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Showing posts with label Hiatus Hernia. Show all posts
Showing posts with label Hiatus Hernia. Show all posts

Jan 18, 2012

A Case Of Hiatus Hernia with Reflux Oesophagitis


© Dr.R.S.Mann 2011

 Presented By 
Dr. R. S. Mann

 A patient, Mr S.Kumar, 33 yrs male, has following complaints since last 7 years, increasing year after year.

Eructations, violent, continuous, loud, starts from morning, increase in afternoon after lunch and constantly increasing, pain in hypochondriac region, epigastrium, back, chest, sometimes left arm, sometimes pain knee with these eructations. Vomiting which relieves for few minutes. Burning and pain in epigastrium region which relieves by eating (it seems a mild relief) and sitting bent. Sleep disturbs by these eructations, have wake up and stand up so that he can eruct and get relief when flatulence passes that is collected in stomach. Can sleep very late and not more then 4 – 5 hours. When he has flatulence, no position gives him relief, sometime lie down, sometime stand up and then sit up but no relief anyway.

He thinks how good it would be if there is no need and provision to eat. He is very much worried about his disease, works very far from his native place, he thinks to resign the job and shift back to that place, thinks what will happen about his wife and kids after him. Thinks if he will die so far, how his dead body will go to his native place.

Angry, very easily on kids when they want to play with him, even he slap them, get angry on wife, noise hurts him.

Thirst very less, not want to eat.

Due to vomiting, he feels rawness in throat and eruptions, which bother him.

Stool hard sometimes. Go once for stool in a day.

Pulse slow. He says his pulse drop as less as to 62 sometimes, and then he feels become much more worried about his health.

Endoscopy report says he has Hiatus hernia and gastritis.

D/H – Taking different kind of antacids, antibiotics off and on since his disease.

P/H – Three years back he quit tobacco chewing.

Repertorization

Radar :

STOMACH - BENDING - forward - amel.
STOMACH - THIRSTLESS
STOMACH - ERUCTATIONS - constant
STOMACH - ERUCTATIONS - violent
STOMACH - VOMITING
STOMACH – PAIN

ABDOMEN - PAIN - Hypochondria
ABDOMEN – FLATULENCE

STOOL - HARD

BACK - PAIN

EXTREMITIES - PAIN - Upper arm
EXTREMITIES - PAIN – Knee

SLEEP - DISTURBED

GENERALS - NIGHT - midnight - before
GENERALS - CHANGE - position - amel. - not amel.
GENERALS - NOISES - agg.
GENERALS - FOOD and DRINKS - food - aversion
GENERALS - PULSE - slow
GENERALS - VOMITING - amel.

MIND - DESPAIR - recovery, of
MIND - ANXIETY - health; about - own health; one's
MIND - ANGER - easily
MIND - DEATH - thoughts of
MIND - FEAR - happen, something will - himself; to

Phos 22/48, Puls 19/43, Acon 19/32, Ars 18/42, Lyco 18/42, 
Nux V 18/38, Sulphur 18/35, Ferrum Met 18/32, Kali Carb 18/31,
Lach 18/31


Another Repertorization on

Complete Dynamics

Generic Symptoms:
Throat; pain; sore, bruised
Heart & circulation; pulse; slow, brachycardia
Back; pain
Sleep; disturbed
Generalities; food and drinks; food in general; aversion to
Generalities; noise; agg.
Generalities; vomiting; amel.

Stomach:
Stomach; bending; amel.; forward
Stomach; eructations; constant
Stomach; eructations; empty; profuse
Stomach; eructations; violent
Stomach; pain
Stomach; thirstlessness
Stomach; vomiting
Abdomen:
Abdomen; flatulence
Abdomen; pain; flatulence; from
Abdomen; pain; hypochondria
Stool; hard
Extremities:
Extremities; knees
Extremities; pain; upper limbs
Mind:
Mind; anger; easily
Mind; anxiety; health, about
Mind; death; thoughts of
Mind; despair; recovery, of
Mind; fear; happen; something will; family, to, or to him

Prescription:-
Phosphorus is the most similar medicine for the case which comes out in both repertorization.

