Retrospective Analytical Case Series Study on the Acid Peptic Disorders treated with Homoeopathic Medications

 

Dr. H. Venkatesan

Research Coordinator, Vinayaka Mission’s Homoeopathic Medical College and Hospital

A Constituent College of Vinayaka Mission’s Research Foundation (Deemed to be University), NH 47,

Sankari Main Road, Seeragapadi, Salem, Tamil Nadu, India, Pin Code: 636308.

*Corresponding Author E-mail: venkathompath@gmail.com

 

ABSTRACT:

Acid peptic disorders include Peptic Ulcer Disease and Gastro Esophageal Reflux Disease. While the majority of ulcers are caused by Non steroidal antiinflammatory drugs (NSAID) or infection with Helicobacter pylori, cigarette use and stress are also established causes of Ulcers. Acid peptic disorders are the result of distinctive, but overlapping pathogenic mechanisms leading to either excessive acid secretion or diminished mucosal defense. Helicobacter pylori infection is a factor in 85% to 100% of duodenal ulcers and 70% to 90% of gastric ulcers. Gastric erosions are diagnosed by endoscopy in 30–50% of patients on chronic NSAID therapy. Tobacco smokers are twice as likely as nonsmokers to develop ulcers. In people under severe physiological stress, ulcers may result from changes in their body's pH levels. Low Socio Economic Status is considered as a risk factor for peptic ulcer disease independent of Helicobacter pylori infection and NSAID. Current management of Acid Peptic Disorders includes the use of combination Antisecretory and Antibiotic therapy for acute Management. Since Indian population are highly exposed to any one or multiple risk factors mentioned above, it is important to find the alternative management evidences for long term Management. Hence Randomly selected Case Records of 30 Acid Peptic Disorder Patients treated with Homoeopathic Medications at Vinayaka Mission’s Homoeopathic Medical College Hospital, Salem, Tamilnadu were retrospectively analyzed for the effectiveness. This Study results showed that the Homoeoapthic medicines Robinia, Natrum sulphuricum, Arsenicum album, Hepar sulphuricum, Bryonia, Eupetorium and Hydrastis Canadensis were found to be effective in treating Acid Peptic Disorders. The Retrospective Case Series analysis has shown that 56.67% of cases showed marked improvement, 33.33% of cases showed moderate improvement and 10% of cases showed mild improvement.

 

KEYWORDS: Acid Peptic Disorder, Duodenal Ulcer, Gastric Ulcer, Gastro Esophageal Reflux Disease, Helicobacter pylori, Peptic ulcer Disease, Homoeopathic management.

 

 


INTRODUCTION:

Acid peptic disorders include Peptic (Gastric and Duodenal) Ulcer Disease and Gastro Esophageal Reflux Disease. While the majority of ulcers are caused by Non steroidal antiinflammatory drugs (NSAID) or infection with Helicobacter pylori, cigarette use and stress are also established causes of Ulcers1. Acid peptic disorders are the result of distinctive, but overlapping pathogenic mechanisms leading to either excessive acid secretion or diminished mucosal defense. Helicobacter pylori infection is a factor in 85% to 100% of duodenal ulcers and 70% to 90% of gastric ulcers. Gastric erosions are diagnosed by endoscopy in 30–50% of patients on chronic NSAID therapy. Tobacco smokers are twice as likely as nonsmokers to develop ulcers. In people under severe physiological stress, ulcers may result from changes in their body's pH level. Low Socio Economic Status is considered as a risk factor for peptic ulcer disease independent of Helicobacter pylori infection and NSAID2-4.

 

Peptic ulcer disease is a pan geographic problem. Gastrointestinal bleed and perforation are the major complications of peptic ulcer disease and these complications are associated with significant morbidity and mortality5. It affects nearly 4 million of global population yearly6. In western countries, its incidence increased in the early twentieth century but started to decline during the latter part of that century7,8. Duodenal ulcers are four times more common than gastric ulcers. Also, duodenal ulcers are more common in men than in the woman8. This decline may have been related to improved hygiene, decrease in prevalence of Helicobacter pylori infection and the use of potent Antisecretory drugs such as Histamine-2 receptor antagonists and Proton pump inhibitors9. Studies from various parts have shown a strong association of Helicobacter pylori with duodenal and gastric ulcer. Indian studies also show a good duodenal ulcer healing [75%-90%] with antibiotic therapy intended to treat Helicobacter pylori infection. However the problem in India is that the relapse rates of Peptic ulcer after eradication therapy is higher than those reported in studies reported from the West. They found that ulcer relapse was seen around 10% of cases without recurrence of Helicobacter pylori infection and in 63% cases with recurrence of Helicobacter pylori infection10.

Gastro Esophageal Reflux Disease (GERD) is one of the most common gastrointestinal disorders that has substantial health and economic consequences. Several modifiable risk factors are associated with GERD11. It develops when these retrograde flows cause troublesome acid heartburn and/or regurgitation at least one day a week12. Prior research showed that GERD affected 10% to 20% of individuals in the Western world, with a comparatively low prevalence (5%) among Asians13. The prevalence of GERD in India ranges from 7.6% to 30%, being < 10% in most population studies, and higher in cohort studies. The dietary factors associated with GERD include use of spices and non-vegetarian food14. Proton Pump Inhibitor is a standard therapy for GERD in the general population; but half of the patients treated shows only partial response to GERD15.

