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Constant diarrhoea
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November 10, 2013
11:31 pm
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Rochelle
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Can anyone see another remedy other than Arsenicum for this lad. 30C – 3 doses worked immediately for a  few days. Gave him a water potency no change – After a month went to Ars 200  1 dose- no change – we are now 2 weeks on and he is hassling me and threatening to go back to Imodium which stops it for a couple of days!! I am going away next week for a fortnight and would like to get him comfortable before I go so if any of you have any ideas I would appreciate it!!  Thanks

 

Background This 21 yr. old man d.o.b. 06/07/1992 came to me from a recommendation. He presented as a slim nervous young man with large grey eyes, cropped hair and large lips. He was about 5ft 11. He answered my question but there wasn’t a lot of spontaneous conversation. He works as an ICT technician at a local primary school.  He has a BTec in IT. He has been prescribed amitriptyline and omeprazole neither of which he is taking now. He has also taken Imodium up to last week and something else Malitium(?) he bought online. He smelt as if he had been passing wind.  He is single and lives with his parents. He smokes 10 a day. Appeared effeminate.

 

Presenting complaint- constant diarrhoea, stomach cramps, worrying and his doctor says it is IBS.

 

“I took the amitriptyline for a month and it did nothing. I stopped is about 2 weeks ago. I last took the Imodium last Friday and haven’t taking the stuff for nausea for a week.”

 

Diarrhoea – “always with a cramping pain. It is watery, mucus around stool and instead of stool sometimes. I can go 8 or 9 times a day. Today I had a bowel movement and it was normal. Last night I had diarrhoea.  It started 7 years ago.”

 

Cramp – “It’s in the abdomen, churning and a bubbling feeling on the left side before I need to go to the toilet. I’ve had biopsies and nothing has been found. I can get pain and worry as I will need to get to a toilet.”

 

“I have always been nervous since very young. I don’t know why. I used to faint.”

 

“When I was 15 I was in a car as a passenger – I always had older friends, mostly my brother’s friends, the car went into a skid and I saw the lamppost getting closer and closer to the car. The next thing I knew I was outside the car on the floor with people around me. They thought I was dead and they had dragged me out. I went to hospital just over night with a broken rib and grazing on the head.  After this my behaviour changed. I was a lot more angry in school. Once I was speaking and the teacher told me to be quiet and I got angry and stormed out. This all lasted about 2 years and I got a counsellor. I remember telling the counsellor about the problem with cars as a passenger.”

 

“When I was 16 – the same day as the previous year someone went into my moped. I haven’t been on a moped since”,

 

He does drive; he came in a car and feels fine about that as he is in control. It is just as a passenger he is nervous.

 

Fainting – “It first happened in primary school when I had bad pains and was taken to hospital. It happened in church with school , with bad pains and sweat. When I was 9 or 10 at the Trafford centre it happened. This was just after my mum’s sister had been on dialysis and my mum gave her a kidney but she died on the operating table.”

 

2 older brothers (how does he get on with his family?)

 

“When I was 2 or 3 I was in hospital with a pipe down my nose and throat for reflux. I get reflux now and again now- it’s a burning feeling. It comes up and goes back down again. It is worse if I have mayonnaise and sometimes cheese.

 

In 2009 he had full investigations of the bowel and they found nothing except he is low on B12 , folates because his stomach can’t absorb them and he is always being sent for blood tests.

 

“I want to put on weight as I am only 9 stone 4 last time I weighed myself”

 

Appetite – “OK but I don’t eat breakfast. Lunch can be a sandwich/veg soup/salad. I snack on chocolate and sweets. Dinner could be anything”

 

Food – desires sweet , roast dinners

Dislikes – sprouts

Agg – cheese sometimes

Drinks – water, coke and squash. Appeared to gulp water. Prefers cold drinks. Doesn’t drink alcohol except on a special occasion.

 

Fears – passenger in a care

–      Heights**

–      Crowds – sits in the aisle seat.

 

“I’m watching people that they are not going to come and sit next to me (why?) I don’t like people I don’t know close to me (Why?) They could do something to me (what?) Attack me. Once I was chased out of the chippy and he started to run towards us. I am afraid of being attacked physically. I avoid anything in which there is a risk of being hurt or becoming ill”

 

“I am anxious about my parents as they won’t tell me things.”

