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Dr. Santosh Yadav (M.D.)
Consultant Homeopath
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• Hyperacidity or Heartburn   or Acid Dyspepsia • Constipation • Piles • Anal Fistula (Fistula-in-ano,   Anorectal Fistula) • Anal Fissure • Peptic ulcers • Irritable Bowel Syndrome • Gall Stone • Jaundice • HepatitisB • Fatty Liver • Ulcerative Colitis
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Mentaly Disorder
Male Disorder
Irritable Bowel Syndrome
IBS is one of the most common disorder of digestive system producing a spectrum of symptoms such as persistent and recurring abdominal pain associated with passing of motion, change of bowel habit (diarrhea, constipation, or alternate diarrhea and constipation), etc. without any apparent cause. The word syndrome means a group of symptoms. IBS is a syndrome because it can cause several symptoms in addition to those mentioned, like cramping, bloating, gas, frequent urge to pass stools, sensation of incomplete evacuation etc.

IBS is the disorder of function, which means that the bowel doesn't work, as it should. If one visualizes the bowel,
it appears perfectly normal without any inflammation or other structural changes. In people with IBS, the intestines squeeze too hard or not hard enough and cause food to move too quickly or too slowly through the intestines.

Through the years, IBS has been called by many names--colitis, mucous colitis, spastic colon, spastic bowel, and functional bowel disease, irritable colon, and nervous colon. Most of these terms are inaccurate and refers to understanding of diseases at that particular time frame. Colitis, for instance, means inflammation of the large intestine (colon). IBS, however, does not cause inflammation of the bowel and should not be confused with another disorders like ulcerative colitis.

IBS though affect people of all ages and both the sexes; it is more common in young people; usually in late adolescence or early adulthood. The condition is almost two to three times common in females as compared to males.
Nature of condition
Almost everything about IBS is totally dependent on the individual patient. For some, IBS may arise during times of stress or crisis, and then subside once the stressful event has passed. For others, IBS strikes seemingly randomly and without warning and never completely goes away. The duration of IBS is different for everybody. The symptoms may wax and wane, being particularly severe at some times and absent at others.

To sum up, this is a chronic relapsing condition.
Effect on lifestyle
IBS can be nothing more than a mild annoyance, completely debilitating, or anywhere in between. Again, it depends on the person and how he or she reacts to it and treats it. IBS can, however, be very painful and can severely affect a person's quality of life, and is second only to the common cold as a cause of absenteeism from work.

IBS and Stress
The key point is that IBS is strongly related to emotional stress and strain. Research on the psychosocial aspects of these disorders has yielded three general observations:

1. Psychological stress exacerbates gastrointestinal symptoms.
2. Psychological disturbances amplify illness experience and adversely affect health status.
3. Having a functional GI disorder like IBS impairs the quality of one’s life.

Positive points
Interestingly, even though the symptoms of IBS can be very painful and debilitating in some, it should be emphasized that this is never a life-threatening condition. Those afflicted with IBS do not have any greater chances of developing inflammatory conditions of bowel like Crohn’s disease or ulcerative colitis, neither do they pose any higher risk of having colon cancer. Moreover this disease cannot be passed to other individuals like some of the infections may have chance to do so.
Causes :
The cause of IBS is not known. Doctors call it a functional disorder because there is no sign of disease such as inflammation or infection when the colon is examined.

With aggressive research done in this area over a period of time, scientists have come to the conclusion that the cause of IBS may be multifactorial, the cumulative effect of which results in the derangement of normal functioning of bowel.

The underlying cause of this disorder is an abnormality of the intestinal muscles contraction. In IBS the intestines may not function normally, either contracting too forcefully or weakly, too slowly or rapidly.

The factors that can adversely affect the job of the bowel are as follows:

1. Psychological factors: Patients of IBS report of increasing symptoms during the events of stress and many patients with IBS report that their symptoms began during periods of major life stressors such as a divorce, death of a loved one, school exams, or after moving to a new job or city. About 50% patients exhibit range of emotional disturbance including anxiety, depression, and neurosis.
It is a known fact that our emotions and intestines are interwoven. The brain and the intestines are closely connected by nerve fibers that control the functioning of the intestines. It is believed that in IBS the communication between brain and gut may be impaired.

