The Complementary Path: Managing Paediatric IBS with Homeopathy and more

Abstract 

Pediatric irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that significantly impacts the quality of life of affected children and their families. Conventional treatment often provides limited relief, leading many to seek alternative and complementary therapies. 

This article explores the complementary path to managing pediatric IBS, with a focus on homeopathy and other integrative approaches.  By integrating homeopathic remedies with dietary adjustments, lifestyle modifications, and psychological support, this article aims to provide insights into enhancing therapeutic outcomes and improving quality of life for paediatric patients.

By examining current research and clinical experiences, we aim to provide a comprehensive overview of how these therapies can be effectively combined to alleviate symptoms and improve overall well-being in paediatric IBS patients.

Homeopathy is a natural medicine system, which cures not only the disease but also the overall physical health. Homeopathy along with other complementary systems can play a very important role in the management of IBS.

Keywords: Paediatric IBS, Homeopathy, Complementary treatment, Child health, Integrative medicine, Holistic approach, Digestive disorders, Natural remedies, Alternative therapies, Paediatric care.

Introduction: Irritable bowel syndrome (IBS) is a chronic or recurrent condition characterized by abdominal pain, changes in bowel habits, and bloating, occurring without any detectable structural or biochemical abnormalities. IBS falls under the broader category of functional gastrointestinal (GI) disorders and is the most prevalent GI diagnosis in paediatric gastroenterology.[1] It is also among the top 10 reasons for visits to primary care physicians. IBS is recognized in children, with many patients reporting that their symptoms began in childhood.[2] Children with a history of recurrent abdominal pain are at a higher risk of developing IBS during adolescence and into adulthood.

Incidence:  IBS is frequently cited as one of the most prevalent functional gastrointestinal disorders (FGIDs) in children. A recent meta-analysis, examining epidemiological studies on abdominal pain from 1957 to 2014, found that IBS was present in 8.8% of cases, while functional dyspepsia (FD) and functional abdominal pain (FAP) were observed in 4.5% and 3.5% of cases, respectively. Another systematic review and meta-analysis focusing on IBS in children from Asia revealed an even higher prevalence, at 12.4%.[3]

Pathogenesis of IBS:  The exact cause of irritable bowel syndrome (IBS) remains unclear, but various factors may contribute to its development. Research in both children and adults has identified several potential mechanisms:

1.  Brain-Gut Interactions: IBS can be considered a disorder involving both the brain and the gut. It is suggested that a dysregulation within the enteric and central nervous systems may lead to changes in sensation, motility, and possibly immune system function.
2. Dietary Factors: Some research indicates that carbohydrate intolerance might significantly affect IBS symptoms. Consumption of lactose, sorbitol, or fructose has been linked to increased gastrointestinal symptoms. Additionally, food allergies could play a minor role in triggering or worsening IBS symptoms for some individuals.
3. Psychosocial Factors: Several studies have shown that IBS patients, particularly adults, have a higher prevalence of psychiatric disorders, including anxiety, major depression, personality disorders, and hysteria.

Diagnosis: Diagnosis of IBS is mostly done on the basis of clinical history.

Clinical Features:

•  Bloating
•  Abdominal pain or discomfort 
• Abnormal stool form (hard or loose stool)
• Abnormal stool frequency (less than 3 time /week or more than 3 time /day) 
• Straining for defecation 
• Feeling of incomplete evacuation
• Passage of mucus per rectum
• Urgency.

• Duration, modalities and associated features helpful in diagnosis are:

 ∙ Symptoms present more than 6 month.

 ∙ Stress aggravates the symptom.

 ∙ Aggravation after a meal.

 ∙ Associated with anxiety, depression or other psychological conditions.[4]

• Other symptoms which may be associated with the disease are: 

 ∙ Dyspepsia.

 ∙ Heartburn.

 ∙ Nausea and vomiting.

 ∙ Lethargy.

 ∙ Backache.

 ∙ Urinary frequency.

 ∙ Insomnia.

 The widely accepted Rome III diagnostic criteria  in clinical practice is: 

∙ Onset of symptoms at least 6 months before diagnosis. 

∙ Recurrent abdominal pain or discomfort for > 3 days per month during the past 3 months.

 ∙ At least 2 or more of the following features: – Improvement with defecation.

 ∙ Onset associated with a change in frequency in stool.

∙  Onset associated with change in stool form.[5]

Diagnostic cascade and Investigations:

Prevention:

∙Regular relaxing exercise, yoga & meditation help to reduce mental stress.

