Dr Gayatri Vilas Nisal
Abdominal colic is the acute episode of underlying causes such as renal calculi , cholelithiasis ,cholecystitis, appendicitis and some of this also include non specific abdominal pain i.e indigestion ,ailments from travelling ,diet , stress etc. most of the admissions in emergency department occurs under this causes
Main organs involved in abdomen are liver, gall bladder ,pancreas ,intestines,renal system
Abdominal colic may be crampy ,colicky, spasmodic , intermittent and severe.2 Various pain scales can be studied such as verbal rating scale , visual analogue scale, 0 to 9 scale etc7.
To find out the specific cause we should do the appropriate investigations which are discussed in this research work. Clinical presentations also will help in finding out the underlying cause
Acute episode of abdominal colic can be treated with homoeopathic medicines for that we must have knowledge of homoeopathic materia medica and principles of homoeopathy
We must also know the scope and limitations of homoeopathy in cases of abdominal colic so that we can immediately advise for surgery if needed.
The cases which are under the scope can be treated according to symptom similarity. various drugs are useful such as magnesium phosphoricum , Lycopodium , nux vomica, arsenicum album ,colocynth etc. the cases which are studied in this research they are usually treated with above medicines and got relieved
Appropriate repetitions and potency according to homoeopathy will help the patient to cure and recover.
CLINICAL FEATURES AND
DIFFERENTIAL DIAGNOSIS
1] Pain in abdomen crampy, colicky ,intermittent, spasmodic
Full pain history should be taken for diagnosis purpose
Verbal rating scale – no pain ,mild, moderate and severe pain
2] Nausea, vomiting
3] Headache, weakness
4 Pain in epigastrium and nausea vomiting along with fullness suggests acute gastritis
5]Pain in epigastrium ,upper abdomen radiating to back may suggests cholecystitis
6] Abdominal pain worse after eating and lying along with vomiting is suggestive of pancreatitis
7]Pain in right iliac fossa along with fever and vomiting suggests appendicitis
8] Pain in lumbar region and in lower abdomen along with any urinary symptoms is due to renal calculi
Visual analogue scale
0 to 9 grading scale
O no pain
1 to 3 mild
4 to 6 moderate,7 to 9 severe
BASED ON DIFFERENT TYPES OF PAIN5
| Type of pain | Probable Diagnosis |
| 1] burning pain
2] scalding pain 3] stabbing pain 4] colicky |
Peptic ulcer and GERD
Urethritis and cystitis Peptic ulcer and acute perforation Biliary, renal , appendicular colic |
INVESTIGATIONS2
1] full blood count , [urea electrolytes, amylase]
2] abdominal x ray
3] erect chest x ray
5] USGabdomen
| Investigations | Findings | Probable diagnosis | |
| 1] Blood test | Increase amylase | Acute pancreatitis | |
| 2] Erect chest xray | Free air | Perforation | |
| 3] Abdomen xray | Gall stone, renal stone | Cholelithiasis ,renal calculi | |
| 4] USG | Gall stones and thick GB wall | Cholecystitis | |
| 5] CT | Abnormality | Abscess or aortic aneurysms | |
HOMOEOPATHIC MEDICINES FOR ABDOMINAL COLIC
1] Magnesium phosphoricum3,4
- Sphere of action –acts on muscles, brain, intestines, nerves and produces cramping pains thus it is great antispasmodic remedy .pains are relieved by warmth
- Pains are sharp, shooting , cutting,, lightning etc.
- Abdominal complaints—severe crampy , colicky abdominal pains, forcing patient to bend double, relieved by warmth and pressure, fullness in abdomen
- Modalities—worse right side cold, touch better warmth , rubbing, bending double pressure
2] Colocynth3,4
- Sphere of action—it has action on nerves and produces intense neuralgia, action on muscles causing twitching and shortening of muscles ,agonising pain in abdomen, cutting twisting grinding etc.
