Tolle Totum

Sharum Sharif, ND

We naturopaths help numerous patients with various digestive disorders and complaints every day by prescribing necessary dietary modifications, specific tailored nutritional and/or herbal supplement regimens, and sometimes bodywork. Even though NDs are able to successfully help many of our patients with digestive problems, there are always cases that don’t respond well to these therapies. In such cases, homeopathy can be an indispensable tool. In this article, I have attempted to discuss the highlights of why and how homeopathy can be used to treat digestive disorders/complaints.

Homeopathic remedies can be highly effective in treating acute digestive conditions such as the stomach flu, bloody diarrhea, and pancreatitis, as well as chronic digestive conditions such as inflammatory bowel disease and hemorrhoids. Homeopathic remedies can certainly function palliatively, but when applied correctly, and especially when combined with the proper dietary and supplement regimens, they may be curative.

If you don’t already use homeopathy in your practice, the good news is that it’s easier to incorporate than you might think! Homeopathic remedies are extremely fast-acting, easy to use for all ages, inexpensive, and earth-friendly, and, you don’t have to worry about adverse interactions between homeopathic remedies and other natural therapies or drugs since the remedies are energetic in nature, not biochemical.

In my opinion, the most important reason to consider the use of homeopathic remedies is that there are cases that are extremely difficult, if not impossible, to treat without homeopathy. For example, a patient of mine with colitis described frequent bloody diarrhea that had lasted for many months. She had not responded to the supplements prescribed to her by another ND, but one dose of the remedy Lac caninum 200C stopped the bloody diarrhea immediately. Coincidentally, since this remedy was the patient’s “constitutional” (i.e., chronic) remedy, she has taken it a couple of times each year over the last few years for overall physical and emotional health. Another example is an Alumina case: An older lady named Estelle came to see me for chronic constipation. Estelle would have a BM once every few weeks. Although dietary modifications and supplements such as laxatives, bitters and magnesium had not changed her constipation, one dose of Alumina 200C, her constitutional homeopathic remedy, brought on daily bowel movements immediately. Her video can be viewed on my website.

You can, of course, use homeopathy in many other situations that are not so difficult or urgent. For instance, I often find patients use numerous supplements, such as digestive enzymes or hydrochloric acid, as crutches in order to alleviate symptoms. Although homeopathic remedies can be just as non-curative as supplements, when used appropriately, they can cure patients’ digestive challenges, often rather quickly.

Homeopathic Case-Taking

I would like now to briefly introduce acute versus constitutional homeopathic prescribing. In homeopathy, we categorize people into various constitutions depending on their physical, mental and emotional characteristics. People may fit any of the hundreds of different constitutions, but there are nearly 50 common constitutions that I prescribe on a regular basis in my practice. For long-term care, the remedy corresponding to the patient’s constitution is used; however, for acute care, you may need to prescribe a different remedy to help with the symptoms at hand. For example, a person with a Calcarea carbonica constitution may need Arsenicum album for acute-onset gastroenteritis.

In addition to a naturopathic review of systems and physical exam, taking a homeopathic case involves the following:

1. Ask questions about the details of the symptoms that characterize the main concern as well as accompanying symptoms. These include quality and intensity, sides, times, modalities (better with or worse with questions), extensions, localizations, and detailed descriptions of all major and accompanying or concomitant symptoms. General or common symptoms (symptoms that everyone with that condition might have) are not as helpful as characteristic symptoms (symptoms that are unique to your patient).
2. Concomitant symptoms. The symptoms that occur at the same time as those related to the chief complaint are known as concomitant symptoms. For example, if the patient has the chief complaint of abdominal pain and happens to be angry, anger is a concomitant symptom. Look for remedies with abdominal pain, and then pick from the ones that have anger. Note that you should not look for remedies in the anger section of the repertory, and then pick the ones that have abdominal pain because, in this case, abdominal pain is the chief complaint, not anger.
3. Prioritization of symptoms. Although the correct remedy can improve many symptoms at once, if the patient presents with more than one symptom, you need to prioritize and treat them accordingly. For example, if the patient presents with acute severe bloody diarrhea, chronic headaches and eczema, you clearly should focus on treating the acute bloody diarrhea first, and when the diarrhea is entirely resolved, focus on treating the chronic headaches and eczema.
4. Etiology. Knowing the etiology (causes and contributing circumstances) of a condition can be critical, and is sometimes more important than the totality of the symptoms. Possible etiologies include trauma, shock, grief, infection, and cancer. Prescribing based on etiology often leads to better results, especially in the short term.
5. Diagnosis/pathology. This is absolutely critical in any branch of medicine. In homeopathy, knowing the diagnosis can help guide treatment because each remedy has an affinity for particular organ(s). Abdominal pain, for example, may be caused by a number of different pathologies, and different pathologies point to different remedies. In some cases, pathology takes precedence over symptoms when choosing a remedy.
6. Center of gravity. An example can best illustrate this concept: If a patient presents with chief complaint of severe diarrhea and vomiting, and feels fine otherwise, the center of gravity in this case is the digestive system. A homeopathic remedy that centers on the digestive tract may help this patient more than their constitutional remedy. The constitutional remedy may be useful again for ongoing care after the diarrhea and vomiting are entirely resolved.