 

“I was never smacked as a child.”

 

“A person who I get on – a colleague- has been going through a tough time. One night I went to hers and her husband called her allsorts. He husband threatened to kill me because we work together.”

 

“When I have bad pains I can fall asleep really tired when I get home from work. On good days I am fine”

 

“I’m shy with people unless I get to know them. It stops me going out and if I didn’t need to leave the house I wouldn’t. I am frightened where I live as they might be carrying guns.”

 

Company – prefers. Doesn’t like being in the house alone. However he avoids people. 

 

Tidy but not fastidious. He always checks that door are locked.

 

Temperature – doesn’t like it too hot but is chilly.

 

Sleep – sometimes wakes at 3 a.m. Dreams – “was out with the person from work in a house. Her husband knocked and I was told to run. I went to the back door but he was there and I woke up”.

 

“Anguish in morning on waking and I don’t know what to do with myself”

 

Restlessness – “I can’t sit for long, especially when there is something on my mind. I

will go for a drive. I lock the doors of the car when I get in.”

 

“I have broken up with a girlfriend of  4 years at Easter which upset me. If we’d been arguing we would have a fall out if I got angry.”

 

“I keep most of my problems to myself. If someone walks past me and ignores me like the head or deputy I think I have said or done something wrong. The same if I text and don’t get one back.”

 

Family Medical History

Reflux in Mum and granddad

Dad – angina, osteoporosis and arthritis.

 

Follow up

 

29th October 2013

 

The remedy worked well for a week with the cessation of his cramps and diarrhoea symptoms and then returned. I suggested that he tapped 10 times on the bottle before taking his daily dose.

 

Overall –“I feel better in myself. I don’t feel like someone is watching me all the time- looking over my shoulder. I am now going to the loo 4 or 5 times a day. I have only been once today so far.”

 

“I stayed at my cousin’s and he said that when I was asleep I breathed in but not out. I looked this up and I think I have sleep apnoea. This would explain why I am tired in the morning apparently.”

 

“The cramping I still get but it is only in the middle of my stomach – right across.”

 

“I have 2 brothers and I get on fine with them.”

 

“I am now eating breakfast – weetabix and last week because it was ½ term and I had more time I had a cooked breakfast”

 

Anxiety in general – “It’s a lot better. I haven’t thought about the colleague’s husband (William) . Previously I would have got  cramps if I heard someone talking about him” (EFT – William in my stomach)

 

“9 to 10 pm I feel bored- I want to do something but I don’t know what”

 

“It has been 2-3 years since I felt so good when the symptoms stopped. I didn’t have to worry about going out”

 

“The stomach problems were going on before the accident. At age 4-5 I was seeing someone about stomach problems but it might have been Reflux. I was on Ranitidine.

 

“I was a lot happier 7 years ago before the accident. I feel down and stuff now. I was really happy when it worked that first week. Before all these problems I was happy and I went out every night.”

 

Ars 200 – 1 dose given.

 

 

 

November 11, 2013
12:07 am
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Shirley Reischman
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Hey Rochelle,

Take a look at Lach, Carbo-veg, Stram, or Sep.  Let me know what you decide and how it goes.

November 11, 2013
12:13 am
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Rochelle
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Thanks Shirley- did you see my rep in the attachment ? Lach comes up the highest but is not there for the painful cramps with urging before stool :(   Nor do any of the others – have just checked and this I feel is an important rubric that has to be there!!

November 11, 2013
1:36 am
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Shirley Reischman
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Since the Ars didn’t work as you went up in potency, it’s not the right remedy.  If a remedy seems to fit in general, unless I’ve read the proving, I wouldn’t discount it just because the rubric doesn’t show up on reporatizing.

November 11, 2013
7:10 am
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David Kempson
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Isn’t that a common symptom for diarrhea anyway? I wouldn’t consider it peculiar enough to worry too much about a remedy covering it

November 11, 2013
9:50 am
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Rochelle
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I don’t know about that – people have an urging which isn’t painful  with a chronic condition – not so much with acute. Thanks as that is an interesting thought.

