MULTI-DIMENSIONAL APPROACH TO HYPERACIDITY & INDIGESTION CONQUER WITH HOMOEOPATHY

  

Abstract 

 

Hyperacidity is also called Acid Dyspepsia, which is one of the most common problem. Hyperacidity is a medical condition in which the stomach secretes a lot of acids. Homoeopathy is a remarkable resource for those dealing with digestive disorders. Homoeopathy can be of assistance in retrieving normal motility and treating any psychological issues related to gastric disorders.

 

Introduction

Dyspepsia, also known as indigestion or upset stomach, is a term that describes discomfort or pain in the upper abdomen. It is not a disease. Various conditions cause dyspepsia. It can be caused due to various medications, stressed lifestyle and spicy foods. The main symptom is usually pain or discomfort in the upper tummy (abdomen). In addition, other symptoms that may develop include Bloating, Belching, Quickly feeling full after eating, Feeling sick (nausea) & Being sick (vomiting).

 

Causes of Dyspepsia

 

Indigestion is usually related to lifestyle and what we eat and drink. It may also be caused by infection or some other digestive conditions.

Some common causes include:

· Life Style factors - Eating too much, Eating too rapidly, Consuming fatty or greasy foods, Consuming spicy foods, Consuming too much caffeine, Consuming too much alcohol, Consuming too much chocolate, Consuming too many fizzy drinks, Emotional trauma, moderate to intense exercise immediately after eating.

· Functional dyspepsia - a type of indigestion that may undermine the stomach's ability to accept and digest food and then pass that food on to the small intestine.

· Gallstones

· Gastritis (inflammation of the stomach)

· Hiatus hernia

· Infection, especially with bacteria known as Helicobacter pylori

· Nervousness

· Obesity - caused by more pressure inside the abdomen

· Pancreatitis (inflammation of the pancreas)

· Peptic ulcers

· Smoking

· Some medications like Antiinflammatory medicines are the most common culprits. These are medicines that many people take for arthritis, muscular pains, sprains, period pains, etc. For example: aspirin, ibuprofen,and diclofenac but there are others. Antiinflammatory medicines sometimes affect the lining of the stomach and allow acid to cause inflammation and ulcers.

· Various other medicines sometimes cause dyspepsia, or make dyspepsia worse. They include: digoxin, antibiotics, steroids, iron, calcium antagonists, nitrates, theophyllines and bisphosphonates.such as antibiotics and NSAIDs (non-steroidal anti-inflammatory drugs)

· Stomach cancer

 

Clinical manifestations of Dyspepsia

Most people with indigestion feel pain and discomfort in the stomach or chest area. The sensation generally appears soon after consuming food or drink. In some cases symptoms may appear some time after a meal. Some people feel full during a meal, even if they have not eaten much. Heartburn and indigestion are two separate conditions.

Heartburn is a burning feeling behind the breastbone, usually after eating.

The Common symptoms are Nausea, Belching, Feeling bloated (very full)

In very rare cases indigestion may be a symptom of stomach cancer.

Mild indigestion is rarely anything to worry about. if symptoms continue for more than two weeks. Consult a physician immediately if pain is severe, and symptoms like

Loss of appetite or weight loss, Vomiting, Black stools, Jaundice (yellow coloring of eyes and skin), Chest pain, Shortness of breath, Sweating, Chest pain radiation to the jaw, arm or neck.

 

Investigations

 

Majority of patients indigestion is mild and does not occur very often. In such cases no treatment from a doctor is required. People who experience indigestion regularly consult a good physician.

Blood test - if the patient has any symptoms of anemia then blood test is needed.

Endoscopy - patients who have not responded to treatment, or those with certain signs and symptoms, may be advised to have their abdomen examined in more detail like endoscopy is advised.

Tests to diagnose Helicobacter pylori infection - this may include a urea breath test, a stool antigen test, and a blood test. Peptic ulcers are often cause by this bacterium.

Liver function test – if the patient may have a biliary condition, which affects the bile

ducts in the liver. This involves a blood test that determines how the liver is working.

X-rays - usually an upper-gastrointestinal and small bowel series. X-rays are taken of the esophagus,stomach and small intestine.