The Law of Similars (“like cures like”) is a fundamental law in homeopathy, but it is not the only law. Based on this law, a remedy is chosen that most closely matches the totality of all the patient’s symptoms. In other words, the key features (keynotes) of the remedy fit the key characteristic physical, mental and emotional symptoms of the patient; however, if you ignore the etiology, pathology and center of gravity of the case and base your assessment and remedy selection only on the Law of Similars (using a simple and thoughtless repertorization), you might only achieve palliative results and fail to address the root cause.

Repertorization

One of my favorite repertories is Dr. Robin Murphy’s repertory.¹ It is a modern repertory that lists the various traditional repertory chapters alphabetically, and also lists numerous diseases by their actual modern names. Most repertories list mainly symptoms, and do not contain many disease names, but in this repertory you can find disease terms such as Parkinson’s disease, hypertension, and cellulitis. Homeopaths using Murphy’s repertory may find that the painstaking process known as repertorization—breaking a disease down into all its symptoms, finding each symptom in the repertory, and finding a remedy that is listed under all of the symptoms—is required less often.

A full repertorization is not always necessary to find an effective remedy. You may want to start by focusing on the most important rubrics, looking at the remedies that are in bold and reading about their keynotes in a Materia Medica. This may lead you to a remedy that closely matches your case, taking into consideration the totality of symptoms, etiology, pathology, and center of gravity.

There are many sections listed in the repertory that are related to digestion, starting with mouth, throat, stomach, abdomen, rectum, and stool, and numerous remedies may be effective for the treatment of each condition listed. Food cravings (or better yet, change in a person’s food cravings) and symptoms associated with the consumption of particular foods should be considered as confirmatory symptoms, helping you confirm your remedy choice, rather than as key symptoms to be addressed by the remedy.

Digestive Conditions in the Repertory

Many digestive conditions can easily be found in the repertory. For example, you can find hemorrhoids in the rectum section. There are many other conditions such as irritable bowel syndrome (IBS) that are not listed in the repertory by name. In such cases, you need to find all the presenting symptoms of your patient in the corresponding anatomical region in the repertory.

Some conditions can be found in more than one section in the repertory. For example, acid reflux can be found in the mouth (mouth:taste:sour), throat (throat:food:esophagus, sensation as if food lodged in), and stomach (stomach:heartburn or stomach:eructations) sections.

Below are some of the most common digestive conditions and some of the most useful remedies for their treatment, in alphabetical order:

• Constipation can be found in the rectum section of the repertory. Some constipation remedies for severe constipation include Alumina, Opium, and Plumbum. In my experience, patients who need these remedies are nearly impossible to treat with basic naturopathic therapies. Other remedies that have less severe constipation include Carcinosin, Nat mur, Sepia and Silica. Many patients with chronic constipation do wonderfully with on-going naturopathic treatments such as bitters, liver cleansing and probiotics in addition to their remedy.
• Diarrhea can be found in both the abdomen and the rectum sections. Diarrhea remedies include: Aloe, Arsenicum album, Baptisia, China, Mercury, Natrum sulphuricum, Podophyllum and Veratrum album. Patients with diarrhea typically respond well to probiotics supplementation.
• Gastroenteritis (“stomach flu”) remedies include Arsencium album and Veratrum album. When patients have diarrhea and vomiting, I have never seen a remedy work better than Arsenicum album. One dose of this remedy in any potency can quickly stop gastroenteritis in its tracks.
• Hemorrhoids is listed under the rectum section. There are numerous remedies for hemorrhoids, but the two I most commonly use are Aloe and Hamamelis virginica.
• IBS can involve many symptoms and may present differently from patient to patient, you need to repertorize the unique and characteristic set of symptoms your patient presents with, keeping in mind other aspects of case-taking including etiology. The most common symptoms are abdominal pain/cramps (abdomen:pain and abdomen:contraction) along with diarrhea (abdomen:diarrhea and rectum:diarrhea) and/or constipation (rectum:constipation). Anxiety (mind:anxiety), gurgling (abdomen:gurgling), heartburn (stomach:heartburn), nausea (stomach:nausea), rumbling in abdomen (abdomen:rumbling), and many other symptoms may or may not be present.   Regarding the stools, you can find specific remedies to address the exact color of the stools (refer to the section on stools in the repertory).
• Inflammatory bowel disease (IBD) is also not specifically in the repertory. As with IBS, you have to find out exactly how the IBD manifests in your patient, and find a remedy that matches your case.
• Nausea can be found in both the stomach and abdomen sections. In my experience, chronic and difficult cases of nausea often respond wonderfully to on-going use of naturopathic therapies such as bitters, liver cleanses along with dietary changes in addition to their homeopathic remedy.
• Pain in the digestive system is repertorized according to its location: you will need to use the mouth, throat, stomach, abdomen or rectum sections. It’s noteworthy that there are more rubrics for pain than for any other symptom in each of these sections.
• Vomiting is listed in the stomach section. Acute vomiting may be due to flu or some other infection and needs to be evaluated and treated promptly. Chronic vomiting, which, in my experience, usually occurs in children) is almost always related to consumption of allergenic foods (namely, gluten and dairy).

