Peptic Ulcers and Homeopathy

Peptic ulcers are open sores or erosions in the mucosal lining of either the duodenum (duodenal ulcers) or the stomach (gastric ulcers) due to irritants (may be allergic, chemical or mechanical or drugs), excessive secretion of digestive juice or infection.

TYPES -

If the stomach is ulcerated, it is known as gastric ulcer and if the duodenum is involved, it is known as duodenal ulcer.

INCIDENCE -

Gastric ulcer peaks in the age group of 50-60. The male, female ratio is almost equal. Duodenal ulcer peaks in the age group of 20-50 years. But the male, female ratio is 2:1. Occurrence of peptic ulcer is more common in people who have 'O' blood group.

• Heredity - this is particularly so with duodenal ulcers.
• Helicobacter pylori - This is the most important etiological factor in peptic ulcer disease, accounting for 90% of duodenal ulcers and 70% of gastric ulcers.
• Increased hydrochloric acid secretion causes changes in the wall of duodenum (gastric metaplasia) setting the stage for invasion by H. Pylori.
• Long term use of Non Steroidal Anti Inflammatory Drugs (NSAIDS) such as aspirin and ibuprofen damage the gastric mucosal barrier.
• Habits - Smoking cigarettes, drinking alcohol and irregular dietary habit confers an increased risk of ulcer.
• Mental and physical stress and strain.
• Foods - Spicy and chilly.
• Toxic - Chemicals or decayed foods.
• Mechanical - Any hard food substance or any investigative procedures.
• Neurological
• Infectious diseases which cause increased urea and bacteria level in blood.

• Abdominal pain - Pain is referred to the epigastrium and is often so sharply localized that the patient can indicate its site with two or three fingers - the 'pointing sign'. Abdominal pain with burning or gnawing sensation.

• Hunger pain - Pain occurs intermittently during the day, often when the stomach is empty, so that the patient identifies it as 'hunger pain' and obtains relief by eating.

• Night pain - Pain wakes the patient from sleep and may be relieved by food, drinking milk or antacids.

• Episodic pain/ Periodicity - Characteristically pain occurs in recurrent episodes.

• Other symptoms - Waterbrash, Heartburn, Loss of appetite, Vomiting, Nausea, Headache, Constipation or diarrhea, Haematemesis Dyspepsia, Weight loss and Dark or black stools.

DIFFERENCE BETWEEN GASTRIC AND DUODENAL ULCER

• Endoscopy.
• Biopsy can be done through endoscope - to rule out serious disease like cancer and for presence of H. pylori.
• Double contrast barium meal examination.
• X-Rays of stomach and duodenum.
• Blood test for antibodies for H. pylori.
• Stool test looking for H. pylori.

COMPLICATIONS -

• Bleeding (hematemesis or malena).
• Perforation causes peritonitis and septic conditions in cases of chronic inflammatory ulcers when the infection deepens.
• Obstruction due to stricture formation caused by chronic peptic ulcer.
• Risk of stomach cancer.

DIFFERENTIAL DIAGNOSIS -

• Occasional dyspepsia (indigestion).
• Malignant ulcer/ carcinoma.

TREATMENT - Elimination of the underlying cause (particularly H. pylori infection or use of NSAIDs), preventing further damage and complications, and reducing the risk of recurrence.

 Surgery -

If ulcers don't respond to diet, regimen and medications and have other complications, surgery is advised as a last resort where the area of ulceration is removed. Surgery is required for certain serious or life-threatening complications of peptic ulcers.

Homoeopathic Treatment -

These days, the operative treatment is restricted to a small proportion of ulcer patients as Homoeopathic medicines do offer a cure in the cases of peptic ulcers. Peptic ulcer disease been a constitutional disease finds its local expression at the level of the digestive system. Being a constitutional disorder, it calls for constitutional approach towards treatment. Homoeopathy offers long-term cure instead of temporary relief as the treatment targets the root cause. Treatment is at the deeper level of immunity and it enhances the healing capacity of the body. Homoeopathy also helps prevent complications of Peptic ulcers. They can be treated successfully in Homeopathy without any side-effects. Homoeopathy improves the general resistance and also avoids recurrences.

Homoeopathic medicines commonly used for peptic ulcers are - Belladonna, Borax, Colocynth, Bryonia, Dulcamara, Nux Vom, Symphytum, Hydrastis, Arg Nit, Acid nit, Aethusa, Ars Alb., Geranium, Hydratis, Merc cor., Ornithogalum, Phos., Uranium nit., Terebintha, Graph., Pulsatilla, Sulphur, Kali Bich, Lycopodium, Carbo Veg, Antim crud, Calc carb, Med., Nat mur, Nat phos, China, etc. These medicines should be taken under the advice and diagnosis of a qualified Homeopath. Details of a few of the medicines are explained below and the remaining drugs too should be studied in a similar manner.

