
Materia Medica by Boericke
Synthesis Repertory 8.0
© Dr. Pawan S. Chandak