- Abdominal co— main cause is anger and irritability, taking cheese etc.agonising abdominal pains causing patient to bend double,pressing pains in abdomen’ colic and cramps in calves, , distension, , dysenteric stool jelly like stools
- Modalities—worse from anger with indignation, eating,drinking
- better by doubling up, lying with head bent forward, hard pressure
3] Nux vomica
- Sphere of action – it is a polychrest remedy main action is on GI tract along with other systems, it causes hypersensitivity and irritation of all organs
- Ailments from alcohol, chronic drug history, spicy food etc.
- Abdominal co—severe constricting pains present as if pressure of stone;due to spicy food andstress complaints starts. Flatulence. Ineffectual urge along with constipation alternating with diarrhea. Nausea and vomiting,better by vomiting
- It is also given for gall stone due to high standard living
- Modalities worse in morning , stress, spices and stimulants, better by strong pressure , rest, vomiting
- Other peculiar symptoms – irritable, angry and restless, dominating personality
4] Aresnicum album3,4
- Sphere of action – arsenic has action on all systems and it produces sever burning pains along with restlessness, great exhaustion, discharges are putrid
- Mind symptoms—great anguish and restless, fears of death,
- Abdominal co—cannot bear sight and smell of food , great thirst for small quantities, burning pains, nausea vomiting which is offensive, spasmodic twisting pains along with burning
- Ailments from cold drinks travelling , tobacco
- better by heat and warm drinks,worse from exertion, cold drinks, 12 to 2 pm and am
5] Chelidonium majus3,4
- Sphere of action – it is prominent liver remedy ,produces pain under inferior angle of scapula mainly right sided
- Paralytic and drawing pains, given for cholecystitis and gall stones
- Abdominal co—gall stone colic distension, liver enlarged
- Tongue yellow thick, halitosis. Nausea and vomiting better by hot water
- Pain in abdomen radiating to back sharp pains present
- Worse – right side , motion, change of weather,
- Better– after dinner ,from pressure
- Mostly given in mother tinctures form
6] Berberis vulgaris3,4
- Sphere of action –renal system gall bladder etc. left sided
- pain in regions of kidneys , haematuria,Renal and gall stone colic, worse by pressure
- Abdominal pains shifting worse by pressure , gall stone colic with constipation, stitching pains present pain radiates to back, sharp sudden stabbing pains, stools are jelly like
- Urinary co—burning pains , urine with thick mucus bright red pain in bladder and thighs , frequent urination
- Worse on motion and standing
Based on acute totality we can prescribe above medicines and then constitutional remedies can be given after acute attack gets over so that complaints will hardly reoccur
7] Belladonna3,4
- Sphere of action – it acts on every part of nervous system and produces active congestion
- Associated with red , flushed face and skin
- Burning pains, throbbing along with complaints
- Symptoms–Constrictive and burning pains , liver is sensitive, appendicitis of congestive type, spasms of stomach, it can also be given for appendicitis , violent colicky pain,
- Empty retching, sensitive to touch
- Modalities – worse touch, motion, draft of air
- Amel by rest standing or sitting erect
8] Lycopodium3,4
- Lycopodium is given for right sided renal colic as well as gall bladder problems
- Stitching and shooting pains in right lumbar and hypochondrium, along with flatulence
- Chronic liver complaints
- Nausea and vomiting along with canine hunger
- Red sand in urine i.e hematuria
- Mentally patient is anxious has fear to take responsibility and desires for solitude
- Modalities – agg between 4 to 8 pm, lying on right side
- Amel by warm food , open air
9]Sarsaparilla3,4
- Given for renal calculi mainly right sided,severe agonizing pains from back to front
- Muscular spasms of lumbar muscles
- Patient cries due to pains
- Urine dribbles when sitting, haematuria, sometimes white sand in urine
- Violent pains at end of urination
- Modalities – agg warm food and drink , night
- Hot external application
Name – MRS XYZ
- Age 54
- married
- F
- Date 15/6/22
- Chief co-
Right sided colicky pain radiating to front
Haematuria
History of taking warfarin tab as per advice of physician due to atrial fibrillation ,mitral stenosis.
