OSTEOPOROSIS

BUILD STRONG BONES AND PREVENT OSTEOPOROSIS WITH ENERGY OF HOMOEOPATHY
     
Good health of the individual is mostly depend on strong bone and healthy skeletal makeup. There are totally 206 bones present in human body which are exquisitely and perfectly placed to keep skeleton in appropriate shape and in a healthy manner. Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bone has hard and solid outer shell surrounding the connecting plates and rods of bones within which lies the bone marrow, internally they are soft and spongy and thus bones are light, strong and flexible.
Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones. Osteopenia, by definition, is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis.

AETIOLOGY & RISK FACTORS

The leading cause of osteoporosis is a lack of certain hormones, particularly oestrogen in women and androgen in men. Women, especially those older than 60 years of age, are frequently diagnosed with the disease. Menopause is accompanied by lower oestrogen levels and increases a woman's risk for osteoporosis. Other factors that may contribute to bone loss in this age group include inadequate intake of calcium and vitamin D, lack of weight-bearing exercise, and other age-related changes in endocrine functions (in addition to lack of oestrogen).
Other conditions that may lead to osteoporosis include overuse of corticosteroids (Cushing syndrome), thyroid problems, lack of muscle use, bone cancer, certain genetic disorders, use of certain medications, and problems such as low calcium in the diet.
Women are at a greater risk than men, especially women who are thin or have a small frame, as are those of advanced age. Women who are white or Asian, especially those with a family member with osteoporosis, have a greater risk of developing osteoporosis than other women.
Women who are postmenopausal, including those who have had early or surgically induced menopause, or abnormal or absence of menstrual periods, are at greater risk.
Cigarette smoking, eating disorders such as anorexia nervosa or bulimia, low amounts of calcium in the diet, heavy alcohol consumption, inactive lifestyle, and use of certain medications, such as corticosteroids and anticonvulsants, are also risk factors.
Rheumatoid arthritis itself is a risk factor for osteoporosis.
Having a parent who has/had osteoporosis is a risk factor for the offspring.

CLINICAL FEATURES

Early in the course of the disease, osteoporosis may cause no symptoms. Later, it may cause height loss or dull pain in the bones or muscles, particularly low back pain or neck pain.
Later in the course of the disease, sharp pains may come on suddenly. The pain may not radiate (spread to other areas); it may be made worse by activity that puts weight on the area, may be accompanied by tenderness, and generally begins to subside in one week. Pain may linger more than three months.
People with osteoporosis may not even recall a fall or other trauma that might cause a broken bone, such as in the spine or foot. Spinal compression fractures may result in loss of height with a stooped posture (called a dowager's hump).
Fractures at other sites, commonly the hip or bones of the wrist, usually result from a fall.

DIAGNOSIS

A routine X-ray can reveal osteoporosis of the bone because the bones appear much thinner and lighter than normal bones. Unfortunately, by the time X-rays can detect osteoporosis, at least 30% of the bone has already been lost. In addition, X-rays are not accurate indicators of bone density. Thus, the appearance of the bone on X-ray often is affected by variations in the degree of exposure of the X-ray film.
The National Osteoporosis Foundation, the American Medical Association, and other major medical organizations recommend a dual-energy X-ray absorptiometry scan (DXA, formerly known as DEXA) be used for the diagnosis of osteoporosis. DXA typically measures bone density in the hip, the spine, and the forearm. The test takes only five to 15 minutes to perform, exposes patients to very little radiation (less than one-tenth to one-hundredth of the amount used on a standard chest X-ray), and is quite precise.
The bone density of the patient is compared to the average peak bone density of young adults of the same sex and race. This score is called the "T score" or T-score, and it expresses the bone density in terms of the number of standard deviations (SD) below peak young adult bone mass.
Osteoporosis is defined as a bone density T score of -2.5 or below.
Osteopenia (between normal and osteoporosis) is defined as bone density T score between -1 and -2.5.
It is important to note that while osteopenia is considered a lesser degree of bone loss than osteoporosis, it nevertheless can be of concern when it is associated with other risk factors that can increase the chances for developing vertebral, hip, and other fractures. In this setting, osteopenia may require medication as part of the treatment program.

