Dr Swati Sharma
Abstract: Acute abdomen is a condition that demands immediate attention and treatment. Approximately 50% cases are admitted to general surgical units urgently. It may be caused by an infection, inflammation, vascular occlusion or obstruction. This condition is a challenge for homoeopathic management, many studies signify the effectiveness of homoeopathic medicines in acute abdominal pain. This article is an attempt to overview about acute abdominal pain and its homoeopathic therapeutic approach.
Keywords: acute abdominal pain, homoeopathic medicines.
Introduction: Acute abdomen refers to a sudden, severe abdominal pain and is considered a medical emergency requiring immediate diagnosis and care. It is a consequence of one or more pathological processes.[1]
Causes and clinical features:[1]
- Inflammation: Pain develops gradually and movements exacerbates pain with abdominal guarding.
| Appendicitis | Pancreatitis |
| Diverticulitis | Pyelonephritis |
| Cholecystitis | Intra-abdominal abscess |
| Pelvic inflammatory disease |
2. Perforation: when a viscus perforates, pain starts abruptly and its severe and leads to generalized peritonitis.
| Peptic ulcer | Ovarian cyst |
| Diverticular disease | Aortic aneurysm |
- Obstruction: colicky pain with spasms which compel the patient to double up. Colicky pain which does not disappear between spasms suggests complicating inflammation.
| Intestinal obstruction | Ureteric calculi |
| Biliary colic |
Investigations:[1]
- Full blood count, urea, electrolytes and amylase taken to look evidence of dehydration, leucocytosis and pancreatitis.
- An erect chest X-ray may show air under the diaphragm, suggestive of perforation and a plain abdominal film may show evidence of obstruction or ileus.
- Abdominal ultrasound may help if gallstones or renal stones suspected and also useful in dection of free fluid or any intra abdominal abscess.
- Contrast studies by either mouth or anus to rule out intestinal obstruction.
- CT scan and angiography.
- Diagnostic laparotomy should be considered when the diagnosis has not been revealed by other investigations.
- All patients must be carefully and regularly re-assessed every 2-4 hours so that any change in condition that might help in diagnosis and clinical decision.
Homoeopathic management:[2,3]
Homoeopathic medicines are prescribed on the basis of individualization and symptom similarity by using holistic approach. Several remedies are available to treat acute abdominal pain on the basis of cause, sensation and modalities of the complaints. Therapeutic indications of acute abdominal pain are as follows:
- Aconitum napellus: Hot, tense, enteritis. Sensitive to touch. Colic, no position relieves. Pains are intolerable, they drive him crazy; restless; at night. Abdominal symptoms are better after warm soup. Burning in the umbilical region.
- Aloe socotrina: Pulsating pain around navel, worse pressure. Cutting, gripping pain under the right ribs or in the right hypochondrium, right lower portion of the abdomen; excruciating before and during stool; all pain ceases after stool, leaving profuse sweating and extreme weakness; copious flatus.
- Belladonna: Distended, hot. Transverse colon protrudes like a pad. Tender, swollen. Pain as if clutched by a hand; worse jar, pressure. Cutting pain across; stitches on the left side of abdomen, when coughing, sneezing or touching it. Extreme sensitiveness to touch, to bed-clothes.
- Chamomilla: Flatulent colic, after anger with red cheeks and hot perspiration. Hepatic colic, acute duodenitis.
- Colchicum autumnale: Ascites. Borborygmi. Pain over liver region. Caecum and ascending colon distended. Autumnal dysentery; white mucus ‘scrapings of intestines’.
- Colocynthis: Agonising pain in abdomen causing patient to bend double with restlessness, twisting and turning to obtain relief >by hard pressure.
- Dioscorea villlosa: Feeble digestive powers. Violent twisting colic, in paroxysms, as if intestines were grasped by powerful hand. Colic pains <from bending forward and while lying >on standing erect or bending backwards.