Abdominal ultrasound - high-frequency sound waves make images that show movement, structure and blood flow.

Abdominal CT (computed tomography) scan.

 

Management

 

Lifestyle changes

For all types of dyspepsia, the National Institute for Health and Care Excellence (NICE) recommends the following lifestyle changes like Make sure you eat regular meals, Lose weight if you are obese, If you are a smoker, consider giving up, Don't drink too much alcohol.

Changing the way you eat may help your symptoms. Steps you can take include: Allow enough time for meals, Chew food carefully and completely, Avoid arguments during meals, Avoid excitement or exercise right after a meal, Relax and get rest if indigestion is caused by stress.

Posture - Lying down or bending forward a lot during the day encourages reflux. Sitting hunched or wearing tight belts may put extra pressure on the stomach, which may make any reflux worse.

Bedtime - If symptoms recur most nights, the following may help:

· Go to bed with an empty, dry stomach. To do this, don't eat in the last three hours before bedtime and don't drink in the last two hours before bedtime. If you are able, try raising the head of the bed by 10 – 20 cms (for example, with books or bricks under the bed's legs). This helps gravity to keep acid from refluxing into the oesophagus. If you do this, do not use additional pillows, because this may increase abdominal pressure.

· Spices and condiments such as pepper, mustard must be avoided.

· Vinegar or pickles, which make food more palatable and lead to overeating, must be avoided.

· Alcohol, tobacco, strong tea and coffee must be avoided. Highly seasoned meats, pulses, potato, rice, cheese, refined, processed, stale and tinned foods should all be avoided.

 

Home Remedies:

1. For instance, drinking a glass of water at the first sign of indigestion can give you much relief. Water helps dilute stomach acids thus giving you relief from bloating and burning.

2. Apple cider vinegar is often used to kick start a slow stomach and settle indigestion due to its antibiotic properties. Add one tablespoon apple cider vinegar to a cup of water. Mix in one teaspoon honey. Drink this solution two to three times a day for quick relief.

3. Fennel seeds can be really helpful for indigestion caused by very spicy or fatty food. Fennelseeds contain oil that can help reduce nausea and control flatulence.

4. Ginger stimulates digestive juices and the flow of enzymes that help you digest your food. This makes ginger an effective remedy for indigestion from overeating.

5. Baking soda - Indigestion often happens due to high levels of stomach acids. Baking soda is one of the most simple and effective treatments for indigestion because it acts like an antacid. Stir one half teaspoon of baking soda into half a glass of water. Drinking this solution will neutralize the acid in your stomach and give your relief from bloating.

6. Coriander is an effective spice to treat indigestion. Add some roasted coriander seeds to half a glass of buttermilk and drink it twice a day.

7. Drinking herbal tea after eating a heavy meal can greatly reduce indigestion. Dip your favorite herbal tea bag into a hot cup of water and cover it for five minutes. Drink it while it is still warm. You can try herbal tea containing mint, raspberry and blackberry for instant relief. Peppermint or chamomile tea can also calm your stomach, especially after overeating.

 

HOMOEOPATHIC MANAGEMENT

 

Homoeopathy is a remarkable resource for those dealing with digestive disorders. Homeopathic constitutional treatment based on the individual case is the most suitable and would aim to heal the underlying physical or emotional crisis causing digestive disorders. The unique physical, emotional and mental expression of illness is characteristic and is used to channel the course of Homoeopathic treatment. The remedies work by stimulating body’s natural ability to heal itself, acting as a catalyst for healing. Homoeopathy can be of assistance in retrieving normal motility and treating any psychological issues related to IBS. Homeopathic remedies can help rebuild mind, body and spirit as well as personal relationships for a balanced lifestyle. Homeopathy will reinforce and tone the body’s systems. Homeopathic remedies can help deal with anxiety, depression, and stress along with digestive problems. It will attend to nutritional problems and help the patient develop a healthier body image.