BONE MINERAL DENSITY TESTING

The National Osteoporosis Foundation guidelines state that there are several groups of people who should consider DXA testing for proper diagnosis of bone health:
All postmenopausal women below age 65 who have risk factors for osteoporosis
All women aged 65 and older
Postmenopausal women with fractures, although this is not mandatory because treatment may well be started regardless of bone density
Women with any of more than 50 medical conditions associated with osteoporosis; a primary care physician can scan a patient's list of medical illnesses to determine if one of these conditions is present (see causes above)
Women whose decision to begin treatment for osteoporosis might be aided by bone density testing to determine the presence or absence of osteoporosis or osteopenia
The National Osteoporosis Foundation guidelines state that bone-density testing does not need to be performed if a person has a known osteoporotic fracture because the patient will be treated for osteoporosis with or without a bone-density study. In addition, bone-density testing is not appropriate if the person undergoing the test is not willing to take treatment based on the results. Therefore, if bone-density testing is done, it should be performed on people willing to take some specific action to improve their bone health based on the results.
Bone biopsy may be useful in unusual forms of osteoporosis. It provides information about rate of bone turnover and presence of secondary forms of osteoporosis. Patient with high bone turnover usually respond to antiresorptive drugs.


MANAGEMENT

General
Lifestyle changes, including quitting cigarette smoking, curtailing excessive alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin D
Exercise has a wide variety of beneficial health effects. However, exercise does not bring about substantial increases in bone density. The benefit of exercise for osteoporosis has mostly to do with decreasing the risk of falls, probably because balance is improved and/or muscle strength is increased. Research has not yet determined what type of exercise is best for osteoporosis or for how long it should be continued. Until research has answered these questions, most doctors recommend weight-bearing exercise, such as walking, preferably daily for optimal health.
Building strong and healthy bones requires an adequate dietary intake of calcium beginning in childhood and adolescence for both sexes.

Home Remedies
Some of the most effective home remedies for osteoporosis include the use of beans, vinegar, spinach, milk, pineapple juice, salmon, tofu, red clover, black   cohosh, yogurt, and calcium supplements, as well as behavioral modifications, including quitting smoking, cutting back on alcohol, maintaining a healthy weight, exercising, and reducing protein intake.
Milk - Arguably the most famous substance to help “build strong bones”, the calcium found in milk is a wonderful way to work a daily bone-boost into your diet and health regimen. A single glass of milk can represent one-quarter of the recommended daily amount.
Lower Protein Intake - Research has suggested that human beings actually consume more protein than is necessary for a healthy life, and the excretion of protein often includes excreting [13]calcium, which compounds the problems of osteoporosis
One of the newest findings concerning osteoporosis has to do with manganese deficiency, so ensuring a high level of that mineral can seriously help fend off bone degradation. Freshly squeezed pineapple juice is a rich source of manganese.
Excessive consumption of calcium to prevent osteoporosis can cause other problems, like calcium deposition that leads to gout, gall stones etc. Long-term treatment with calcium supplements is not recommended because some patients develop bone spurs, kidney and gall bladder stones due to calcium deposits. Discuss with trained medical professional about diet which is suitable for age before adding any major home remedies for osteoporosis.

HOMOEOPATHIC MANAGEMENT
The aim of homeopathy is not only to treat osteoporosis but to address its underlying cause and individual susceptibility. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. As far as therapeutic medication is concerned, several well-proved medicines are available for osteoporosis treatment that can be selected on the basis of cause, sensation and modalities of the complaints.
Homoeopathic remedies used in low potency doses can be a great part in the quest to nourish, build, and maintain strong, healthy, vitally intelligent and flexible bones.  Homoeopathically prepared minerals in particular help us to engage the energy of the foods, herbs, and exercise we also use to build and strengthen bone. Homoeopathics used in this way might be seen as reminders to our body’s intelligent foundation which directs nourishment and growth, Homoeopathy can also be a most useful bridge when even the best lifestyle efforts are failing to work well enough and you find yourself tempted to take calcium supplements. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. Some important remedies are given below for osteoporosis treatment:

Indicated Remedies
Indications

Calcaria Phos
it is an excellent remedy for osteoporosis. Delicate and easily breakable bones. The bones of the head are deficient in quality and quantity. This will promote the absorption of calcium from the food that the patient takes. The bones of the neck are too small and weak to support the head which is normally large. The bones of the extremities are also weak and fragile. Stools green, undigested and offensive. No appetite, it is a bone builder and creates new blood cells. It gives general tone to the entire organism.

Calcaria Carb
remarkable medicine for osteoporosis. Promotes the absorption of calcium

Calcaria Iod
should be thought of when there is deficiency of muscles and fat in addition to deficiency of bones. Unhealthy condition of glands is always present when this remedy is indicated.

Silicea

People who need this remedy are often nervous, easily tired, very chilly, and tend to sweat at night. They have a refined or delicate appearance, and often have weakness in the spine. Their injuries are slow to heal, and they tend to have a low resistance to infection. Moderate exercise often warms the person up and improves energy.