2. Sensitivity to food: Symptoms of IBS have also been known to be triggered by the ingestion of certain foods to which the individual is sensitive. Chocolate, milk products, caffeine, or large amounts of alcohol are frequent offenders.
One theory states that lack of fiber in the diet can have detrimental effect. This lack of fiber causes irregular contractions of the large intestines.

3. Genetics and heredity: Some studies indicate that there are more chances of IBS running in a family. It is believed that there are some inborn tendencies of an individual that make him/her react adversely to stress or certain food and resulting in IBS.

4. Some patients develop IBS following an episode of gastroenteritis or abdominal surgeries like removal of gallbladder.

5. Researchers have also found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can increase IBS symptoms

6. Conventional medicines: Many patients of IBS report worsening of their symptoms following use of some of the conventional medicines like antibiotics, steroids, anti-inflammatory medicines etc.
Although many IBS sufferers get similar symptoms, each individual with IBS has his own unique set of symptoms.
IBS presents in wide spectrum of severity. For some people it may just be an occasional mild episode or nuisance. For others, it can be a debilitating illness that causes frequent absenteeism from work.
The most common symptoms of IBS are as follows:
1. Altered bowel movements/habits: Some people with IBS have constipation (difficult or infrequent bowel movements, hard stools); others have diarrhea (frequent loose stools, often with an urgent need to move the bowels); and some people experience both, for example several weeks of constipation followed by a few days of diarrhea. The diarrhea typically occurs immediately after a meal or when getting up in the morning. Sometimes people with IBS pass mucus with their bowel movements.

2. Abdominal pain and cramps: The abdominal discomfort of an irritable bowel ranges from sharp, cramp to a continuous, dull ache. Common sites of pain include the lower abdomen, specifically the left lower quadrant. Meals may precipitate pain while pain is commonly relieved by defecation.

3. Gas formation, bloating, abdominal distention: Patients frequently report increased amounts of bloating and gas and distended feeling.

4. Urgency: Sometimes the person with IBS has a cramp and an urge to move the bowels but cannot do so.

5. Sensation of incomplete evacuation: The patient feels like he still needs to have a bowel movement after he has already had one.(incomplete evacuation)

6. Extra-colonial symptoms: In addition, a number of other symptoms not directly related to bowel may be present in patients with IBS. These include: nausea (with or without vomiting), feeling full after eating only a small meal, difficulty swallowing, a sensation of a lump in the throat or a closing of the throat, heartburn or acid indigestion, chest pain, sensation of urinary urgency, incomplete emptying after urinating, fatigue and generalized body ache or muscular pains, and pain during sexual intercourse.

Bleeding, fever, weight loss, and persistent severe pain are not symptoms of IBS but may indicate other problems.

Homoeopathy effectively manages various symptoms of IBS gently and safely.
Since there is no diagnostic marker associated with IBS, the diagnosis is based on symptoms and by excluding other diseases, which may have similar symptoms such as ulcerative colitis, colon cancer, diverticulosis, parasites, dysentery and other infectious illnesses. To arrive at the diagnosis of IBS positively, the doctor usually will take following steps:

1. Thorough medical history:

The doctor will take a complete medical history that includes a careful description of symptoms. The symptoms that favor diagnosis of IBS are

1. Relief of abdominal pain with defecation,
2. Looser stools with the onset of pain,
3. More frequent bowel movements at onset of pain,
4. Abdominal bloating or distention,
5. Feelings of incomplete evacuation, and
6. Passage of mucus per rectum.

2. Physical examination:
Most patients, however, will be given a thorough physical exam, which is performed mainly to rule out other medical illnesses. The patient has an overall healthy appearance. The patient may be tense or anxious. The patient may present with sigmoid tenderness or a palpable sigmoid colon.

3. Laboratory test:
A stool sample will be tested for evidence of bleeding by using a special chemical test called Hemoccult slides. This is very important in the evaluation since IBS should not be associated with any bleeding. Stool will also be examined for evidences of microorganisms notorious for producing symptoms of diarrhea or constipation.