He has given me a couple of new symptoms about him – head shaking and face grimacing (from his parents) which I have added to the rep and I now wonder about Belladonna but with have to talk to him about this. He is taking a great interest in remedies and reps – looking remedies up which most don’t do. He came up with Lyc and Arg Nit for himself neither of which I think is suitable!

November 11, 2013
10:02 am
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Rochelle
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Shirley Reischman said
Since the Ars didn’t work as you went up in potency, it’s not the right remedy.  If a remedy seems to fit in general, unless I’ve read the proving, I wouldn’t discount it just because the rubric doesn’t show up on reporatizing.

I was wondering about going to 1M or 10M. I also wondered if he initial improvement was placebo effect!!

I will talk to him around Lach  and  Stram ( although don’t see the violence as he is a gentle soul) with the new rep thanks but because the others are no where  near the first  27 in my rep .

 

 

 

November 11, 2013
12:16 pm
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Shirley Reischman
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I would try Sepia.  It’s for young men and women who are delicate and sensitive (Hering).

November 11, 2013
2:14 pm
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Rochelle
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Shirley Reischman said
I would try Sepia.  It’s for young men and women who are delicate and sensitive (Hering).

Thanks Shirley- I will study the MM of the Rectum chapter in Clarke(my bible) and see if his symptoms are similar. He is certainly delicate and sensitive !!

November 11, 2013
4:27 pm
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drofart
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Have a look at Acid. Phos. too.

November 11, 2013
5:01 pm
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Rochelle
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drofart said
Have a look at Acid. Phos. too.

OK will do thanks.

 

November 11, 2013
9:33 pm
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David Kempson
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I don’t know about that – people have an urging which isn’t painful  with a chronic condition – not so much with acute. Thanks as that is an interesting thought

Yes but then that would be peculiar, like having mucous in the chest without a cough, or diabetes without thirst, or a migraine without pain. Diarrhea is defined by the painful urging before stool, so for me it would be too common to use as a differentiating symptom. The kind of pain would definitely be useful if it was unusual, or some other modality. For me I try to look at what differentiates this patient from any other patient with the same condition.

 

One of the things that I noticed about this case was that there was a lot of factual information, but not very much information about what is going on inside of him. Generally in such cases I would stick with low potencies either because the patient themselves in not experiencing much peculiarity or they are unable to express it well enough. There has been a fair amount of medical suppression as well, which may have dulled the case somewhat and this is a situation I also find low potencies are better for. Perhaps even LMs might work well here.

I repertorized the following symptoms:

Stool+mucous

Bubbling/churning/rumbling  before stool

Ailments from injury

Averse to breakfast

Fainting with/after pain

Fear of heights

Fear of being attacked

Anthrophobia

Exhaustion from pain

Weakness from pain

Aversion to company yet fear of being alone

Body odour of stool

Fear of being murdered/killed

Anxiety on waking

Restless cannot sit

 

This brought up Ars, Sulph, Phos, Lach, Thuj, Acon, Rhus-t, Sil, Lyc as the main remedies in descending order of rubrics. However the only two of those remedies that comes up in the Aversion to company yet fear of being alone, which I would consider to be a fairly peculiar mental, are Aconite and Lycopodium.  Perhaps one of those might be worth looking at? Lyc caught my interest out of that group anyway.

 

November 11, 2013
10:42 pm
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Hi David thanks for this. I have to say if I get diarrhoea I never have a painful urging with it :) !!!

You can see where I got Ars from and you will have noted that I did start with 30c which to me is a low potency and as I said it worked for a few days and stopped and giving the Ars 30 in a daily WP didn’t do anything at all!!

Now Lycopodium is one he has come up with for himself which I really hadn’t considered seriously until last night when he became most demanding on email saying if I don’t do something he will start taking the Imodium again. Now sounds like Lyco to me don’t you agree? I didn’t see him as domineering in anyway until this.

Since last night when I said the only time I could see was today (he was on a course) even after 9pm or tomorrow mornbing if he can get time off work I haven’t heard a thing from him. I have patients in tomorrow when he could come and then I am busy most of Wednesday before I go away for a fortnight. Now it would also IMO for someone who needs Lyco to give up when he can’t get his own way. Its certainly a thought. Lyco certainly comes up high for my rep and is the only of the top Rx coming out for both 2 new symptoms he gave me last night of grimacing and involuntary shaking of the head which his mum told him to tell me about. I certainly didn’t notice either.