Severe coliky pains present
| Location | Sensation | modality | Concomitant |
| Right lumbar
And iliac fossa and hypogastrium |
Colicky, crampy | Amel warm application | Restless during attack |
Sudden onset, rapid progress , since 5 days
Associated co
No any
- Past history
Operated for BMV 8 yr back for mitral valve stenosis
Hysterectomy done
- Family history
Mother- diabetes
Brother- diabetes
- Personal history-
Diet pure veg
App- normal
Desire -not specific
Aversion- sour
Bowels- normal
Urine – hematuria
Perspiration profuse
- Thermals- towards hot
Tol season summer
Covering seasonal
Food as served
Fan req
Open air preferable
- Mentals
Restless and anxious
- Local examination
Tenderness in right iliac and hypogastrium and right lumbar region
- Differential diagnosis
Right renal colic presentation
Appendicitis
- Investigations- USG abd and pelvis
- Probable diagnosis
Right renal colic[ due to adverse effect of warfarin]
- Classification of disease
Dynamic – acute –individual
- Analysis
1] anxious
2] restless
3] colickycrampy pain in right lumbar radiating to front
4]haematuria
5] pain ameliorated by warmth application
- Evaluation and acute totality
1] anxious
2] restless
3] colicky crampy pain in right lumbar radiating to front
4]haematuria
5] pain ameliorated by warmth application
- Reportorial approach – kentian
- Repertory used- zomeo software complete repertory
- Reportorial totality
1] anxious
2] restless
3] colicky crampy pain in right lumbar radiating to front
4]haematuria
5] pain ameliorated by warmth application
- Remedy differentiation
| Lycopodium | Nux vomica | Sarsaparilla | |
| Ø Lycopodium is given for right sided renal colic as well as gall bladder problems
Ø Stitching and shooting pains in right lumbar and hypochondrium, along with flatulence Ø Chronic liver complaints Ø Nausea and vomiting along with canine hunger Ø Modalities – agg between 4 to 8 pm, lying on right side Ø Amel by warm food , open air |
Sphere of action – it is a polychrest remedy main action is on GI tract along with other systems, it causes hypersensitivity and irritation of all organs
2]Abdominal co—severe constricting pains present as if pressure of stone.due to spicy food stress complaints starts.Ineffectual urge along with constipation alternating with diarrhea. Nausea and vomiting, better by vomiting 3]It is also given for gall stone due to high standard living Modalities worse in morning , stress, spices and stimulants, better by strong pressure , rest, vomiting 4]Other peculiar symptoms – irritable, angry and restless, fastidious |
Given for renal calculi mainly right sided,severe agonizing pains from back to front
Muscular spasms of lumbar muscles Patient cries due to pains Urine dribbles when sitting, haematuria Violent pains at end of urination Modalities –agg warm food and drink , night Hot external application |
|
Remedy selection
Lycopodium and mag phos (sos)
- Susceptibility- high [ as the onset is sudden along with characteristic symptoms]
- Potency- high
Prescription
1] LYCOPODIUM CLAVATUM 1M
6 PILLS in half cup water
1 tsp every hour for 3 days
2] MAGNESIUM PHOSPHORICUM 200
| Date | Follow up | Advice |
| 17/6/22
22/6/22 |
Better completely, blood clots passed from urine. No pain , no haematuria now
No any complaints |
Mag phos 200 sos
Intake of water and proper food |
References
1] Tortora Principles Of Anatomy And Physiology
2] Davidsons Practice Of Medicine
3] Surgery Therapeutics By Shrikant Kulkarni
4] Homoeopathic Material Medica By William Boericke
5] Surgery Clinical Book By S.Das
6] Textbook Of Pathology BY Harsh Mohan
7]https;//pubmed.ncbi.nlm.nih.go
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