Role of Phatak’s Repertory In Homoeopathic Management of Celiac Disease: A Complementary Therapeutic Approach
Abstract
Celiac disease is an autoimmune chronic enteropathy that is induced by dietary gluten in genetically predisposed persons. It causes villous atrophy of the small intestine and subsequent malabsorption having a variety of gastro intestinal and systemic effects. Although the primary treatment protocol has become a lifelong gluten-free diet, most of the patients are still having persistent symptoms and lower quality in life. With its unique non-drug approach of individualized and comprehensive holistic approach, homoeopathy can become a supplementary treatment option that targets alleviation of symptoms, balance of the constitution, and well-being enhancement. The paper discusses the extent, philosophy, and constraints of homoeopathic treatment of celiac disease.
Keywords
Celiac disease, gluten sensitivity, homoeopathy, malabsorption, constitutional treatment, complementary medicine
Introduction
Celiac disease is a genetically predisposed immunologically driven illness that is induced by eating wheat, barley, and rye, whose grains contain gluten [1]. The inflammatory process causes atrophy of the small intestine in the form of villous, which subsequently causes poor uptake of nutrients and a high number of clinical manifestations. The prevalence of celiac disease is approximated to be at 1 percent and a good number of cases have remained un-diagnosed around the world [2]. Even with the intense compliance to gluten-free diet, patients still report having some symptoms, which is why alternative systems of medicine, including homoeopathy, are of interest.
Etiopathogenesis and Clinical Features
Celiac disease pathogenesis consists of T-cell immune response to gluten peptides especially gliadin leading to inflammation of the mucosal areas, villus atrophy and hyperplasia of the crypt [3]. It can be clinically manifested with chronic diarrhea, steatorrhea, abdominal distension, weight loss, anemia, fatigue, osteopenia and dermatitis herpetiformis. Other extra-intestinal manifestations that are known are neurological signs, infertility, and growth retardation in children [4].
Homoeopathic Perspective
The celiac disease can be viewed in terms of homoeopathic perspective as a chronic constitutional illness with disrupted assimilation and disrupted vital force. Based on the Hahnemann concept of chronic disease, chronic functional disturbances are an indication of constitutional imbalance [5]. Homoeopathic therapy insists on the individual approach of disease management depending on the entirety of the symptoms, both physical, mental, and emotional, and not only on pathological diagnosis.
A Concise Repertory of Homoeopathic Medicines :-
The compilation of Homoeopathic Medicines by Phatak is a Concise Repertory of Homoeopathic Medicines authored by Dr. S. R. Phatak that is clinically oriented and designed to refer to and use in practice. It is of particular value in the routine practice related to managing chronic and functional disorders(8).
It is time efficient because the repertory is organized in alphabetic order, is brief, clear and the superfluous sub-rubrics have been removed. Rubrics are written in simple straight forward language, as though they seem to be clinical diagnoses or commonly known conditions.(8)
The repertory of Phatak has strong emphasis on generalities, modalities, pathological generals, and clinical conditions, which is why it comes in especially handy when the number of characteristic symptoms is limited. It melds pathology with homoeopathic principles although it endorses individualization.(8).
Another characteristic of this repertory is the presence of clinical rubrics, drug affinities, and cross-references, which helps the physician to reduce remedies in the most effective way. The remedies are enumerated with different typographic emphasis which shows their relative importance.it is a good bedside repertory, and is frequently consulted in the confirmation of final remedies in conjunction with materia medica.(8).
Rubrics Related To Celiac Disease In Phatak Repertory (8):-
- Abdomen, bloated
- Anemia
- Apathy
- Appetite, increased
- Appetite, ravenous
- Assimilation, defective
- Children, pot-bellied
- Children, thin, emaciated
- Children, delayed development
- Children, diarrhea with emaciation
- Children, big abdomen, thin limbs
- Diarrhea
- Diarrhea, chronic
- Diarrhea, offensive
- Diarrhea, undigested food
- Diarrhea, fatty / greasy
- Distension
- Dullness
- Emaciation
- Emaciation despite good appetite
- Flatulence
- Food, intolerance to
- Growth, arrested (children)
- Indigestion
- Irritability
- Malnutrition
- Marasmus
- Mesenteric glands, enlargement
- Milk, aggravates
- Nutrition, impaired
- Pain, abdomen, after eating
- Stool, pale
- Stool, copious
- Stool, exhausting
- Stool, frothy
- Stool, clay-colored
- Tabes mesenterica
- Weakness, general
Homoeopathy Therapeutic Approach.
Celiac disease is treated with homoeopathic treatment that is constitutional and individualised. The choice of remedies depends on a thorough case-taking in which case the digestive, food intolerance, general modalities, mental-emotional state, and related systemic complaints are taken into account. The remedies that are normally taken into consideration during clinical practice are:
- Natrum muriaticum: Patients with long-term weakness, anemia, emaciation, and digestive disturbances are prescribed this one, and it is usually accompanied by emotional reserve [6].
- Lycopodium clavatum: It is helpful in the cases of bloating, flatulence, hepatic dysfunction, and poor assimilation and evening enhancement [7].
- Calcaria carbonica: It is recommended in people with slow rates of metabolism, exhaustion, retarded development in children, and a predisposition to nutritional deficiencies [6].
- Arsenicum album: This drug is considered in chronic diarrhea with severe weakness, feeling of anxiety, irritability and intolerance of food [7].
- Sulphur: This is usually used in chronic cases when the malabsorption is present, the patient experiences burning sensations and recurrent digestive disorders [6].
The choice of potency and repetition is determined by the vulnerability of the patient, and clinical outcome and treatment must be taken under the guidance of a specialised homoeopathic practitioner.
Diet, Nutrition, and Supportive Care
Strict lifelong gluten-free diet is the basis of the management of celiac disease and is crucial to avoid the damage of the mucosa and long-term complications [1,3]. Homoeopathic therapy is complementary and does not supersede the compliance with the diet. Correction of micronutrient deficiencies, stress management, nutrition supplementation and regular follow-ups are a part and parcel of comprehensive care.
Scope and Limitations
Currently, there is poor-quality clinical evidence on the use of homoeopathy as a curative agent of celiac disease. Its purpose can be considered adjunctive and is aimed at reducing symptoms, enhancing vitality, and quality of life. It is necessary to continue working with the traditional medical treatment and conduct regular monitoring with the help of serological and nutritional tests.
Conclusion
Homoeopathy can be a supportive and complementary means of treating celiac disease based on the patterns of each symptom, constitutional imbalances and other comorbidities. Combined with rigorous management of the gluten-free diet and the traditional medical practice, a personalized homoeopathic treatment can have a positive impact on the well-being of patients. More systemic studies and trials are needed to develop its effectiveness and treatment parameters.
References
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- Lebwohl B, Sanders DS, Green PHR. Coeliac disease. The Lancet. 2018;391(10115):70–81.
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- Green PHR, Cellier C. Celiac disease. New England Journal of Medicine. 2007;357(17):1731–1743.
- Hahnemann S. Organon of Medicine. 6th ed. New Delhi: B. Jain Publishers; 2002.
- Boericke W. Pocket Manual of Homoeopathic Materia Medica. New Delhi: B. Jain Publishers; Reprint Edition.
- Kent JT. Lectures on Homoeopathic Materia Medica. New Delhi: B. Jain Publishers; Reprint Edition.
- Phatak SR. A concise repertory of homoeopathic medicines. New Delhi: B. Jain Publishers; 2005.
