Irritable Bowel Syndrome

These are common problems faced nowadays. Modern living adds on to these problems a lot more. Though there is a lot of difference in these two diseases categorically, I prefer to keep them together for the clinical purpose. In most of the patients these two conditions alternate frequently. In some one condition get transformed to another. Most of the cases present themselves with typical symptoms of these conditions.

• Frequent urge to stool. Constant unfinished feeling.
• Can't come out of toilet due to this feeling (Rectal dissatisfaction).
• Stool difficult to pass or unable to control.
• Lack of confidence in sphincter ani.
• Frequent small stool with mucus.
• Blood in stool is on and off.
• Pain during or after stool.
• All have either anxiety or depression in their life. Some constant worry-even the worry of their presenting complaints also keeps the problem continuing for years.

A thorough case taking - first listening to their complaints patiently develops a good rapport with the patient. Perfect counseling and assurance of the recovery gives the patient more confidence. Charting a plan to withdraw the medication in phased manner helps in avoiding unwanted aggravation.

The following cases are only examples to show how the patients present with. Case1: Mr. M., 36 yrs. male working as a teacher is diagnosed as "IDIOPATHIC PROCTO COLITIS" suffering since 10 years. The histopathological report reads as MODERATE TO SEVERE CHRONIC SUBACUTE COLITIS WITH FOCAL ULCERATION. He has bloody stool with frequent urge 8 to 10 times a day. Unable to control the urge. Unfinished feeling His wife is not living with him now due to some misunderstanding.

Case 2:Mr.K.M.S., aged 47, having a printing office. Frequent urge to stool. Difficult to control. Must attend to toilet immediately. Stool pasty, semisolid and offensive. Some time bloody stool with mucus. Fear of going out. Fear of eating any thing out because eating initiates urge to stool which is very difficult to control. His son is 14 years old with mild mental retardation.

Case 3: R.G. aged 27 years. Stool 5-6 times a day. Pasty, sticky, semisolid stool, must sit for a long time to clear. Constant unfinished feeling. Washing initiates the urge again. He is under weight. No known worry other than this problem.

Case 4: Mrs.U., 58 yrs. Severe burning in abdomen with painful stool. Either constipation or loose stool but never a normal stool for years. Underwent Hysterectomy, Cholecystectomy, Appendisectomy and omentectomy, and diagnosed as ulcerative colitis. She has Hypertension and peptic ulcer. She is in severe depression but not knowing why. She is on sleeping pills daily.

In all the above cases anxiety, worry and depression were present along with rectal complaints. All were diagnosed as ulcerative colitis or irritable bowel syndrome.

All these patients received Aloes, Arg. nit, Merc cor, Nit. ac, Puls and Sulphur on various occasions and now almost alright but an occasional appearance of one or two symptoms of which I suggested them to ignore.

These and various other cases, prescriptions and marked improvement led me to study the cases and materia medica in detail. I found one medicine to have almost all the symptoms of these conditions. I prescribed this medicine for two patients and both are doing well now. Anyhow these two cases need further observation for final reporting.

• Difficult and irregular evacuations.
• Before stool: colic, cutting, constant pressing in rectum, constant but fruitless desire.
• During stool: nausea, tenesmus, spasm of anus, cutting in anus and rectum, acute pain in abdomen, sensation as if feces remained and could not be expelled, splinter-like pains in rectum (with ineffectual urging), burning, tearing, palpitation of heart.
• After stool: continued urging, exhaustion, irritation, anxiety, general uneasiness, anus sores, raw, cutting, straining, shooting in rectum, continuing for hours, prolapse with sensation of constriction in anus: stitching pains, haemorrhage, discharge of prostatic fluid.
• Constipation. Inability to evacuate feces.
• Constant ineffectual desire, not better by stool.
• Feces hard and dry.
• Constipation with fissure symptoms: bleeding, pain, distending stool.
• Evacuations too frequent.
• Urgent desire to evacuate.
• Loose evacuations, sometimes mucous, or of a putrid smell.
• Offensive and undigested evacuations.
• Much discharge of blood after stools.
• Sanguineous, dysenteric evacuations, with tenesmus.
• Black, offensive blood, mucous pseudo-membranes, with straining and burning in rectum.
• Colic, before stools.
• After stools, excitability and dejection.
• Burning pain, and itching in anus and rectum, with prolapse.
• Sticking in rectum, and spasmodic contraction in anus during stool, fissures.
• Oozing excoriation at anus.
• Hemorrhoids, protruding, painless or burning.
• Pain as if rectum would be torn asunder during a stool.
• Swelling of hemorrhoidal tumours in anus, which bleed at every evacuation - Moisture on anus."
The drug is Nitric acid.

Though stress and tension is one of the well known factor associated with Irritable Bowel Syndrome and Ulcerative Colitis, I do not give importance to them because they are the common symptoms to these disorders. However Nitric acid covers the following symptoms which are more common in Irritable Bowel Syndrome and Ulcerative Colitis:

• Excessive melancholy and fits of anguish, especially in evening, or at night.
• Uneasiness respecting health, with fear of death.
• Excessive nervousness, great excitability, especially after the abuse of Mercury. Easily startled and frightened.
• Unfitness for labor.
• Concentration in self, - Taciturn, disinclined to communicate anything.
• Vexed at trifles.
• Attacks of rage, despair, with cursing and maledictions.
• Irritability and obstinacy.
• Passion.
• I hope, most of the cases of Irritable Bowel Syndrome and Ulcerative Colitis, if not all cases, may respond with timely usage of Nitric Acid.