Nux vomica

Constitution - Thin people, with dark hair and dark complexion, who lead a sedentary life, nervous, extremely sensitive to external impressions.

Cause - Dyspepsia from drinking strong coffee, high living, alcohol, highly spiced seasoned food, irregular diet, long continued mental or physical stress, excessive intake of medicines.

Symptoms relating to GIT indicating hyperacidity - Nausea in the morning and after eating. Weight and pain in stomach which is worse some time after eating. Nausea and vomiting, with much retching. Epigastrium bloated, with pressure as of a stone, several hours after eating. Sour, bitter eructations.

Concomitants - Region of stomach very sensitive to touch. Desire for stimulants. Loves fat and tolerates them well. Constipation, with frequent ineffectual urging; passing small quantity at each attempt; feeling as if part remained unexpelled. Throat: rough, scraped feeling. Tickling after waking in morning.

Other keynotes - Oversensitive to all external impressions. Extremely irritable. Aversion to cold air. Irresistible desire to sleep in the evening.

Modalities -

< - morning, mental exertion, after eating, stimulants, spices, cold, dry weather.

> - in evening, damp wet weather.

Lycopodium

Constitution - Carbonitrogenoid constitution. Intellectually keen but physically weak. Upper part of body is emaciated, lower part semi-dropsical. Unhealthy complexion looks older than he is.

Cause - Dyspepsia due to farinaceous and fermentable food, cabbage, beans, etc.

Symptoms relating to GIT indicating hyperacidity - After eating, pressure in stomach, with bitter taste in mouth. Eating even little causes fullness. Immediately after a light meal there is bloating and fullness of stomach. Incomplete burning eructations. Sour eructations. Rolling of flatulence. Food and drink regurgitates through nose. Wakes at night feeling hungry.

Concomitants - Aversion to bread. Desire for sweets. Likes to take food and drink hot. Excessive hunger. Stool hard, difficult, small, incomplete.

Keynotes - Right sided complaints. Fan like movement of alae nasi. Half open eyes in sleep.

Modalities -

< - 4 to 8 p.m., right side, heat except throat and stomach.

> - warm food and drink, loosening the garments, open air.

Robinia -

Symptoms relating to GIT indicating hyperacidity - Intensely acrid eructations. Nausea, with sour eructations. Profuse vomiting of an intensely sour fluid; acrid and greenish vomiting. Great distension of stomach and bowels. Flatulent colic. Incarcerated flatus. Sour stools. Acidity in children; child smells sour. Nightly burning pains in stomach with constipation with urgent desire.

Concomitants - Frontal headache, dull, throbbing; worse motion and reading.

Acetic Acid -
Constitution - Pale, lean, emaciated persons.

Symptoms relating to GIT indicating hyperacidity - Burning pains as of an ulcer. Cancer of stomach. Sour eructations. Vomits every kind of food. Heartburn and water brash. Hyperchlorhydria.

Concomitants - Profuse salivation. Intense burning thirst. Haemorrhage from bowels. Great prostration.

Anacardium -
Symptoms relating to GIT indicating hyperacidity - Duodenal ulcer; All gone sensation when stomach is empty, > by eating, during the process of digestion. Apt to choke while eating and drinking. Swallows food and drink hastily. Pain usually two hours after eating, with a dull epigastric pain extending to the back of the trunk. Always better after eating.

Concomitants - Ineffectual desire for stool, rectum seems to be plugged up. Sensation of a band or hoop around a part. Sudden loss of memory.

Arsenicum Album -
Cause - Gastric derangements after fruits, ice creams, beer, strong cheese, alcohol.

Symptoms relating to GIT indicating hyperacidity - Burning pains in abdomen, burns like fire, as if hot coals were applied to the parts. Vomiting of bile, blood, brown black mucus mixed with blood. Gastralgia < at mid day and mid night. Severe, burning pain and exhaustion; pain immediately after eating food and a lack of appetite.

Modalities - > by heat, hot drinks.

Keynotes - Cannot bear the smell or sight of food. Excessive thirst for warm drinks at short intervals. Fear, anxiety, restlessness. Prostration.

