Homoeopathic drugs in the management of GERD

Dr Amrutha S

Abstract:
Among the most common diseases in India, Gastro-esophageal reflux disease (GERD) is one, where the quality of life is affected severely by symptoms such as heartburn and acid regurgitation. Studies says that, In India, its prevalence ranges from 7.6 to 30%, being < 10% in most population studies. According to Other studies, the prevalence of GERD was 22.2 % in southern India, and was more common among older subjects and men, also increasing age and BMI, lower educational level, an urban environment appears to be risk factors of GERD symptoms.

KEYWORDS: Gastro-esophageal reflux disease, Risk factors

ABBREVIATIONS: GERD – Gastro-esophageal reflux disease

INTRODUCTION:

GERD is a condition that develops when the reflux of stomach contents causes troublesome symptoms or complications. The two most common symptoms are heartburn and regurgitation. Occasional episodes are common in healthy individuals.

PATHOPHYSIOLOGY
Gastro-oesophageal reflux disease develops when the oesophageal mucosa is exposed to gastroduodenal contents for prolonged periods of time, resulting in symptoms and, in a proportion of cases, oesophagitis. several factors are known to be involved, like obesity and dietary factors, defective oesophageal clearance, Hiatus hernia, delayed gastric emptying, increased intra-abdominal pressure, abnormal esophageal sphincter – reduced tone, inappropriate relaxation.

CLINICAL FEATURES AND COMPLICATIONS

• Symptoms like, Heartburn and regurgitation, often provoked by bending, straining or lying down.
• ‘Waterbrash’, which is salivation due to reflex salivary gland stimulation as acid enters the gullet, is often present. They are often overweight.
• Some are woken at night by choking as refluxed fluid irritates the larynx.
• There may be odynophagia or dysphagia. A variety of other features have been described such as atypical chest pain (mimic angina) and may be due to reflux-induced oesophageal spasm.

Others include hoarseness (‘acid laryngitis’), recurrent chest infections, chronic cough and asthma.

An untreated GERD can be Complicated into various conditions like Oesophagitis, Barrett’s oesophagus, Anaemia, Benign oesophageal stricture, Gastric volvulus.

HOMOEOPATHIC APPROACH

As mentioned above, an untreated GERD will cause severe complications, so, it’s better to treat the symptoms in its early manifestations. Homoeopathy has a wide range of medicines for the symptoms of GERD, and according to the cause and the presentations of symptoms, that is, based on the totality, a well-suited medicine can normalize the condition, with general management like changes in diet and life-style modifications.

Considering the symptoms of GERD for repertorisation, the following medicines were indicated:

1. Pulsatilla

Eructation’s taste of food remains a long time; after ices, fruits and pasty. Bitter and diminished taste of all food. Pain as from subcutaneous ulceration. Flatulence, heartburn. Dyspepsia, with tightness after a meal; must loosen clothes. Thirstless. Vomiting of food eaten long back. Pain in stomach an hour after eating. Waterbrash, with foul taste in morning. Stomach deranged; feels heavy. Worse from eating rich fat food,pork,bread, milk after eating. Better by cold food and drinks.

2. Ammonium carbonicum

Pain at pit of stomach with heartburn, nausea and waterbrash, and chilliness. Aggravated after eating, better by pressure and lying down.  Flatulent dyspepsia.   Good appetite but easily satisfied. sensitive painfulness of stomach even to clothes. Violet sanguineous vomiting. Heat and sensation of burning in stomach.

3. Ambra grisea

Eructation’s with violent, convulsive cough. Acid eructation’s, like heartburn. Distension of stomach and abdomen after midnight. Thirstlessness. Sensation of coldness in abdomen. Sourness in mouth after taking milk. imperfect eructation’s, frequent and sour. Hiccough after having smoked meat. Nausea and vomiting. sensation of burning in stomach and in precordial region.  After eating, cough and feels, as if food did not go down the stomach.

4. Carbo vegetabilis

Eructations, heaviness, fullness and sleepiness, tense from flatulence with pain. Aggravated on lying down. Eructations rancid, sour, putrid after drinking or eating. belching gives temporary relief.  Asthmatic breathing from flatulence. nausea in morning. Burning in stomach extending to back and along the spine.  Contractive pain extending to chest, with abdominal distension. Bends double due to crampy pain. Sensitiveness of epigastrium. Slow digestion, food putrefies before it digests. Gastralgia of nursing women, with excessive flatulence, sour, rancid belching. Aversion to milk, meat, and fat things, which causes flatulence, better by eructations. The simplest food distresses. Epigastric region very sensitive.

5. Lycopodium

Dyspepsia due to farinaceous and fermentable food, cabbage, beans, etc. Excessive hunger. Food taste sour. Acidity, sour eructations. Great weakness of digestion. Pressure in stomach, after eating with bitter taste in mouth. Eating ever so little creates fullness. Can’t eat oysters. Increased flatulence. Wakes at night feeling hungry. Hiccough. Incomplete burning eructations rise only to pharynx, and burn for hours. Likes hot food and drinks. Worse at night time. Sensation of fasting after meals, but without hunger. bad effects of onion.