Phosphorus


This remedy is often helpful to people who are sensitive, suggestible, imaginative, but easily tired or weakened physically. Bones may be less strong than normal, or be slow to heal after fractures. Weakness is often felt in the spine, with burning pain between the shoulder blades. People who need this remedy are often tall and thin with an easily-flushing face. A desire for refreshing foods (especially ice cream) and strong thirst for cold or carbonated drinks are other indications for Phosphorus

Symphytum
When osteoporosis is a problem, fractures often occur from mild trauma. This remedy can be useful for strengthening and healing bones when new fractures occur, and also helpful when pain persists in old, healed fractures (see Fractures).

Osteocynesine
Homoeopathic calcium tablets
French and Czech teams reported beneficial effects of a complex homeopathic medicine Osteocynesine in osteoporosis in menopausal women. Women got bone density tests before and after 3- and 6-month treatment with Osteocynesine that contains homeopathic dilutions of Calcarea carbonica, Calcarea phosphorica, Calcarea fluorica and Sulphur iodatum. The follow-ups showed increase of bone density.

HIGH BLOOD PRESSURE (HYPERTENSION) - ITS MODERN UNDERSTANDING AND HOMOEOPATHIC APPROACH

                                                                                               

Hypertension or high blood pressure, sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevated. Hypertension, or abnormally high blood pressure, is often referred to as the “silent killer.” This is because it does not usually manifest any symptoms while causing damage to the heart, brain, kidneys, and eyes. By hearing the word Blood Pressure, People himself thinks that it’s a serious disease likewise but fact is that increased blood pressure than its normal range is not merely a disease by itself, but a sign or manifestation of a pathological process.

According to the World Health Organization, “Hypertension affects 600 million people worldwide. Yet many are unaware that they have the disease and are at risk of developing a stroke, heart disease, blindness and kidney failure. Hypertension causes five million premature deaths per year, yet there is no proper solution for curing hypertension.”

High blood pressure seems to be more common in modern times. Intensive struggle for existence associated with continual anxiety, greed, ambition, artificial methods of living, want of faith in religion, intemperance, irregular hours, adulterated and unwholesome food and many vices peculiar to modern civilization do play an important part in its causation. With the advancement of medical sciences and the invention of sphygmomanometer, the detection of hypertension become very easy and patient myself inclined to check there blood pressure in frequent intervals and more cases are brought to the notice of the physicians.

Normal blood pressure at rest is within the range of 100– 140mmHg systolic and 60–90mmHg diastolic. High blood pressure is said to be present if it is often at or above 140/90 mmHg.

Causes of Hypertension

Hypertension is classified as either primary (essential) hypertension or secondary hypertension; about 90–95% of cases are categorized as "primary hypertension" which means high blood pressure with no obvious underlying medical cause. The remaining 5–10% of cases (secondary hypertension) are caused by other conditions that affect the kidneys, arteries, heart or endocrine system. In females the prevalence is closely related to age, with a substantial increase occurring after age 50. This increase is presumably related to the hormonal changes of menopause. The ratio of hypertension frequency in women versus men increases from 0.6 to 0.7 at age 30 to 1.1 to1.2 at age 65.

Primary (essential) hypertension - For most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years.

Secondary hypertension - Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:

Kidney problems, Adrenal gland tumors, Thyroid problems, Certain defects in blood vessels congenitaly, Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs, Illegal drugs, such as cocaine and amphetamines, Alcohol abuse or chronic alcohol use, Obstructive sleep apnea.

Risk Factors

Strong familial and genetic predisposition and a number of modifiable predisposing factors have also been identified. Several studies have demonstrated the influences of Weight gain, Insulin resistance, Salt intake, Physically inactive, Mental stress, Tobacco Smoking Alcohol use, Elevated haematocrit, Hypertriglyceridaemia and Rapid heart rate. Sometimes pregnancy contributes to high blood pressure, as well. Although high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits, such as an unhealthy diet, obesity and lack of exercise, contribute to high blood pressure.

Clinical manifestations

Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms usually don't occur until high blood pressure has reached a severe or life threatening stage.

American Heart Association, Recommended Blood Pressure Levels are

1.      Optimal Level < 120 / 80, it should be rechecked in every 2 years.

2.      Normal Level < 130 / 85, it should be rechecked in every 2 years.

3.      High Normal Level <130 – 139 / 85 – 90 it should be rechecked in every 1 years.

Diagnosis

Blood pressure measurements fall into four general categories:

Normal blood pressure - blood pressure is normal if it's below 120/80 mm Hg. Once blood pressure rises above 120/80 mm Hg, the risk of cardiovascular disease begins to increase.

Prehypertension - Prehypertension is a systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Prehypertension tends to get worse over time.

Stage 1 hypertension - Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg.

Stage 2 hypertension - More severe hypertension, stage 2 hypertension is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher.