 

Some Homoeopathic remedies for Dyspepsia are

 

Indicated Remedies	Indications
Antimonium crudum	This relieves indigestion from eating too much, especially rich or acidic foods or cured meat. Symptoms are relieved by applying heat to the abdomen.
Arsenicum album	This remedy may be indicated if a person feels anxious, restless yet exhausted, and is worse from the smell and sight of food. Burning pain is felt in the stomach and esophagus, which often is relieved by warmth and sitting up. Vomiting and diarrhea are possible. Upsets from spoiled food or from eating too much fruit often respond to this remedy.
Bryonia	When this remedy is indicated, the stomach feels heavy, with rising acid and a bitter or sour taste. Pain and nausea are worse from motion of any kind. The person may have a dry mouth and be thirsty for long drinks, which may increase discomfort. Bryonia is strongly suggested if a person is grumpy and wants to stay completely still and not be touched or talked to.
Carbo vegetabilis	Sour belching bringing only small relief, burning pain in the stomach and abdomen, and flatulence after eating may be seen when this remedy is needed. The person feels cold and faint, with a strong desire for fresh or moving air. Digestion may be slow and incomplete, with nausea or cramping.
Cinchona officinalis	This remedy relieves bloating of the abdomen and foul-smelling gas, sometimes with painless, but exhausting, diarrhea.
Colocynthis	Cutting, cramping pain in the stomach and abdomen, with relief from hard pressure or from doubling over, indicates a need for this remedy. A bitter taste in the mouth, a feeling that the intestines are about to burst, or a sensation that stones are grinding together in the abdomen may be present. Indigestion may be worse when the person feels upset, especially after suppressing anger.
Lycopodium	This remedy is indicated for many digestive troubles. The person’s appetite may be ravenous, but eating even a small amount can cause a feeling of fullness and bloating. Rumbling gas may form in the abdomen, pressing upward and making breathing difficult. The person often has a strong desire for sweets, is sleepy after meals, and feels worst in the late afternoon and evening.
Magnesia phosphorica	This remedy relieves abdominal cramps improved by heat and bending over.
Natrum carbonicum	This remedy can be helpful to mild people who have trouble digesting and assimilating many foods and have to stay on restricted diets. Indigestion, heartburn, and ulcers can occur if offending foods are eaten. Milk or dairy products can lead to flatulence or sputtery diarrhea that leaves an empty feeling in the stomach. Cravings for potatoes and sweets are common; also milk, but it makes these people sick, so they have usually learned to avoid it.
Natrum phosphoricum	A sour taste in the mouth, an acid or burning sensation in the stomach, sour vomiting, regurgitated bits of food, and a yellow coating on the tongue are all indications for this remedy. The person may have problems after consuming dairy products or too much sugar. Another indication for Natrum phos is a craving for fried eggs.
Nux vomica	This remedy is often useful for indigestion, and is especially suited to those who overindulge in stimulants, food, and alcohol. Chilliness, irritability, and sensitivity to odors, sound, and light are often seen. Pain and weight can be felt in the stomach, with cramps or constricting pains. The person often feels an urge to vomit or move the bowels (which may make the person feel better, but is rarely successful).
Phosphorus	Burning pain in the stomach that feels better from eating ice cream or other cold, refreshing foods suggests a need for this remedy. The person is usually thirsty for cold drinks, but often feels nauseous or vomits once liquids warm up in the stomach. People needing Phosphorus may have a tendency toward easy bleeding and sometimes develop stomach ulcers.
Pulsatilla	Indigestion that is worse from eating rich and fatty foods, with a feeling of a lump or pulsation in the stomach, suggests a need for this remedy. Discomfort often is worse from warmth, especially in a stuffy room, and the person may feel better from gentle walking in open air. A bitter taste in the mouth can take the pleasure out of eating. A person who needs Pulsatilla usually does not feel thirsty and may be tearful and emotional.
Zingiber	Made from ginger, it relieves nausea with belching and diarrhea, especially if the stomach feels like a heavy stone.
Papain	This is made from the digestion supportive papaya enzyme.Eases frequent painful urging that may lead to diarrhea, much belching and abdominal pressure.
Hydrastis	Applies when constipation leads to a sinking feeling in the stomach and a total loathing of food.
Iris vers	Relieves irritating constipation with a constant urging to stool and a nauseating headache.

