Diarrhoea & its Homeopathic Approach

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 traveller’s diarrhoea)

Bacterial: E. coli, Campylobacter jejuni, salmonella

Parasites: Giardia, Clostridia, Aeromonas, Cryptosporidia, E. histolytica, Insospora

Viruses: Rota, Norwalk

Fungal

Food Poisoning:

Clostridia, Bacilus cereus, Salmonella, Staphylococcus aureus, Vibrio, Shigella, Campylobacter jejuni, E. coli, Yersinia, Liesteria

Opportunistic Infections:

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.
Faecal Impaction
Toxins
Intestinal Ischaemia
Acute Diverticulitis
Runner’s Diarrhoea

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

Poverty
Inadequate access to clean drinking water.
Inadequate sewage disposal
Poor education
Rapid Urbanisation
Lack of access to primary health care.
Food Consumption
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.

Clinical Features:

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, Reiter’s syndrome.

Laboratory Diagnosis:

Routine Blood Counts
Stool Examination
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.

Treatment:

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.

Prevention:

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

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

RECTUM - CHOLERA – infantum

RECTUM - CHOLERA – morbus

RECTUM - PROLAPSUS - diarrhea, during

STOOL – BLOODY

STOOL – COPIOUS

STOOL - FORCIBLE, sudden, gushing

STOOL – GREEN

STOOL – MUCOUS

STOOL - ODOR – offensive

STOOL - ODOR – putrid

STOOL - THIN, liquid

STOOL – WATERY

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

Materia Medica:

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.

References:

API Practice of Medicine

Pointers to the Common Remedies by Dr. M.L. Tyler.

Materia Medica by Boericke

Synthesis Repertory 8.0