January 2010 | Vol 7 | Issue 1

January 2010 | Volume 7 | Issue 1

 

case
 
A case of Ulcerative Colitis
 



 



Dr.R.Jayasudha
Raj Homoeo Health Care Centre
Salem-Attur Main Road
Hasthampatti, Peddanaickenpalayam
Salem - 636109
9443048440, 9715687447


    Introduction:

       Dr.Jayasudha, a young homoeopath takes much initiative to present the case studies with evidence based applications. She is highly enthusiastic in studies and practice. Here she presents a case of Chronic ulcerative colitis with evidence based studies.

       A 35 year old male, driver by profession, presented the complaints of
    · Bleeding per rectum with oozing of mucus since 5 years
    · Increased frequency of stool since 5 years

    History of presenting complaints
    Initially the patient experienced increased frequency of stool, passed stool 8 – 10 times per day .The stool was loose with mucus and alternated with hard pellety stool, the stool was very offensive and painful during passing.
    Flatulence experienced loud during expulsion, loud and he didn’t know weather he passed stool or flatus. The yellowish stool was passed along with blood and yellowish mucus. Pain was stitching after stool, felt in the rectum for hours together with bleeding sometimes.
    The complaints caused anxiety while eating and using toilet. Frequency disturbed his sleep. He felt pain in the left ileoceacal region.

    Past history
    He had headache in the past and underwent allopathic treatment. He was under the care of a Gastro enterologist for the presenting complaints since 6 months.

    Family history
    Nothing significant

    Personal history
    He was addicted to alcohol, pan, chewing and smoking

    Physical generals
    Appetite is good and takes at regular intervals
    Thirst: Good, regular, satisfied
    Cravings: Mutton++
    Sleep: Decreased due to occupation and disturbed with least noise
    Urine: Day/5-6 times, night /1-2 times

    Mental generals
    He is a driver by profession, has to drive continuously for a long time with loss of sleep. One time he was unfortunate to see a fire accident of his friend’s vehicle and it grounded for his anxiety and fear while driving. Gradually he developed the digestive complaints.
    Anxiety – Hypochondriac
    Anxiety – Loss of sleep
    Anxiety – long lasting
    Obstinate
    Hatred
    Fear of Accident

    General examination
    Appearance: Oily dark and Anaemic

    Systemic examination
    Mild tenderness over the left ileocaecal region

    Investigation report
    Sigmoidoscopy impressed that severe distal ulcerative colitis
    The rectum was with multiple exudates++, multiple petechial haemorrhages ++ and few polyps
    The sigmoid colon presented with exudates++, multiple petechial haemorrhage+ few polyps up to 40cm (Refer plate I)



    Provisional Diagnosis
    Distal ulcerative colitis (severe)
    Totality of symptom and Repertorial Analysis
    [Kent Repertory with Generalities]
    Obstinate
    Hatred
    Anxiety-loss of sleep
    Anxiety - Hypochondriac
    Anxiety - long lasting
    Fear of accidents
    Hot patient
    Anaemia
    Cravings - mutton++
    Startles in sleep with least noise
    Stool-Diarrhoea alters with constipation
    Stool-Haemorrhage
    Stool-Offensive +
    Sweat - profuse - offensive++
    Stool - Anxiety from
    Abdomen-ulcerating pain
    Pain ilieocaecal region

    Remedy Analysis
    Nitric acid
    Arsenicum album
    Sulphur

    Miasmatic Cleavage



    Fundamental Miasm: Psora

    Dominant Miasm: Syphilis

    Hahnemann’s classification of Disease: Fully developed chronic mixed miasmatic disease.

    Plan of Treatment
    It’s the chronic disease of syphilitic and Psoric miasm. A remedy based on miasmatic and constitutional is considered. First the syphilis is to treat and the Psoric manifestations

    Remedy of Choice
    Nitric Acid – the right choice as it constitutionally, miasmatically and symptomatically selected as similimum

    Potency selection
    Nitric acid – 30C is selected as it is the minimum dose with the susceptibility of the patient.

    First Prescription 28.8.2008
    R/x
    Nitric acid 30 – 1 globule in 15 ml of aqueous solution thrice daily 2 drops for 15 days with 8 succession for 1st week and 10 succession for later 1 week.



     




    Investigation Report on 10.7.09
    Normal CT Colonography. No abnormality in the large bowel. (refer plate II)



    Conclusion
    As Ulcerative Colitis is a fully developed mixed chronic miasmatic disease has responded well to the miasmatic and constitutional treatment.the similimum has matched the constitution, miasm and totality of the patient.