The remedy that comes second to my rep now is Bell and I would love to question him around this remedy. We have the suddenness with the pain and diarrhoea but I don’t know of any fevers he may have had in the past. 

 

 

 

 

 

 

November 12, 2013
6:30 am
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David Kempson
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Painless diarrhea is more unusual – I would use that as a symptom!

 

Yep I can see how Arsenicum shows up for this case, no doubt. I probably would have tried it as well. 30c is actually a medium level potency – low I typically consider 6c or 12c, or LM1 or LM2. I am not sure if going down would help at this stage, as it looks more like Arsen might have only been palliative.

For me the thing that really stands out about Lyc is the fear of people, with all the anxiety and shyness, the desire for sweets, the reflux, the restlessness, the general phobic state.

November 12, 2013
9:25 am
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After all these years of us corresponding on various forums David I still don’t do LMs!! Have never had much success with them and they also don’t seem to work for me!! I would have gone lower if it had been a purely physical problem but there is lots of M&E stuff here. Anyway he has not been back to me so has probably gone back on the Imodium to log up the works!! Lets see if he returns for his next appointment after I return fro  Singapore!!

(Luckily yesterday’s follow up was thrilled with her improvement – husband says she is like a changed woman – that was Arsenicum 1M – 1 dose!!)

One of today’s cases is a hassle- a 12yr old bed wetter. I need to find out just why he wants to continue with this- I suspect attention from parents as he still hasn’t put into place to put his cell phone on to wake him 3 hours after he has gone to bed to get up and urinate. He sleeps very soundly. He is afraid of the dark, of things he sees in the dark and I have tried to use NLP techniques on this.  Mum has at last put a night light in his room.  A very Calc child. The most I have managed to achieve here is a day or so immediately after whatever remedy I have tried!! I have even tried Equisetum low dose. Today I am going to try Picture Tapping (EFT variation) and see if I can find out what is behind this.

November 12, 2013
11:55 pm
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Just to say he has just been in  touch to say he has had 2 panic attacks today so I am leaving him some Aconite 30 with the instructions to take 3 in 24 hours (sorry folks, very typical UK prescribing method that I use) and then as needed if he starts with another.

 

David – I was searching for something in my files and found loads of srtuff I had printed out from you in 2000 from homeopathyhome. Remember that site- it was the Hpathy.com of yesteryear!!!!! Brilliant in its heyday- taught me loads. Ben Rozenthall was our beloved Kaviraj!! I  didn’t find that out until recently went I met him RIP.

November 13, 2013
12:31 am
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David Kempson
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Hi Rochelle,

 

You don’t think it is an aggravation on the 1M? It seems around the time it would happen. I would be wary of adding a new remedy into treatment so quickly. I would think it is a good sign that Ars is working.

I only vaguely recall homoeopathyhome now. Haven’t thought about that site in many years.

November 13, 2013
12:47 am
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Rochelle
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I didn’t give him a 1M but a 200C.  

He sounded so relieved and thanked me for leaving him something before I went away. The Aconite 30 I don’t feel will do him any harm and if it helps his diarrhoea I will be even more convinced that the whole thing is psychological!!

 

You and I wrote profusely in the Forums on homeopathyhome in 2000!!

November 13, 2013
1:18 am
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David Kempson
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Sorry Rochelle – I must have mixed up the cases you were discussing – the improvement on 1M Arsenicum was a different patient?

The question I would pose though, is how will you know which remedy helped his diarrhea?

November 13, 2013
1:26 am
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I reckon that since the Ars 30 worked immediately and repeating it and going up on the remedy has not made any improvement after it stopped working the Ars must be the wrong remedy. He is now got himself into a state where he is having panic attacks which as we all know Aconite works wonders for and I feel he needs his confidence back.  Aconite is down as a similar remedy and also one that follows Ars well so I felt it was a good choice. If it improves the diarrhoea so much the better but I feel confident that it will help the panic attacks. which is the uppermost thing on his mind at the moment.

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