Oct. 14, 2011

Phos 200 CH 3 doses prescribed 6 hourly. With Sac lac for 10 days.

Oct. 21, 2011

Very much relieved, no vomiting, eructations reduced lot much. Sound sleep. After many years he has some days when he has no burning, eructations or abdominal discomfort.
Sac Lac for 15 days.

Nov. 5, 2011

Remain normal on every alternate day. Mild eructations on alternate day for few hours.
Pain throat as if raw and stinging.
Phos 1M CH 3 doses prescribed 6 hourly. With Sac lac for 10 days.

Nov. 8, 2011

Vomiting this morning, just after drinking water, water becomes hot as if boiling in stomach, and vomited out.
Restless, anxious.
Note*:- Phos 1M must not be given; it was early to shift to upper potency, early repetition.
Sac lac prescribed with assurance.

Nov. 16, 2011

Eructations, burning, pain, vomiting reduced.
If he has some discomfort after eating, it remains just for half to one hour.
Sleeping very well.
Stool normal.
Appetite good can eat everything now without any burning and worry about abdomen.

Sac Lac prescribed for 10 days.

Nov. 26, 2011

Very much improved.
Eructations only 2 times in 1 day.
Sleep very good.
No vomiting.
Sac Lac prescribed for 10 days.

Dec. 6, 2011

Pain head, from 3 days, continuous whole the day, with vertigo.
Throat feels raw and heavy.
Eructations better.
Vomiting once, just 2 days before.
Worried again for his disorder, although better.

Phos 200  1 dose.
Sac lac for 10 days.

Dec. 17, 2011

Head pain and vertigo improved on next day of last prescription.
Sac Lac for 10 days.

Dec. 27, 2011

Patient has started some discomforts again. Eructations which improves after eating.
Burning pain in throat which also ameliorates after eating. Patient is feeling feverish constantly.
Throat inflamed. 

Another Repertorization on
Radar: 

THROAT - INFLAMMATION
THROAT - PAIN - burning - eating, after - amel.
THROAT - PAIN - burning
THROAT - PAIN - rawness
STOMACH - ERUCTATIONS
FEVER - FEVER, heat in general
GENERALS - EATING - after - amel.



Mez 7/15, Phos 6/17, Merc Sol 6/15,Natrum Mur 6/15,Puls 6/15, Sepia 6/15,Aconite 6/14, Hep 6/14, Lachesis6/14,Nux V 6/14,Sulphur 6/14.

Phos prescribed on Dec. 6 although help in headache and vertigo but it produced new symptoms in patient. On repertorization Mez seems best similar now which also antidotes the Phosphorus.

Prescription:- Mez 30 Ch 3 doses prescribed with sac lac for 10 days.

Jan 7, 2012

All the symptoms relieved very next day of prescribing Mez 30. Not any symptom and discomfort present.
Sac lac for 10 days.

Jan 18, 2012

Not any discomfort or symptom is felt by patient. Medicine is discontinued.

Nov 2, 2011

A case of Duodenitis, Gastritits, Reflux Oesophagitis and Hiatus Hernia

© Dr.R.S.Mann & Dr. Vandana Patni 2011

Presented by 
Dr. R S Mann & Dr. Vandana Patni.

Mr G. Singh, 33 yrs, Male patient presented the following complaints

March 25, 2011.

Pain abdomen, cramping, eating after, stool before which ameliorates after stool. Flatulence, distension of abdomen with rumbling. Stool mucous on and off. Flatulence very offensive, alternate constipation and diarrhea. Constipation on eating meat.

All the problem for many years, diagnosed for Reflux Oesophagitis, Hiatus hernia, Gastritis and duodenitis on Endoscopy. Using antacids and many other medicines for years. 