Both numbers in a blood pressure reading are important. But after age 60, the systolic reading is even more significant. Isolated systolic hypertension — when diastolic pressure is normal but systolic pressure is high — is a common type of high blood pressure among people older than 60.

White coat high blood pressure

A single elevated blood pressure reading in the doctor's office can be misleading because the elevation may be only temporary. It may be caused by a patient's anxiety related to the stress of the examination and fear that something will be wrong with his or her health. The initial visit to the physician's office is often the cause of an artificially high blood pressure that may disappear with repeated testing after rest and with follow-up visits and blood pressure checks. One out of four people that are thought to have mild hypertension actually may have normal blood pressure when they are outside the physician's office. An increase in blood pressure noted only in the doctor's office is called 'white coat hypertension.' The name suggests that the physician's white coat induces the patient's anxiety and a brief increase in blood pressure. A diagnosis of white coat hypertension might imply that it is not a clinically important or dangerous finding. However, caution is warranted in assessing white coat hypertension. An elevated blood pressure brought on by the stress and anxiety of a visit to the doctor may not necessarily always be a harmless finding since other stresses in a patient's life may also cause elevations in the blood pressure that are not ordinarily being measured. Monitoring blood pressure at home by blood pressure cuff or continuous monitoring equipment or at a pharmacy can help estimate the frequency and consistency of higher blood pressure readings. Additionally, conducting appropriate tests to search for any complications of hypertension can help evaluate the significance of variable blood pressure readings.

Borderline high blood pressure

Borderline hypertension is defined as mildly elevated blood pressure higher than 140/90 mm Hg sometimes, and lower than that at other times. As in the case of white coat hypertension, patients with borderline hypertension need to have their blood pressure taken on several occasions and their end organ damage assessed in order to establish whether their hypertension is significant. People with borderline hypertension may have a tendency as they get older to develop more sustained or higher elevations of blood pressure. They have a modestly increased risk of developing cardiovascular disease. Therefore, even if the hypertension does not appear to be significant initially, people with borderline hypertension should have continuing follow-up of their blood pressure and monitoring for the complications of hypertension.

If, during the follow-up of a patient with borderline hypertension, the blood pressure becomes persistently higher than 140/ 90 mm Hg, an antihypertensive medication is usually started. Even if the diastolic pressure remains at a borderline level (usually less than 90 mm Hg, yet persistently above 85) treatment may be started in certain circumstances.

Complications of hypertension:

In the beginning hypertension is labile, but in due course, it becomes established hypertension. The complications are more common in higher blood pressures. The accompanying arteriosclerosis may be the reason for cardiovascular diseases in uncontrolled hypertension; Ischemic heart diseases like angina pectoris, myocardial infarction or congestive heart failure. 50% of patients die, 33% get cerebral strokes, 15% get renal failure. Renal failure is more common in hypertension with diabetes as the patients suffer from proteinuria, which is an evidence of nephropathy.

The complications are classified into two types-

Hypertensive complications like Malignant hypertension, Congestive cardiac failure Aortic dissection and aneurysm, Nephrosclerosis, Cerebral hemorrhages and infarctions

Atherosclerotic complications like Ischemic heart diseases like angina pectoris and myocardial infractions, Sudden death, Arrhythmias, Cerebral thrombotic strokes, Peripheral vascular diseases

Home Remedies for High Blood Pressure:

• Bananas are one fruit that people with high blood pressure can eat regularly to control it. Bananas are a rich source of potassium, which helps control blood pressure levels. At the same time, they are low in sodium and have no cholesterol, both of which also are good for people with this problem.
• Coconut Water - People with high blood pressure must keep their bodies well hydrated. It is a good idea to drink eight to 10 glasses of water daily. Coconut water is particularly beneficial for lowering blood pressure.
• Black seed oil contains a number of active ingredients that have been shown to help reduce cholesterol and control high blood pressure. Therefore, to reduce excess blood pressure simply take one teaspoon of Black Seed oil daily. Black Seed Oil can also be mixed into juice or tea if you don't like the taste of the raw oil.
• Garlic has also been known to help reduce high blood pressure. Although the exact reasons are still not clear, studies have shown that eating just a single clove a day (either raw or cooked) has a beneficial effect. An added bonus for eating garlic is that it is also known to reduce cholesterol. Therefore, regularly consuming garlic, either fresh or in capsule form, is a great way to reduce your risk of heart disease.
• Lemons help keep blood vessels soft and pliable and by removing any rigidity, high blood pressure will be reduced. In addition, you can help lower your chance of heart failure by consuming lemon juice regularly, due to its vitamin B content.
• Ginkgo Biloba is an herb which helps increase blood circulation in our bodies by dilating our blood vessels. Therefore, asimple remedy to lower blood pressure is to take 120mg of Ginkgo Biloba extract daily before any meal.
• Watermelon seeds contain a compound called cucurbocitrin, which helps widen the blood capillaries. At the same time, it also helps improve kidney functioning. This in turn reduces blood pressure levels and also helps a lot with arthritis.