6. Nux vomica

Pre- eminently the remedy for many of the condition’s incident to modern life. Under much mental work, stress, worries. Persons indulged in the sedative effects of tobacco, opium, seeks stimulants like coffee, wine, possibly in excess. Sour taste, nausea in the morning, after eating. Weight and pain in stomach worse some-time after eating. Flatulence and pyrosis. Sour and bitter eructations. Retching. Ravenous hunger, especially about a day before an attack of dyspepsia. Region of stomach sensitive to pressure. Bloated epigastrium with stony pressure feeling, several hours after eating. loves fats and tolerates them well. Difficulty in belching of gas. Wants to vomit, but cannot. Worse- early morning. Water brash. Gastralgia; pain go into back and chest; better by vomiting and hot drinks, worse by food. Indigestion. Colic and pressure in stomach extending to shoulders in morning, fasting, and after eating. Painful sensitiveness in pit of stomach to least pressure.

7. Magnesium carb

Desire for fruit, acids, and vegetables. Eructations sour, and vomiting of bitter water. Craving for meat. Dyspepsia. Loss of appetite, bitter taste with white coated tongue, and viscid mucous on tongue and teeth. Desire for fruit and acid drinks. Great desire to vegetables with dislike for meat. Aversion to green food. Acid risings, frequent with pain in stomach. Nausea and vertigo during a meal followed by retching, and vomiting of bitter saltish serum. Passive constrictive pain in stomach. Pain, as from ulceration in the stomach. worse in night. Milk is refused, if taken causes pain in stomach.

8. Natrum phosphoricum

Ailments with excess of acidity. Sour eructations and taste. Sour vomiting. Yellow creamy coated back of roof of mouth and tongue. Flatulence with sour risings. Causations from sugar, milk, fat food, bitter foods. acidity in children fed with excess of milk and sugar. Canine hunger with gone sensation in stomach even in chest. Eructations after eating. Heaviness and pressure in epigastrium. Vomiting of sour cheesy mases. desire for strong tasting things; eggs, fried fish, beer which makes feel better. Aversion to bread and butter.

9. Iris versicolor

Burning of whole alimentary canal. Vomiting, sour bloody, biliary. Nausea. Profuse flow of saliva. Less appetite. Dyspepsia; food tastes flat or acid. Taste at first sweetish or insipid; later severe burning. Mouth and stomach feel on fire; as if impossible to breath, it is so acrid. Mouth and tongue feel scalded. Eructations of tasteless gas; frequently empty. Nausea and vomiting of watery and very acid substance; sour milk in children. Contents of stomach ‘turns to vinegar’.  Pain in stomach before breakfast and from drinking water. Cancer of pylorus with sour vomiting and prostration. Periodical vomiting spells, every month, six weeks, lasts for 2-3 days.

10. Robinia

Remedy for hyperchlorhydria. Cases where albuminoid        digestion is rapid and starch digestion in perverted. Acidity accompanied with frontal headache. Intensely acrid eructations. Acrid and greenish vomiting, colic and flatulence. Nightly burning pains in stomach and constipation with urgent desire. Acidity of children. Dull heavy aching in stomach, nausea; sour eructations. Sour stools; child smells sour. Heartburn on lying down. Nausea for three hours, followed by sour vomit. Vomiting of intensely sour fluid, setting teeth on edge. Vomiting of ropy mucus; tinged with blood. Sharp pain in stomach day and night. Worse eating cabbages, turnips, raw fruit, ice creams, fats.

11. Phosphorous

Sour taste and sour eructations after every meal. Belching large quantities of wind, after eating. Throws up the ingesta by the mouthfuls. Water is thrown up as soon as it gets warm in the stomach. Post operative vomiting. Cardiac opening seems contracted, narrow, comes up again, scarcely swallowed. Stomach pain better by cold food, ices. Inflammation of stomach. Inflammation of stomach, with burning extending to throat and bowels. Worse walking. Bad effects of eating too much salt. Taste saltish, sour, or sweetish in mouth, especially after a meal. After a meal- drowsiness, indolence, heat and anxiety, burning sensation in hands, acidity increased, pressure and fullness in stomach, chest, abdomen, accompanied by obstructed respiration, vomiting of food, inflation of abdomen, headache, sour eructations, hiccough, debility, colic. oppression and burning in epigastrium.

12. Calcarea carbonicum

Frequent sour vomiting and eructations. Dislike of fat. Loss of appetite when overworked. Heartburn and loud belching. Aversion to meat, boiled things. Craves indigestible things- chalk, coal, pencil, also eggs, salt, sweets. Milk disagrees. Repugnance to hot food. Pain in epigastrium on touch. Thirst, longing for cold drinks. Hyperchlorhydria. Worse while eating. Dyspepsia. Sour vomiting, especially in children, during dentition. Pinching’s, cutting pains, and nocturnal aching in epigastrium. Mouth fills with sour water.

Conclusion
Use of homoeopathic medicine in treatment of GERD is proved to be effective clinically, but more scientific researches need to be done. In management of a GERD individual along with medicines, life style modifications are also important like food habits, avoiding high spicy food and other triggering food habits, eating at proper time intervals, cessation of smoking, reducing alcohol intake, managing of stress, regular physical exercise, weight loss etc. According to an individual case and its totality, the indicated similimum has to be given for good result.

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