Repertorizations  in Radar 9:-
ABDOMEN - DISTENSION - flatulence - from
ABDOMEN - DISTENSION - painful
ABDOMEN - FLATULENCE
ABDOMEN - PAIN - cramping - eating - after
ABDOMEN - PAIN - cramping - stool - after - amel.
ABDOMEN - PAIN - cramping - stool - before
RECTUM - CONSTIPATION
RECTUM - DIARRHEA - alternating with - constipation
RECTUM - FLATUS - offensive
STOOL - MUCOUS
GENERALS - FOOD and DRINKS - meat - agg.





Prescription :-
Sulph 200 CH  2 dose on 2 hours gap.
China 30 CH  One dose daily.
Pulsatilla 30 CH One dose daily.

For a week.

April 2, 2011.

A little better but have few another complaints not described earlier and was not present on first visit because he was continuously using Antacids, now because antacids are stopped after first prescription, some more symptoms are here.

Stomach burning pain which aggravates after eating. Flatulence offensive, rumbling in abdomen here and there. All the complaints aggravates after eating. Heaviness stomach after eating.

Prescription :-
Lycopodium 30 CH One dose daily.
Robinia 30 CH One dose daily.

For two weeks.

April 19, 2011

Flatulence, Burning in stomach, rumbling improved.
Pain Hypogastrium ameliorate by pressure.
Burning  pain in all over the abdomen, better by drinking water.

Repertorizations  in Radar 9:-

STOMACH - HEAVINESS - eating - after
ABDOMEN - PAIN - burning
ABDOMEN - PAIN - Hypogastrium - pressure - amel.
GENERALS - FOOD and DRINKS - water - amel.




Prescription :-
Iodum 30 CH  Two doses two hourly.
Sang Can 30 CH  One dose daily
Robinia 30 CH One dose daily

For one week.

April 27, 2011

All complaints better with very mild distress.

Prescription –

Lycopodium 30 CH  One dose daily.
Robinia 30 CH One dose daily.

For one week.

May 7, 2011

Burning abdomen.
Rumbling, flatulence.
Mucous stool.
Abdomen pain cramping.

Earlier symptoms returned back.




Prescription:-

Sulhpur 200 CH  Two doses on 2 hours gap.
Nux Vomica 30 CH One dose daily on bed time.

For one week.

May 13, 2011

All complaints relieved again.

Prescription:-

Sac. Lac. Only

For a week.

May 24, 2011

Stool thin, not formed properly.
Mucous with stool only one day.
Pain burning abdomen which aggravates after eating.
Flatulence, distension.

Prescription –

Sac. Lac. Only
For a week.

June 2, 2011

Has good appetite, but easy satiety.
Stool fatty, greasy, stick to pot.

Repertorizations  in Radar 9:-
STOMACH - APPETITE - easy satiety
STOOL - FATTY, greasy




Prescription:-

Platina 200 CH 2 doses with an interval of two hours.
Sac. Lac.

For One week.

June 14, 2011

Get Coryza.
Sneezing.
Raw, sore throat.

Prescription –

Ars. Alb. 30 CH One dose Daily

For 3 days only.

June 30, 2011

Flatulence.
Stool Black.
Pain Epigastrium.

Repertorizations  in Radar 9:-
STOMACH - PAIN - Epigastrium
ABDOMEN – FLATULENCE
STOOL - BLACK





Prescription –

Vertarum Album 30 CH One dose daily.
Cuprum Met 30 CH One dose daily.

For one week.

July 9, 2011

Heaviness in stomach which aggravates on eating.
Burning in stomach ameliorates by drinking plain water.
Burning and acrid eructation.
Sluggishness.

Repertorizations  in Radar 9:-
STOMACH - ERUCTATIONS; TYPE OF - burning
STOMACH - ERUCTATIONS; TYPE OF – acrid
STOMACH - HEAVINESS - eating - after
STOMACH - PAIN - burning
GENERALS - SLUGGISHNESS of the body


GENERALS - FOOD and DRINKS - water - amel




Prescription –

Phosphorus 200 CH  2 doses with gap of two hours.
Lycopodium 30 CH One dose daily.