HOMOEOPATHIC MANAGEMENT

Homoeopathy considers health as a state indicating harmonious functioning of the life force. Disease is a deviation from health, which develops when the life force is unable to overcome obstructions to its smooth functioning. Being a chronic disease, it requires constitutional, antimiasmatic treatment. It is the totality of symptoms which guides the homoeopath to the indicated remedy. A constitutional remedy chosen by an experienced prescriber is the most appropriate way to treat deep-seated, serious, or chronic conditions. Some remedies may be useful as first-aid in intense situations, but medical care should also be sought immediately. Remedies below have been helpful to some people with hypertension.

Indicated Remedies	Indications
Argentum nitricum	If blood pressure rises with anxiety and nervousness, this remedy may be indicated. “Stage fright” or anticipation of a stressful event can bring on dizziness, headache, diarrhea, and a pounding pulse. People who need this remedy are typically warm-blooded, imaginative, impulsive, claustrophobic, and have strong cravings for sweets and salt.
Aurum metallicum	This remedy is sometimes indicated for serious people, focused on career and accomplishment, with blood pressure problems related to stress. Worry, depression, or anger may occur, especially when these people feel they have made a mistake or failed in some way. A general tendency to feel worse at night, and a strong desire for alcohol, sweets, bread, and pastries are other indications for Aurum.
Belladonna	This remedy is indicated when symptoms come on suddenly, with great intensity and heat. The person’s face is flushed, with dilated pupils, and pulsations and throbbing may be felt in various parts of the body. Despite the general heat, the person’s hands and feet may be cold. Vertigo and pounding headaches, worse from jarring and worse from light, may also occur.
Calcarea carbonica	This remedy is often helpful to people with high blood pressure who easily tire and have poor stamina. They are typically responsible types, who feel overwhelmed when ill and fear a breakdown. Palpitations and breathing problems can be worse from walking up a slope or stairs, and also when lying down. A general chilliness with clammy hands and feet (the feet may heat up in bed at night) and sweat on the head during sleep are other indications. The person may have cravings for sweets and eggs, and tend toward weight problems.
Glonoinum	A flushed face with a pounding headache and visible throbbing in the blood vessels of the neck may indicate a need for this remedy. The chest can feel congested or hot, with a pounding or irregular heartbeat. The person is worse from moving around, after heat and sun exposure, and after drinking alcohol. A feeling of “being lost in a familiar place” is a strong indication for this remedy.
Lachesis	A person who needs this remedy typically is intense and talkative, with inner passion and agitation that need an outlet—a “pressure-cooker.” The person may have a strong fear of disease, and feelings of suspicion, revenge, or jealousy are common. The person may also have heart or artery problems, look flushed or purplish, and feel constriction in the chest, with pulsations in many areas. Feeling worse after taking a nap or on waking in the morning, and a strong intolerance of clothing around the neck (or any kind of restriction) are other indications for Lachesis.
Natrum muriaticum	A person who needs this remedy seems reserved and responsible, but may have very strong feelings (of grief, disappointment, anger, lingering grudges, a fear of misfortune) inside. Headaches and palpitations are common, as well as a feeling of tension (even coldness) in the chest. The person feels worse from being in the sun, worse around midmorning, and better from being alone in a quiet place. A craving for salt and strong thirst can help to confirm the choice of this remedy.
Nux vomica	A person who needs this remedy is usually impatient and driven—easily frustrated, angered, and offended. A strong desire for coffee and other stimulants, sweets, strong foods, and alcohol or drugs may aggravate blood pressure problems. Palpitations, constricting feelings in the chest, constipation, and hemorrhoids are often seen. The person is typically sensitive to light, noise, odors, and interference.
Phosphorus	A person who needs this remedy usually is sensitive, suggestible, and sympathetic, with a tendency toward weakness, dizziness, a “spaced-out” feeling, and fearfulness. Nosebleeds, facial flushing, palpitations, and a feeling of heaviness or pain in the chest, and left-sided problems are often seen. A strong desire for cold drinks and refreshing things, and a marked improvement after eating and sleeping are other indications for Phosphorus.
Plumbum	This remedy is indicated for people with degenerative problems of the nerves and hardening of the arteries. Chest tightness and palpitations are often worse when lying on the left side. Contractures, paralysis, and nerve or muscle problems are also likely. The person may have a history of heavy drinking and “high living”—becoming apathetic or depressed when physical debility and memory problems develop.
Sanguinaria	A feeling that blood is rushing to the head, with flushed red cheeks and pulsing in the neck, may indicate this remedy. The person may have headaches or migraines (usually on the right and worse from light and noise). Right-sided neck and shoulder problems, allergies, heartburn, and digestive problems are often seen, and burning pains are typical. Symptoms are worse from motion, and relief may come from being in the dark and sleeping. A craving for spicy food, and a tendency to feel worse from eating sweets are other indications for Sanguinaria.
Terminalia Arjuna	A great remedy for heart maladies. Highly effective in cases of high blood pressure with vertigo, palpitation and a sense of mental and physical exhaustion. It is a good remedy for diseases of the heart, both organic and functional, angina pectoris, weakness and pain in the heart.
Viscum Album	Feeling of suffocation when lying on the left side. Stertorous breathing. Spasmodic cough. Arterial hypertension with valvular insufficiency. Unable to rest in a reclining position. Oedematous swelling of the extremities. Teeth chatter. Eyes sleepy, difficult to open, lids heavy. Bowels obstinately constipated. Urine milky-white after standing. Palpitation during coitus. Heart gives a throb and then a pause. Pulse small, quick and very irregular, slow, full and bounding. Low tension due to dilated blood vessels.
Ignatia Amara	Indicated in high blood pressure due to emotions, disappointed love and/or grief. Fluttering of the muscles of chest. Throbbing cardiac hyperaesthesia. Anxious feeling in precordia. Difficult respiration, as if there is some weight on the chest, shortness of breath when walking. Feeling of suffocation on running. Palpitation of the heart at night. Strong disposition to be frightened. Sadness and concentrated sorrow with sighing. Loves solitude.