 

Current management of Acid Peptic Disorders includes the use of combination Antisecretory and Antibiotic therapy for acute Management1,2. Since Indian population are highly exposed to any one or multiple risk factors mentioned above, it is important to find the alternative management evidences for long term Management. Long term use of the Proton Pump Inhibitor Therapy has its own complications. Most important complication is an increased risk of enteric infections among the treated persons16.

 

Recent researches explore the effectiveness of many traditional Homoeopathic Medicines in the treatment of Lifestyle disorders17,18. Such that Acid Peptic Disorders are also responding well to the Homoeopathic Medications19,20. Hence Randomly selected Case Records of 30 Acid Peptic Disorder Patients treated with Homoeopathic Medications at Vinayaka Mission’s Homoeopathic Medical College Hospital, Salem, Tamilnadu were retrospectively analyzed for the effectiveness. The details of the Study are given below in detail.

 

MATERIALS AND METHODS:

Source of data:

Randomly selected 30 Acid Peptic Disorder (APD) Patient’s Data were retrospectively collected from Vinayaka Mission’s Homoeopathic Medical College Hospital, Salem, Tamilnadu, India.

 

Sampling Method Adopted:

The Sample Case Records were selected on the basis of the following fixed Inclusion and exclusion criteria.

·       Inclusion criteria: Both Male and Female patients of age 15 to 35 years with the complaints of Dyspepsia, GERD, Gastritis, Gastric Ulcer and Duodenal Ulcer were selected.

·       Exclusion criteria: Patients with the symptoms of Zollinger Ellison Syndrome, Haematamesis, Malena, Gastric Corrosion due to Poisoning and signs of Systemic Infection were excluded.

 

Operational Design observed in the Sample Case Records:

·       The Complete Details of all the patients were collected through the Standard College Case record format.

·       The patients were diagnosed on the basis of Presenting Symptoms, Examination Findings, Available Investigatory Reports, Past History, etc.,

·       The Collected symptoms were analyzed based on Kentian Philosophical method.

·       Followed by Repertorization of the selected symptoms the medicines were selected and prescribed in 30C Potency to all the patients.

·       Each patient was treated for at least 90 days with a daily dose of Medicine.

·       Repetition of Medicines was given on the basis of need.

·       The patients were assessed symptomatically after the treatment.

 

Some Sample Characters like Age Distribution, Gender Distribution, etc., were analyzed. This Retrospective study was carried out during January 2020 to March 2020 by Dept of Research and Development, Vinayaka Mission’s Homoeopathic Medical College Hospital, NH 47, Sakari Main Road, Seeragapadi, Salem, Tamilnadu, Pin code - 636308.

 

OBSERVATIONS AND RESULTS:

From the selected samples it is observed that APD has commonly (43.3%) presented in the Age Group of 31- 35 Years (Table 1) and both Males and Females are equally affected (Table 2).

 

Table 1: Age wise distribution of patients


Age

Total

Percentage

15-20 YEARS

4

13.3%

21-25 YEARS

5

16.7%

26-30 YEARS

8

26.7%

31-35 YEARS

13

43.3%

 

Table 2: Gender wise distribution of patients


Gender

Total

Percentage

Males

14

46.7%

Females

16

53.3%

 

The Exciting factors for their APD were analyzed and are shown in the Chart 1. Eating Spicy Foods and Mental Stress were found to be the most common Exciting Factors. The Distribution of Acid Peptic Disorders were also found and shown in Chart 2.

 

 

Chart 1: Distribution of Exciting Factors for APD

 

 

Chart 2: Distribution of Acid Peptic Disorders

This Study results showed that the Homoeoapthic medicines Robinia and Natrum sulphuricum are frequently indicated. Arsenicum album, Hepar sulphuricum, Bryonia, Eupetorium and Hydrastis Canadensis were the other drugs found to be effective in treating Acid Peptic Disorders as shown in Chart 3.

 

 

Chart 3: Distribution of Homoeopathic Medicines Prescribed

 

The Retrospective Case Series analysis has shown that 56.67% of cases showed marked improvement, 33.33% of cases showed moderate improvement and 10% of cases showed mild improvement according to the Pre and Post Treatment APD Symptom Assessment Scale as shown in Chart 4.

 

DISCUSSION:

Retrospective Study showed that both Males (46.67%) and Females (53.33%) are equally affected and Eating Spicy Foods and Mental Stress were found to be the most common Exciting Factors for APD. The all the 30 Sampled APD patients treated with Homoeoapthic Medications have shown improvement. 56.67 % Patients had showed Marked Improvement and another 33.33 % had showed Moderate Improvement. The Homoeopathic medicines Robinia (43.33%) and Natrum sulphuricum (26.67%) were found to be frequently used in the patients.

CONCLUSION:

This Retrospective Analytical Case Series Study on 30 Acid Peptic Disorder Patients treated at Vinayaka Mission’s Homoeopathic Medical College Hospital, Salem, Tamilnadu had shown a Marked Efficiency of Homoeoapthic Medicines. Hence Acid Peptic Disorder patients can be treated by Homoeopathic Medicines without any Side effects and Recurrence.

 

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Received on 30.03.2020         Modified on 15.04.2020

Accepted on 29.04.2020     ©AandV Publications All right reserved

Res.  J. Pharmacology and Pharmacodynamics.2020; 12(2): 97-100.

DOI: 10.5958/2321-5836.2020.00019.1