Bismuth -
Symptoms relating to GIT indicating hyperacidity - Gastralgia, pain from stomach through to spine. Vomiting of water as soon as it reaches the stomach, food retained longer, of enormous quantities at intervals of several days when food has filled the stomach. Pressure in stomach as from a load in one spot, alternating with burning, pain crampy, spasmodic.

Condurango -
Symptoms relating to GIT indicating hyperacidity - Gastric ulcer, carcinoma of stomach. Constant burning pains. Vomiting of food, burning behind sternum, where food seems to stick. Stricture of oesophagus. Chronic gastric catarrh.

Crotalus Horridus -
Symptoms relating to GIT indicating hyperacidity - Gastric ulcer, cancer of stomach. Vomiting of bloody slimy mucus. Black or coffee ground vomiting. Violent vomiting of food.

Concomitants - Haematemesis and malena. Chronic alcoholism. Intolerance of clothing around stomach. Diarrhoea, stool black, offensive, like coffee grounds. Black, dark, fluid, non coagulable blood. Tongue fiery red, smooth and polished. Prostration, broken down constitution.
 

Graphites -
Symptoms relating to GIT indicating hyperacidity - Duodenal ulcer; Chronic constipation, stool hard knotty with lumps united by mucus threads.

Modalities - > - after eating, drinking hot milk.

Grindelia Squarrosa -
Symptoms relating to GIT indicating hyperacidity - Gastric ulcer, gastric pains associated with splenic congestion. Nausea and retching. Hyperchlorhydria. Hyperaemia of gastric mucus membrane. Dullness and pain in left hypochondrium. Paresis of pneumogastric. Gastritis with asthmatic symptoms.

Hydrastis -
Constitution - Old debilitated persons.
Symptoms relating to GIT indicating hyperacidity - Gastroduodenal catarrh. Carcinoma of stomach. Cachetic or malignant dyscrasia. Ulcerations, profuse discharge of thick yellow stringy mucus. Atonic dyspepsia.

Concomitants - Chronic constipation. Enlarged liver, jaundice. Cancer pains. Broken down by excessive use of alcohol.

Iodum -

Constitution - Emaciation, loosing flesh while eating well. Scrofulous diathesis
Symptoms relating to GIT indicating hyperacidity - Duodenal ulcer; Empty eructations, as if every particle of food was turned in to air. Constipation > by drinking cold milk. Ravenous hunger ,

Modalities - > - while eating or after eating.

Kali Bichromicum -
Symptoms relating to GIT indicating hyperacidity - Gastric ulcer; punched out or round ulcer of stomach. Pain in small spots, can be covered with the point of finger; appears and disappears suddenly, rapidly shifting. Pain in the epigastric region. Burning or shooting abdominal pain. Weight in pit of stomach, flatulence, vomiting of stringy, ropy mucus and blood. Loss of appetite.

Modalities - < - immediately after eating, after midnight.

PREVENTION -

Proper lifestyle modifications, diet and regimen measures shall help in prevention peptic ulcer formation. It also helps in speedy recovery and arrests the further progression of complications. Dietary and regimen measures that should help are as follows:

DO's

• The food should be masticated well and swallowed.
• The food should be taken in a relaxed manner, without any hurry.

TO TAKE

• Easily digestible, oil free diet so that the work load of stomach and intestine can be reduced.
• Frequent small meals should be encouraged to utilize the acid load in the stomach.
• Water is to be taken before and after meals.
• Nutritious diet should be taken at regular intervals or at regular time.
• Diet rich in fiber, like green vegetables and fruits which are good for digestion and also for the general health should be consumed regularly.
• Foods containing flavonoids, like apples, celery, cranberries (including cranberry juice), onions, and tea may inhibit the growth of H. pylori.

TO AVOID

• Stressful and hurried life.
• Habits of smoking, drinking alcohol, chewing tobacco and overeating which increases acid secretion of the stomach.
• Hunger - which denotes acid load, avoid it by taking small meals often. 
• Full meal, oily diet, pickles and fatty snacks before bed time.
• Food containing high spices, chilies and pepper.
• Dry bread, cakes and cookies.
• High fat content nuts and biscuits.
• Aerated drinks, coffee and tea.
• Milk products.
• Stress by the regular use of relaxation techniques such as yoga, tai chi, or meditation.
• Cabbage, onions, garlic, cauliflower, tomatoes - if not tolerated
• Drugs like NSAIDs - pain killers (for example. - aspirin)

Hence, through Homoeopathic treatment permanent relief from peptic ulcer can be achieved. Ulcers take time to heal, so medicines should be continued for long time, even if the pain goes away. Homoeopathy aids in eradicating the ulcer even without the need of surgery.