IRRITABLE BOWEL SYNDROME (IBS) – PSYCHOSOMATIC HOMOEOPATHIC APPROACH

Irritable bowel syndrome (IBS) is a mix of belly discomfort or pain and trouble with bowel habits, it is a functional bowel disorder characterized by mild to severe abdominal pain, discomfort, bloating and alteration of bowel habits. In some cases, the symptoms are relieved by bowel movements. Diarrhoea or constipation may predominate, or they may alternate.

It’s not life-threatening, and it doesn't make more likely to get other colon conditions, such as ulcerative colitis, Crohn's disease, or colon cancer. But IBS can be a long-lasting problem that changes life. People with IBS may miss work or school more often, and they may feel less able to take part in daily activities. Some people may need to change their work setting like shifting to working at home, changing hours, or even not working at all.

IBS is diagnosed when a person has abdominal pain or discomfort at least three times per month for the last 3 months without other disease or injury that could explain the pain. The pain or discomfort of IBS may occur with a change in stool frequency or consistency or may be relieved by a bowel movement.

CAUSES:

The causes of IBS are not well understood. Researchers believe a combination of physical and mental health problems can lead to IBS. Studies suggest that the colon gets hypersensitive, overreacting to mild stimulation. Instead of slow, rhythmic muscle movements, the bowel muscles spasm. That can cause diarrhea or constipation. The possible causes of IBS include the following:

·         Brain-gut signal problems - Signals between the brain and nerves of the small and large intestines, also called the gut, control how the intestines work. Problems with brain-gut signals may cause IBS symptoms, such as changes in bowel habits and pain or discomfort.

·         GI motor problems: Normal motility, or movement, may not be present in the colon of a person who has IBS. Slow motility can lead to constipation and fast motility can lead to diarrhea. Spasms, or sudden strong muscle contractions that come and go, can cause abdominal pain. Some people with IBS also experience hyperreactivity, which is an excessive increase in contractions of the bowel in response to stress or eating.

·         Mental health problems: Mental health, or psychological, problems such as panic disorder, anxiety, depression, and post-traumatic stress disorder are common in people with IBS. The link between these disorders and development of IBS is unclear. GI disorders, including IBS, are often found in people who have reported past physical or sexual abuse. Researchers believe people who have been abused tend to express psychological stress through physical symptoms.

·         Bacterial gastroenteritis: Some people who have bacterial gastroenteritis—an infection or irritation of the stomach and intestines caused by bacteria—develop IBS. Researchers do not know why gastroenteritis leads to IBS in some people and not others, though psychological problems and abnormalities of the lining of the GI tract may be factors.

·         Small intestinal bacterial overgrowth (SIBO): Normally, few bacteria live in the small intestine. SIBO is an increase in the number of bacteria or a change in the type of bacteria in the small intestine. These bacteria can produce excess gas and may also cause diarrhea and weight loss. However, the studies were weak and more research is needed to show a link between SIBO and IBS.