- Dulcamara: Colic from cold. Acts prominently on umbilical region. Cutting pain around the navel. Swelling of the inguinal gland.
- Lycopodium: Hepatitis, atrophic form nutmeg liver. Pain shooting across the lower abdomen, from right to left. Abdomen bloated, constant sense of fermanetation, like yeast.
- Mag phos: Enteralgia, relived by pressure. Flatulent colic, forcing the patient to bend double; relieved by rubbing, warmth, pressure; accompanied with belching of gas, which gives no relief. Bloated abdomen, must loosen clothing, walk about and constantly pass flatus.
- Nux vomica: Flatulent distention with spasmodic colic. Colic from uncovering. Liver engorged, with stitches and soreness. Colic with upward pressure, causing short breath. Strangulated hernia.
- Plumbum metallicum: Excessive colic, radiating to all parts of body. Abdominal wall feels drawn by a string to the spine. Intussusceptions; strangulated hernia. Abdomen retracted, obstructed flatus with intense colic. Colic alternates with delirium and pain in atrophic limbs.
- Polygonum punctatum: Griping pain, with great rumbling, nausea and liquid faeces. Flatulent colic.
- Trombidium muscae: Severe pain before and after stool; stool only after eating. Gripping in the hypochondrium, in the morning. Hepatitis, brown, thin, watery stool with tenesmus.
Discussion and conclusion:
The acute abdomen is an emergency condition in which physician can go for quick prescription through therapeutic approach and give relief to the patient’s condition as soon as possible.
References:
- Walker RB, Colledge RN, Ralston HS, Penman DI. Davidson’s Principles and Practice of Medicine. 22nd edition. China:Churchill Livingstone Elsevier;2014. Chapter 22. The acute abdomen;pg.861-862.
- Boericke William. Boerike’s new manual of homoeopathic materia medica with repertory. Third edition. New Delhi: B. Jain Publishers (P) Ltd.; 2000.
- Allen HC. Allen’s keynotes with leading remedies of the materia medica and bowel nosodes. Tenth edition. New Delhi: B. Jain Publishers (P)Ltd.; 2005.
Dr. SWATI SHARMA
PG Scholar Department of Homoeopathic Materia medica, Swasthya Kalyan Homoeopathic Medical College and Research Centre, Sitapura, Jaipur (Raj.).
healthy abdomen healthy food assimilation pure blood formation nourishes tissues.fast swallowing puts extra load on tummy ought to have been done by teeth mastication.anger creates heat called pitta roga by ayurveds.fear disturbs nervous system vata roga.worry haste jealousy poision whole system all vata pitta kapha roga arogyavardidini vati multi purpose tridosha remedy.self pity is worst disease weakens whole body.yawning is cry by body for more oxygen due to fast respiration rate time not given for oxygen carbonic gas exchange cured by cup of coffe which excites sensory nerves and sleepless.ancients said human being is upgraded animal instead of four legs stand on two legs two legs front are hands tool to rise to any height.disease is own creation they said no pathy is required.if inevitable Borland remedies digestive tract cover eighty percent homeopathy.
Dioscorea,severe burning gripping colic bowels as intestines twisted pain radiates to other parts of body better by bend back or walk.mental physical stress overdrinking tea creates arsenic phos type active mind but digestion weak hypochlorhydria,after eating excess gas flatulence is formed which rumbles,william gentry says useful in renal colic urethra spasmodic stricture,other indications secondarily male sexual atony emissions in sleep right leg sciatica brittle nails.Dioscorea most homeopaths say in colic q or low potency useful later high potency may improve tonicity of bowels improve mind irritation,grand mothers could recognise tea is bad for digestion if taken empty stomach then you do not like to have food.Dioscorea q is multipurpose remedy of eclectics for active mind feeble constitution persons esp males with gas accumulation bowels.many place hands around hips bend back are dioscorea candidates.tea is digestive if taken after meals if digestive atony is there.those taking unienzyme for digestion try dioscorea low potency to help as substitute for enzymes avoid colics.