Other tests may be done to rule out deficiency of enzymes required for digestion of milk sugar or checking the level of hormones like thyroid etc.

4. X-ray:
The doctor also may do diagnostic procedures such as x-rays of lower G.I. series also called as barium enema. It is a special type of X-ray that uses barium sulfate to outline the lining of the rectum and colon. Barium sulfate is a chalky chemical that shows up as white on X-ray film.

The individual is made to lie on his/her side on an x-ray table, he/she will be given enema of barium fluid through a tube that is inserted into the rectum. You will be instructed to 'hold' the fluid inside while an X-ray technician will take a series of X-rays. The procedure is painless.

These studies done with x-ray helps the doctor to rule out conditions like tumor, inflammation, obstruction, and Crohn's disease, etc.

5. Endoscopy:
Endoscopy is a process of viewing the inside of colon and its various parts through a flexible tube inserted through the anus to find out if there is disease. These examinations are usually performed to rule out other colon disorders such as colon cancer, ulcers, inflammation and other problems, that may produce similar symptoms.

The patient is asked to lie on his left side on the exam table. Medication will be given to limit any discomfort experienced during the procedure. Then, the doctor will insert a flexible colonoscope into your rectum. This test uses a colonoscope, which is a flexible tube with lenses, a tiny TV camera and a light at the end. Through fiber-optic technology and a video computer chip, the colonoscope can scan the inside of the colon and transmit images to a video screen.

The colonoscopy procedure can take up to 1 1/2 hours and is performed in a hospital as an outpatient procedure.

Since the mainstay of diagnosis of IBS is based on patient's symptoms and complaints, the medical fraternity has laid down certain criteria for positive confirmation of irritable bowel syndrome. To know more about them click here.

The Manning Criteria to distinguish IBS from organic disease are as follows:
- Onset of pain associated with more frequent bowel movements
- Onset of pain associated with looser bowel movements
- Pain relieved by defecation
- Visible abdominal bloating
- Subjective sensation of incomplete evacuation more than 25% of the time
- Mucorrhea more than 25% of the time

Recently, a consensus panel updated the Manning Criteria. The result provides a standardized diagnosis for research and clinical practice.

During the past three months, have you experienced continuous or recurrent symptoms of:

1. Abdominal pain or discomfort which is:
- Relieved by defecation? and/or
- Associated with a change in frequency of stool? and/or
- Associated with a change of consistency of stool?

2. Two of the following at least 25 percent of occasions or days?
- Altered stool frequency (more than 3 bowel movements/day or fewer than 3 bms/week)
- Altered stool form (lumpy/hard or loose/watery stools)
- Altered stool passage (straining, urgency, or feeling of incomplete evacuation)
- Passage of mucus
- Bloating or feeling of abdominal distension

Diagnosis usually is made after these symptoms have occurred for at least 3 months.

The Rome Criteria for the diagnosis of IBS require that patients must have the following continuous or recurrent symptoms for at least 3 months:

Abdominal pain or discomfort characterized by the following:
- Relieved by defecation
- Associated with a change in stool frequency
- Associated with a change in stool consistency

Two or more of the following characteristics at least 25% of the time:
- Altered stool frequency
- Altered stool form
- Altered stool passage
- Mucorrhea
- Abdominal bloating or subjective distention
Role of Homeopathy in Irritable Bowel Syndrome:
Irritable Bowel Syndrome is most of the times found associated with stress and intolerance of selective food items. These food items may very from person to person.

Homeopathy has greater success in managing cases of Irritable Bowel Syndrome for many reasons. Homeopathic approach to a chronic case has lot of psychological exploration of the patients in order to arrive at a right remedy for the person.

These methods of investigation help in selecting most suitable remedy for the person. Besides the action of right remedy which is selected very carefully, patients experience of talking out their inner feeling states with the homeopathic physician also plays an important role in the successful treatment of Irritable Bowel Syndrome.

Other sense homeopathic physician plays a role of councilor during treatment of such chronic illness which is certainly made worse on account of stress. Besides this homeopathic medicines are safe and effective. It works without producing any side effects. Patients can avoid side effects arising from the long term use of conventional treatment
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