·         Body chemicals: People with IBS have altered levels of neurotransmitters, which are chemicals in the body that transmit nerve signals, and GI hormones, though the role these chemicals play in developing IBS is unclear.

·         Food sensitivity: Many people with IBS report that certain foods and beverages can cause symptoms, such as foods rich in carbohydrates, spicy or fatty foods, coffee, and alcohol. However, people with food sensitivity typically do not have clinical signs of food allergy. Researchers have proposed that symptoms may result from poor absorption of sugars or bile acids, which help break down fats and get rid of wastes in the body.

·         IBS can occur at any age, but it often begins in the teen years or early adulthood. It is twice as common in women as in men.

STRESS AND IBS :

Stress can stimulate colon spasms in people with IBS. The colon has many nerves that connect it to the brain. These nerves control the normal contractions of the colon and cause abdominal discomfort at stressful times. In people with IBS, the colon can be overly responsive to even slight conflict or stress. Stress makes the mind more aware of the sensations that arise in the colon. IBS symptoms can also increase a person’s stress level. Some options for managing stress include

·         participating in stress reduction and relaxation therapies such as meditation

·         getting counseling and support

·         taking part in regular exercise such as walking or yoga

·         minimizing stressful life situations as much as possible

·         getting enough sleep

SYMPTOMS

Symptoms range from mild to severe. Most people have mild symptoms. Symptoms are different from person to person.

The main symptoms of IBS are abdominal pain, fullness, gas, and bloating that have been present for at least 3 days a month for the last 3 months. The pain and other symptoms will often:

·         Be reduced or go away after a bowel movement

·         Occur when there is a change in how often you have bowel movements

People with IBS may switch between constipation and diarrhea, or mostly have one or the other.

·         People with diarrhea will have frequent, loose, watery stools. They will often have an urgent need to have a bowel movement, which may be hard to control.

·         Those with constipation will have a hard time passing stool, as well as fewer bowel movements. They will often need to strain and will feel cramps with a bowel movement. Often, they do not release any stool, or only a small amount.

·         For some people, the symptoms may get worse for a few weeks or a month, and then decrease for a while. For other people, symptoms are present most of the time.

·         People with IBS may also lose their appetite.

INVESTIGATIONS:

There is no test to diagnose IBS, simple physical examinations and complete medical history is enough. The medical history will include questions about symptoms, family history of GI disorders, recent infections, medications, and stressful events related to the onset of symptoms.

Additional diagnostic tests may be needed based on the results of the screening blood test and for people who also have signs such as fever, rectal bleeding, weight loss, anemia, family history of colon cancer, irritable bowel disease. Additional diagnostic tests may include a stool test, lower GI series, and flexible sigmoidoscopy or colonoscopy. Colonoscopy may also be recommended for people who are older than 50 to screen for colon cancer.

GENERAL MANAGEMENT:

The goal of treatment is to relieve symptoms.

Lifestyle changes can help in some cases of IBS. For example, regular exercise and improved sleep habits may reduce anxiety and help relieve bowel symptoms.

Dietary changes can be helpful. However, no specific diet can be recommended for IBS, because the condition differs from one person to another.

Large meals can cause cramping and diarrhea, so eating smaller meals more often, or eating smaller portions, may help IBS symptoms. Eating meals that are low in fat and high in carbohydrates, such as pasta, rice, whole-grain breads and cereals, fruits, and vegetables, may help.

Certain foods and drinks may cause IBS symptoms in some people, such as

·         foods high in fat

·         milk products

·         drinks with alcohol or caffeine

·         drinks with large amounts of artificial sweeteners, which are substances used in place of sugar

·         foods that may cause gas, such as beans and cabbage

People with IBS may want to limit or avoid these foods. Keeping a food diary is a good way to track which foods cause symptoms so they can be excluded from or reduced in the diet.

Dietary fiber may lessen constipation in people with IBS, but it may not help with lowering pain. Fiber helps keep stool soft so it moves smoothly through the colon. The Academy of Nutrition and Dietetics recommends consuming 20 to 35 grams of fiber a day for adults. Fiber may cause gas and trigger symptoms in some people with IBS. Increasing fiber intake by 2 to 3 grams per day may help reduce the risk of increased gas and bloating.

Therapies for Mental Health Problems

The following therapies can help improve IBS symptoms due to mental health problems:

Talk therapy. Talking with a therapist may reduce stress and improve IBS symptoms. Two types of talk therapy used to treat IBS are cognitive behavioral therapy and psychodynamic, or interpersonal, therapy. Cognitive behavioral therapy focuses on the person’s thoughts and actions. Psychodynamic therapy focuses on how emotions affect IBS symptoms. This type of therapy often involves relaxation and stress management techniques.