 

Conclusion

Homeopathic remedies can help rebuild mind, body and spirit as well as personal relationships for a balanced lifestyle. Homeopathy will reinforce and tone the body’s systems. Homeopathic remedies can help deal with anxiety, depression, and stress along with digestive problems. It will attend to nutritional problems and help the patient develop a healthier body image.Homeopathic constitutional treatment based on the individual case is the most suitable and would aim to heal the underlying physical or emotional crisis causing digestive disorders.

 

 

A STUDY ON THE EFFECTIVENESS OF HOMOEOPATHIC CONSTITUTIONAL MEDICINE IN THE MANAGEMENT OF NON-ALCOHOLIC FATTY LIVER DISEASE

 Abstract

 NAFLD is an important cause of liver disease in India. During the past century, dramatic modifications in lifestyle have radically changed the health priorities in most areas of the world, owing to a growing incidence of non-communicable disease. Fatty liver has earlier often been related with excessive alcohol consumption. During the past 20 years, the interest in fatty liver occurring in non-drinkers i.e. non-alcoholic fatty liver disease (NAFLD) has raised quickly.

Methods A prospective experimental study design without control group.Patients will be collected from the In-patient and Out-patient Departments, Peripheral Centres, Rural Health Camps and Medical Camps conducted by Vinayaka Mission’s Homoeopathic Medical College and Hospital

Result This study provides evidence to say that, there is significant reduction in the Non-alcoholic fatty liver disease after giving homoeopathic constitutional medicine

Keywords: Homeopathy, liver, NAFLD, constitutional medicine, life style disorder.

ABBREVIATIONS: NAFLD- Non-alcoholic fatty liver disease, NASH- non-alcoholic steatohepatitis

Introduction

 The spectrum of NAFLD includes: simple fatty liver without necro inflammatory activity; non-alcoholic steatohepatitis (NASH), a condition characterised by hepatocellular injury, inflammation, and fibrosis; cirrhosis; and in some individuals hepatocellular carcinoma.⁽¹⁾ The prevalence of NAFLD is affected by many factors, including genetics and environment and is therefore difficult to define.⁽²⁾

CAUSES

Primary causes

Obesity, Glucose intolerance, Hypertension, Hypertriglyceridemia, Low HDL cholesterol,

Type 2 diabetes. ⁽³⁾

 

Secondary causes

Disorders of lipid metabolism- Abetalipoproteinemia (Bassen–Kornzweig syndrome), Hypobetalipoproteinemia,Familial combined hyperlipidemia, Glycogen storage disease, Weber–Christian disease, Lipodystrophy.

Nutritional causes- Total parenteral nutrition, Severe surgical weight loss, Starvation

Medications-HAART, Oestrogen, Glucocorticoids, amiodarone, tamoxifen, diltiazem, methotrexate, zidovudine, cocaine, valproate, aspirin tetracycline.

Other causes- Celiac Disease, Wilson disease, Toxicity/environmental

Infections- Hepatitis C virus, small bowel diverticulosis with bacterial overgrowth, Human immunodeficiency virus.^{(4),(5), (6)}

GENETIC BACKGROUND OF NAFLD

PNPLA3 and TM6SF2 have been identified as potential genetic modifiers.⁽⁷⁾

PATHOPHYSIOLOGY

Several mechanisms have been postulated to explain the pathogenesis of NASH.The current two-hit hypothesis explains why not everyone with fatty liver disease develops hepatic fibrosis

The “firsthit” is development of hepatic macro-steatosis as a result of increased lipolysis and free fatty acids. Postulated mechanisms leading to hepatic steatosis include increased lipogenesis, decreased lipid export, and a reduction of free fatty acid oxidation with insulin resistance leading to fatty acid dysregulation.Several potential “second hits” include oxidative stress from reactive oxygen species in the mitochondria and cytochrome P450 enzymes. Further second hits include the presence of endotoxins, cytokines, adipokines, and environmental factors. These complex interactions of the various factors lead to insulin resistance, and serum & liver iron overload and oxidative stress that lead to necro inflammation and fibrosis.^{(8), (9)}

CLINICAL FEATURES

Most patients with NAFLD are asymptomatic.

When patients are symptomatic, symptoms include:

§ Fatigue ⁽¹⁰⁾

§ Up to 40 per cent have persistent right upper abdominal pain and may complain of lethargy and malaise. ⁽¹¹⁾ The upper abdominal pain may have sharp or dull quality.