July 18, 2011

Pain epigastrium.
Pain gnawing.
Pain eating after.
Stool thin, mucous.
Symptoms  on July 9, 2011  are also included in repertorization.

Repertorizations  in Radar 9:-
STOMACH - ERUCTATIONS; TYPE OF - acrid
STOMACH - ERUCTATIONS; TYPE OF - burning
STOMACH - HEAVINESS - eating - after
STOMACH - HERNIA; HIATUS
STOMACH - PAIN - burning
STOMACH - PAIN - eating – after
STOMACH - PAIN - Epigastrium
STOMACH - PAIN - gnawing
ABDOMEN - PAIN - gnawing
STOOL - MUCOUS
STOOL - THIN
GENERALS - FOOD and DRINKS - water - amel.
GENERALS - SLUGGISHNESS of the body





Prescription –

Last prescription was right.

Sac. Lac.

For one week.

July 25, 2011

Stool mucous for 2 days.
Pain and Burning improved.
General weakness, desire to lie down.
Meat causes constipation.
In summers patient feel much aggravations.
Always remain cheerful and happy. (Enters consulting room smiling)
Pain lower limbs.
Appetite with easy satiety.

Repertorizations  in Radar 9:-
MIND - CHEERFUL
STOMACH - APPETITE - easy satiety
STOOL - MUCOUS
EXTREMITIES - PAIN - Lower limbs
GENERALS - LIE DOWN - desire to
GENERALS - SEASONS - summer; in - agg.
GENERALS - WEAKNESS

RECTUM - CONSTIPATION
GENERALS - FOOD and DRINKS - meat - agg.






Prescription –

Lycopodium 200 CH 2 doses with two hours gap.
Sac. Lac

For one week.

August 5, 2011

All symptoms improved.
On August 4, eaten meat but no constipation today.

Prescription –

Sac. Lac.

For one week.

August 25, 2011

On August 11 mucus stool, pain stomach, rumbling, cramping pain and urging for stool eating after, all these complaints subsided next day.

On August 24, waken in morning with uneasiness in stomach, drink some water which vomited out after sometime, very sour, then ameliorated immediately after vomiting.But stil have desire to drink chilled water.
Pain epigastrium as well as he started breakfast.
Feeling lot much appetite but could only eat one chapatti (Bread).
Bloated feeling, eating after.
Weakness, wants to lie down.
Heaviness of head.
Sneezing paroxysmal with post nasal discharge.

Repertorizations  in Radar 9:-
HEAD - HEAVINESS
NOSE - DISCHARGE - Posterior nares
NOSE - SNEEZING - paroxysmal
STOMACH - APPETITE - easy satiety
STOMACH - PAIN - eating - after
STOMACH - VOMITING - drinking - after
STOMACH - VOMITING; TYPE OF - sour
GENERALS - FOOD and DRINKS - cold drink, cold water - amel.
GENERALS - FOOD and DRINKS - cold drink, cold water - desire
GENERALS - LIE DOWN - desire to
GENERALS - WEAKNESS



Prescription –

Phosphorus 200 CH 2 doses with gap pf two hours.
Sac. Lac.

For one week.

September 10, 2011

All complaints better.
Patients says he never felt so much easy and light in his stomach.


No Prescription.

November 1, 2011

No complaints.


Inferences –

  1. Earlier, case started with few symptoms, and wrong prescriptions were given.
  2. The cases which are under allopathic treatment does not disclose all the symptoms on first visit, because they are hidden, after discontinuing those medicines we get more symptoms on later visits.
  3. Phosphorus and Lycopodium cured the case finally.
  4. Prescribing more then one medicine at a time, only complicated the case.
  5. Earlier prescriptions just push the case towards more clear features.
  6. Many similar medicines can give relief to patient but they does not cure. And their effect does not continue for a long time. 
  7. Daily prescriptions in chronic cases, like this, only prolong the case unnecessarily.  

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© Dr.R.S.Mann & Dr. Vandana Patni 2011