Hypnotherapy. In hypnotherapy, the therapist uses hypnosis to help the person relax into a trancelike state. This type of therapy may help the person relax the muscles in the colon.

Mindfulness training. People practicing this type of meditation are taught to focus their attention on sensations occurring at the moment and to avoid worrying about the meaning of those sensations, also called catastrophizing.

HOMEOPATHIC 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.

Indicated Remedies	Indications
Argentum nitricum:	Digestive upsets accompanied by nervousness and anxiety suggest the use of this remedy. Bloating, rumbling flatulence, nausea, and greenish diarrhea can be sudden and intense. Diarrhea may come on immediately after drinking water. Eating too much sweet or salty food (which the person often craves) may also lead to problems. A person who needs this remedy tends to be expressive, impulsive, and claustrophobic, and may have blood sugar problems.
Asafoetida	A feeling of constriction all along the digestive tract (especially if muscular contractions in the intestines and esophagus seem to be moving in the wrong direction) strongly indicates this remedy. The person may have a feeling that a bubble is stuck in the throat, or that a lump is moving up from the stomach. The abdomen feels inflated, but the person finds it hard to pass gas in either direction to get relief. Constipation brings on griping pains. Diarrhea can be explosive, and the person may even regurgitate food in small amounts.The person may exhibit a strong emotional or “hysterical” element when this remedy is needed.
Colocynthis	This remedy is indicated when cutting pains and cramping occur, making the person bend double or need to lie down and press on the abdomen. Cramps may be felt in the area of the pubic bone. Pain is likely to be worse just before the diarrhea passes, and after eating fruit or drinking water. Problems tend to be aggravated by emotions, especially if indignation or anger has been felt but not expressed. Back pain, leg pain, and gall bladder problems are sometimes seen when this remedy is needed.
Lilium tigrinum	When this remedy is indicated, the person may make frequent unsuccessful efforts to move the bowels all day and have sudden diarrhea the following morning. A feeling of a lump in the rectum, worse when standing up, is common. Hemorrhoids may develop. Constricting feelings are often felt in the chest. The person is likely to be worse from excitement and strong emotions, and may tend toward irritability or even rage.
Lycopodium	This remedy is often indicated for people with chronic digestive discomforts and bowel problems. Bloating and a feeling of fullness come on early in a meal or shortly after, and a large amount of gas is usually produced. Heartburn and stomach pain are common, and the person may feel better from rubbing the abdomen. Things are typically worse between four and eight p.m. Despite so many digestive troubles, the person can have a ravenous appetite, and may even get up in the middle of the night to eat. Problems with self-confidence, a worried facial expression, a craving for sweets, and a preference for warm drinks are other indications forLycopodium.
Natrum carbonicum	This remedy is often indicated for mild people who have trouble digesting and assimilating many foods and have to stay on restricted diets. Indigestion, heartburn, and even ulcers may occur if offending foods are eaten. The person often is intolerant of milk, and drinking it or eating dairy products can lead to gas and sputtery diarrhea with an empty feeling in the stomach. The person may have cravings for potatoes and for sweets (and sometimes also milk, but has learned to avoid it). A person who needs this remedy usually makes an effort to be cheerful and considerate, but, when feeling weak and sensitive wants to be alone to rest.
Nux vomica	Abdominal pains and bowel problems accompanied by tension, constricting sensations, chilliness, and irritability can indicate a need for this remedy. Soreness in the muscles of the abdominal wall, as well as painful gas and cramps are common. Firm pressure on the abdomen brings some relief. When constipated, the person has an urge to move the bowels, but only small amounts come out. The person may experience a constant feeling of uneasiness in the rectum. After diarrhea has passed, the pain may be eased for a little while. A person who needs this remedy often craves strong spicy foods, alcohol, tobacco, coffee, and other stimulants—and usually feels worse from having them.
Podophyllum	This remedy is indicated when abdominal pain and cramping with a gurgling, sinking, empty feeling are followed by watery, offensive-smelling diarrhea—alternating with constipation, or pasty yellow bowel movements containing mucus. Things tend to be worse in the very early morning, and the person may feel weak and faint or have a headache afterward. Rubbing the abdomen (especially on the right) may help relieve discomfort. A person who needs this remedy may also experience stiffness in the joints and muscles.
Sulphur	This remedy is often indicated when a sudden urge toward diarrhea wakes the person early in the morning (typically five a.m.) and makes them hurry to the bathroom. Diarrhea can come on several times a day. The person may, at other times, be constipated and have gas with an offensive and pervasive smell. Oozing around the rectum, as well as itching, burning, and red irritation may also be experienced. A person who needs this remedy may tend to have poor posture and back pain, and feel worse from standing up too long.