§ Thirst, and anxiety, feeling of changing temperature, and bloating were the most common complaints.

§ Sleep disorder and late onset of sleeping were noticeable. ⁽¹²⁾

§ A smaller fraction of patients experiences symptoms indicative of more serious liver disease and may develop pruritus, anorexia, and nausea. ⁽¹³⁾

MATERIALS AND METHODS

Source of Data:

Patients will be collected from the In-patient and Out-patient Departments, Peripheral Centres, Rural Health Camps and Medical Camps conducted by Vinayaka Mission’s Homoeopathic Medical College and Hospital.

Method of Collection of the Data:

Research design:

A prospective experimental study design without control group.

Sample design:

Purposive sampling done according to inclusion and exclusion criteria.

Data collection:

Primary and secondary data collected through a predesigned case sheet.

 

Statistical analysis:

Paired t- test

Inclusion criteria fixed for the study:

§ Age group of 20 to 65 years

§ Both male and female has been included.

§ Persons with clinical symptomatic presentation of NAFLD.

§ Diagnosed cases of NAFLD

§ Subjects who have given consent for the study

Medication will be on the basis of constitutional homeopathic totality.

Exclusion Criteria fixed for the study:

§ Persons with history of chronic alcohol intake

§ Cases with established complications and advanced stage of liver disease.

§ Cases associated with other severe systemic illness.

§ Age group below 20 and above 65 years.

Prognostic criteria:

It is based on the symptomatic improvement and investigatory findings (was evaluated according to the Non-Alcoholic Fatty Liver Disease- US-FLI score) after the treatment.

Ultra-Sonographic Score for Evaluation of Presence and Severity of Non-Alcoholic Fatty Liver Disease- US-FLI (Ultra Sonographic Fatty Liver Indicator)

The severity of NAFLD was evaluated according to a semi quantitative US-FLI ranging from 0 to 8 and composing following indicators:

§ Presence or absence of liver-kidney contrast, graded as absent (score of 0), mild or moderate (score of 2), or severe (score of 3)

§ Presence or absence of posterior attenuation of the ultrasound beam (score of 1 or 0)

§ Presence or absence of vessel blurring (score of 1 or 0),

§ Difficulty visualizing the gallbladder wall (score of 1)

§ difficulty visualizing the diaphragm (score of 1)

§ Area of focal sparing (score of 1)

 

The subjects were divided into three groups of NAFLD severity according to the

US-FLI:

§ Normal liver (US-FLI = 0 or 1)

§ Mild NAFLD (US-FLI = 2 or 3)

§ Severe NAFLD (US-FLI ≥ 4)

Methodology

The patients will be investigated to confirm the diagnosis before starting the study. Detailed case history by interview as per the proforma prepared for the topic Medication will be on the basis of constitutional homeopathic totality. Cases will be followed for a period of 1 year, with a fortnightly O.P.D visits.

Result

The test statistic “t” follows patient’s t distribution with n- 1 (29) degrees of freedom. Here, tabled value of „t‟ at 5% level of significance is 2.045 for 29 degrees of freedom. Since the calculated value is 7.423 which are greater than the table at 5%, we reject null hypothesis.

Inference

This study provides evidence to say that, there is significant reduction in the Non-alcoholic fatty liver disease after giving homoeopathic constitutional medicine.

Therefore, Homoeopathic constitutional medicine is effective in cases of Non-alcoholic fatty liver disease.

Discussion

NAFLD, the commonest liver disorder in the world, is closely associated with metabolic syndrome, particularly obesity and insulin resistance. Sedentary lifestyle and poor dietary choices are leading to obesity, subsequently increasing risk for developing metabolic syndrome and NAFLD. It can progress to cirrhosis, hepatocellular carcinoma, and liver failure.

The development and progression of NAFLD are also affected by diet and genetic factors. Over the last decade, it has been shown that the clinical burden of NAFLD is not only confined to liver-related morbidity and mortality, but there is now growing evidence that NAFLD is a multisystem disease, affecting extra-hepatic organs and regulatory pathways.

Thirty clinically and ultrasonographic diagnosed cases of Non-alcoholic fatty liver patients were taken into consideration for the study.