Potency Selection

Any potency may be used for treating any condition, whether acute or chronic. The lower the potency of a remedy, the less powerful the effect, and the faster it wears off. As a general rule, the 6C and 12C potencies are prescribed to be taken daily or every few days. The effect of 30C potencies can last for days to weeks, while 200C and higher potencies can stay active in the body for weeks to months. I typically start out with lower potencies, and increase them over time if needed. The effect of a homeopathic remedy may be shorter in patients with acute illness, those weakened by a chronic debilitating condition, and those experiencing intense physical or emotional stress. For example, the 30C potency of a remedy may need to be repeated daily for a few days in an acute digestive tract infection; however, a remedy in the 30C potency may stay active in a person with a chronic condition for weeks to months.

If you are not totally confident in your remedy selection, you should stay away from the 200C and higher potencies since they can have a powerful impact on the body and mind; you can always test the waters with potencies of 12C or 30C. Keep in mind that these lower potencies are so weak that you may not discern significant changes, especially in chronic cases, so you and your patient may both need to be patient! If there is a dire need for immediate and serious help, regardless of whether the condition is acute or chronic, the patient is sufficiently vital to handle a higher potency, and I am certain of my remedy selection, I usually prescribe a 200C potency, which can often bring out rapid recovery. How do we know when to re-dose? As a simple rule, the remedy can be repeated when the symptoms are starting to return.

Case Follow-up

Since homeopathic remedies affect the whole person, you should do a full review of systems and physical exam to find out how all of your patient’s symptoms changed immediately after taking the remedy, as well as days to weeks or even months later.

According to Hering’s Law of Cure, you can expect healing to always proceed from emotional to physical (example: anxiety heals first, then digestive symptoms), inside to outside (example: IBS heals first, then skin), and top to bottom (example: heartburn heals first, then constipation), and in reverse order in time of appearance or suppression of the symptoms (example: a recent symptom heals first, then an old symptom).

The correct remedy sometimes brings about an immediate shift in the person’s mood and energy, often within minutes of taking the remedy. Relief from other symptoms typically follows.

Common constitutions that have GI problems

Among the most common homeopathic constitutions, I find that Carcinosin, Lycopodium, Nux vomica, and Silica suffer most commonly from significant digestive problems and require lifelong homeopathic and naturopathic care for their digestive systems to stay balanced.

The Lycopodium and Nux vomica constitutions are known by homeopathic practitioners to have poor liver function, and these remedies are used even by non-homeopathic practitioners to help improve liver function. Practicing in the Pacific NW for nearly 15 years, the constitution I encounter most of all is Lycopodium. Patients with this constitution happen to have the worst digestive health. Their achilles heel is their liver, and their main digestive symptoms are typically abdominal bloating and discomfort and constipation. Nux vomica individuals also have significant liver weakness and can have various digestive symptoms, but they visit my office far less frequently, probably because they are often workaholics and are too busy to take care of their health.

I have never seen a Carcinosin patient without significant digestive problems, including constipation and abdominal discomfort or pain, particularly when not careful with diet. Like Carcinosins, individuals with the Silica constitution have numerous digestive problems, most importantly constipation. Interestingly, I have only seen two cases of collagenous gastritis, a rare intestinal disorder in which the lining of the small intestine is frail, and both had the Silica constitution; of course, the entire body is frail in the Silica constitution.

There are several other common constitutions that often complain of GI problems, but their GI disturbance is significantly milder in nature than the four constitutions listed above:

• Most Natrum muriaticum individuals have constipation due to the dryness that runs throughout their body, even on an emotional level.
• I find that Sulphur individuals complain of acid reflux as their main digestive concern.
• Sepias often have constipation, which makes sense since the central theme in Sepia is stasis and stagnation. It’s well known that they “are better with” exercise, and in particular, their constipation responds well to exercise.
• Finally, I see many Pulsatilla patients with various digestive disturbances, and although their digestive symptoms are sometimes severe, they fortunately respond extremely well to their remedy.

Reference:

1. Murphy R. Homeopathic Clinical Repertory: A Modern Alphabetical and Practical Repertory (3^rd Ed). Pagosa Springs, CO: Hahnemann Academy of North America; 2005.
   

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   Sharum Sharif, ND, has a primary care practice in Kent, Washington, and is an Affiliate Clinical Faculty at Bastyr University. He is a graduate of Bastyr University and New England School of Homeopathy. Dr Sharif has written a book titled “Visual Homeopathy: Identifying the Common Constitutions Within Minutes.” His website, www.VisualHomeopathy.com, has numerous patient videos for the purpose of teaching basic constitutional homeopathy. He has taught homeopathy at naturopathic medical schools in the United States and Canada, and has been a presenter at professional conferences. He is happily married and enjoys spending time with his family.