• CHOLELITHASIS and its Homoeopathic Treatment

    Condition is a characterized by presence of stones in gall bladder.

     

     

     

    ETIOLOGY
    Chokestorol stones
    Exess of cholesterol

    • Obesity.
    • Hyperlipidaemia .
    • Diabetes mellitus.
    • High refined carbohydrate diet.
    • Low febre diet.

    Bile stasis

    • Pregnancy.
    • Latrogenic: contraceptives.

    Infective

    • Recurrent a calculus cholecystitis.

    Deficaient bile secretion

    • Crohn’s disease.

    Pigment stones

      • Low protein diet.
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    • Hereditary spherocytosis.
    • Sickle cell anaemia.
    • Thalassemia.
    • Age: Mddle age.
    • Sex: Common in females.
    • Clinical Features
    • Gall stones present in following three ways
    • Silent cholelithiasis
    • Acute cholecystitis
    • Chronic cholecytitis
    • Silent cholelithiasis
    • Asymptomatic

    ACUTE CHOLECYSTITIS
    Acute inflammation of bladder characterized by right upper abdominal pain nausea, Vomiting and tenderness over right hypochondrium.

    Cause

    • Gall stone impaction in
    • Hartman s pouch
    • Cystic duct
    • Causatiue organism
    • E. coli
    • Klebsiella
    • Streptococcus faeca;is

    CLINICAL FEATURES
    Symptoms

    • Onset sudden
    • Pain
    • Location :right hypochondrium
    • Radiation to right scapular region
    • Character severe colicky
    • worse eating
    • Nausea
    • Vomiting
    • Flatulence
    • Fever

    Signs

    • General examination
    • Subject is ill
    • Facies anxious
    • Temperature: 380 C or more
    • Abdominal examination
    • On palpation
    • Tenderness rigidity of right hypochonferium
    • Palpable mass
    • In right hypochndrium below costal
    • Margin
    • Shape globular
    • Moves with respiration
    • Murphy sign positive
    • Pain on taking deep breath while examiner s hand is pressed below right costal margin
    • Psoas’s sign positive
    • Area of hyperesthesia over 9th 10th 11th ribs posteriory on right on right side

    COMPLICCATIONS
    Obstructive jaundice
    Cholangitis
    Septicaemia
    Empyema
    Mucocele

    CHRONIC CHOLECYSTITIS
    Repeated attacks of biliary colic abdominal distension flatulence nausea by fatty food.

    Cause
    Contraction of gall bladder due to
    Chronic inflammation
    Obstruction of outled of gall bladder by stone inaction

    CLINICAL FEATURES
    Symptoms

    • Onset insidious
    • Pain
    • Episodic paroxysmal
    • Location right hypochndrium
    • Radiation: between shoulder blades
    • Duration several hours
    • Character severe excruciating
    • Worse after eating
    • Flatulent dyspepsia
    • Sensation of fullness after food
    • Flatulence
    • Hertburn
    • Nausea
    • Vomiting
    • Worse after fatty food
    • Better by belching

    COMPLICATIONS

    • Biliary colic
    • Obstructive jaundice
    • Chronic Pancreatitis
    • Carcinoma gall bladder

    INVESTIGATIONS

    • USG Abdomen
    • Diagnostic
    • Gall stones seen as dense mobile objects which cast acoustic shadow
    • X-Ray abdomen
    • Reveals radio-opaque or radio-lucent gall stones or soft tissue mass in region of gall bladder.
    • Blood (in acute cholecystitis)
    • TLC:leucocytosis.
    • DLC: polymorgs increased.
    • ESR: raised.

    PROGNOSIS

    • Guarded.

    MIASMATIC CLEAVAGE

    • Predominant symptomatically.

    THERAPEUTIC AIM

    • To treat symptomatically.
    • To prevent complications.

    GENERAL MANAGEMENT

    • Acute
    • Bed rest till signs of inflammation and fever subside
    • Diet
    • Nothing by mouth till nausea vomiting subside
    • Later on fluid fat free diet
    • Maintain fluid electrolyte balance
    • Local heat
    • Chronic
    • Diet
    • Small frequent meals
    • Avoid fatty things refined carbohydrates
    • Reduce weight if obese
    • Evaluate for surgical intervention

    HOMOEOPAHIC TREATMENT

    Acute

    • Belladonna
    • Berberis Vulgaris
    • Chelidonium M.
    • Dioscorea

    Chronic

    • Carduus Marianus
    • Chelidonium
    • China Off
    • Chionanthus
    • Fel tauri
    • Hydrastis Can
    • Intercurrent
    • Calcarea Carbonica
    • Lycopodium
    • Nux Vomica
    • Thuja Oc.

     

     

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