The patients were between the age group of 20- 65 years. Patients of both sexes were treated. A detailed case history with the proper clinical examination was done in all the patients.

The protocol for the study was cases are followed for a period of 1 year and investigations will be done before and after treatment.

The treatment result has shown that maximum number of patients (12) were under Mild Improvement which is 40%, while Moderate Improvement was seen in 33.3% of patients (10), and 13.3% of patients (04) got recovered and no improvement is seen in 13.3% of patients (04) in this study.As per the study 36.7% were male and 63.3% were female patients. The male female ratio is 1:2.In total number of patients, 40% (12) patients got variationin liver function test and 60% (18) have no variation in their liver function test.In total number of patients 13.3% (4) patients are vegetarian and 86.7% (26) are non-vegetarian.In total number of patients 76.6% (23) patients were clinically presented symptomatic and 23.3% (7) patients were presented as asymptomatic.The remedies that are used most frequently for managing the patients was Phosphorous, Lycopodium, Nuxvomica in 5 (16.60%) cases each. The next were Calcarea carb and Sulphur in 3 (10%) cases each and Chelidonium, Arsenicum and Pulsatilla in 2 (6.70%) cases each and the least used were Bryonia, Lachesis, and Mercurius Solubilis each in 1 (3.33%) case. The commonly affected age group according to my study was 45-49 years (20%), and 60-65 years (16.6%)

The fundamental miasm which covered mostly was psora which is seen in 80% of patient.

Dominant miasm which covered mostly was sycosis (56.7%).

This study provides evidence to say that, there is significant reduction of Non-alcoholic fatty liver disease after giving Homoeopathic constitutional medicine.

The Homoeopathic system of medicine, patient is considered as unique, requiring individual assessment and treatment. As an integrated entity, including the physical, mental, emotional, spiritual, social and any other aspects of the total person. Homeopathy looks beyond the labels of disease to cure their causes rather than merely their symptoms and it stimulates the body’s own natural healing powers to bring health, vitality and well-being. It does not treat superficially by just driving away the symptoms but heals the patient from within.

 

CONCLUSION

Thirty clinically diagnosed cases of NAFLD were taken into consideration for the study. The patients were between the age group of 20-65 years. Patients of both sexes were treated. A detailed case history with the proper clinical examination with ultrasonography of abdomen and Liver Function Test was done in all the patients.

 In total number of patients 76.6% (23) patients were clinically presented symptomatic and 23.3% (7) patients were presented as asymptomatic.The remedies that are used most frequently for managing the patients was Phosphorous, Lycopodium, and Nuxvomica in 5 (16.60%) case each.

Along with constitutional treatment, general management in the form of diet and exercise guidelines was given to the patients. According to need of the cases some acute remedies were prescribed in between.

My study shows that NAFLD can be effectively treated with Homoeopathic constitutional medicines.the Homoeopathic treatment based on Holistic approach is having a good scope in treating non-alcoholic fatty liver disease patients, as most of the sample patients got relief, both symptomatically and diagnostically.

RECOMMENDATIONS

§ A Similar study should be done under large sample.

§ Proper advertisement should be given patients regarding the treatment of NAFLD in Homoeopathy and it has no side effects in treatment.

§ It will be always scientific if control (placebo) group would have been kept simultaneously to verify the effectiveness of treatment.

§ Study can be done with fibrosis score.

§ Comparative study with specific liver remedies and constitutional treatment can be done.

§ Study can be done to find the incidence of Non-Alcoholic Fatty Liver Disease and its association with cardiac Risk Factors in Patients with type 2 Diabetes and obesity.

§ Patient should be counsel for the disease condition and regarding regular follow up.

 

 

LIMITATIONS

§ There is a common misunderstanding in public that in Homeopathy treatment is long standing.

§ The effectiveness of Homoeopathic treatment in case of NAFLD is less aware in public.

§ People will not follow regular follow up, so we have to counsel them regarding treatment and the importance of regular follow up in homoeopathy.

§ Mental symptoms have a significant role in selection of medicine; it is difficult to elicit the mental symptoms in the first visit.

§ Patient will not follow the advised diet and regimen during the treatment.

§ After getting slight improvement in the condition they will leave the treatment

§ There was no control group since the sample size was small.