∙Different therapies can be used to reduce stress like cognitive Behavioural therapy, relaxation therapy, hypnotherapy, psychotherapy.

∙Maintain sleep pattern 

∙Eat a healthy balanced diet including fiber in food.

Management:

Managing paediatric IBS is critically important for the well-being and development of affected children. IBS can significantly disrupt a child’s daily life, causing recurrent abdominal pain, irregular bowel habits, and emotional distress. 

Effective management focuses on alleviating symptoms, which not only reduces discomfort but also improves the child’s ability to eat well, sleep properly, and engage in school and social activities without interruption.

 By addressing these symptoms early on, management strategies can prevent the condition from worsening and minimize its impact on long-term health. Moreover, managing paediatric IBS supports mental health by reducing stress and anxiety associated with unpredictable symptoms.

 Ultimately, effective management of paediatric IBS is pivotal in enhancing the quality of life for affected children, ensuring they can thrive physically, emotionally, and socially as they grow.

 Alternative therapies like homoeopathy often take a holistic approach, addressing not just the physical symptoms but also considering the child’s emotional and mental well-being, which can be appealing in treating conditions that have both physical and psychological components.

IBS is affected by lifestyle, nutrition, stress and emotions. Initial IBS management includes education, reassurance, and investigation of psychosocial issues. Information to the patient regarding the triggering factors of IBS along with advice regarding diet etc. as given below is essential[4]

Dietary Management:

• Follow a balanced diet.
• Avoid foods that may trigger IBS symptoms, such as high-fat foods, cabbage, beans, and legumes.
• Stick to regular meal times.
• Incorporate a diet rich in fiber, including bulking agents like psyllium, as it can help alleviate constipation. Increase fiber intake gradually to minimize bloating and gas.
• Exclude dairy products from the diet if lactose or fructose intolerance is present.
• Ensure adequate daily fluid intake.[4]

Lifestyle and Psychological Management:

• Identify and address sources of stress.
• Encourage regular physical activity, such as exercise, yoga, and daily meditation.
• Suggest therapies like cognitive behavioral therapy, psychodynamic interpersonal therapy, or relaxation training to help manage stress when necessary.
• Promote consistency in sleep patterns and meal schedules.[6]

Rewiring the Gut-Brain Connection:  A science-based approach focuses on healing the root causes of chronic health issues by harnessing the power of the subconscious mind and the limbic system. It’s well-known that stress is a fundamental contributor to chronic health problems. You may have heard statements like “99% of all illnesses are stress-related.” [6]

The mind, body, and spirit are interconnected. Physical illnesses often stem from disturbances or “dis-ease” in the mind and spirit. Similarly, physical challenges, such as sleep deprivation or lack of exercise, can disrupt inner peace and lead to mental and spiritual distress.

Mental and spiritual conflicts can manifest as physical symptoms in the body. For instance, in irritable bowel syndrome (IBS), conflicts related to the need for control or safety can play a significant role.[6]

“Morsel Conflict”: A morsel is a survival lifeline or sustenance, such as food, relationships, job and money, family connection, health in body. Digestion problems and eating disorders are often “morsel conflicts.” Example: Inability to get rid or eliminate a morsel (ex. nagging parent, feeling stuck in a rut/school/season of life) . Proper counselling of children can help to resolve this conflict.[7,8] 

Homeopathy is a truly holistic form of treatment, addressing not only the bowel symptoms but also the psychological and other extra-bowel symptoms that may be present in each individual. This approach can play a beneficial role in managing irritable bowel syndrome (IBS). Research in homeopathy has shown promising results in the treatment of IBS. Numerous remedies are available in homeopathic literature, which can be selected based on the totality of symptoms presented by each individual case.

For instance, the Synthesis Repertory lists around 584 remedies under the rubric “diarrhea,” 434 remedies under “constipation,” 121 remedies for “alternating constipation and diarrhea,” and about 7 remedies for “pain relieved by stool.”

Some Important Homeopathic remedies for treating IBS include:

• Antimonium Crudum: Useful for indigestion after large meals, with alternating constipation and diarrhea.
• Staphysagria: Effective when IBS is linked to suppressed anger.
• Arsenicum Album: Indicated for intolerable abdominal pain with diarrhea, restlessness, and excessive thirst taken in small sips.
• Aloe Socotrina: Beneficial for IBS with abdominal pain, gas, diarrhea, and a lack of confidence in controlling the sphincter ani.
• Carbo Vegetabilis: Helps with flatulent colic, a distended abdomen, and situations where even the simplest foods cause discomfort, with temporary relief from belching.

Other than these indications of few important homeopathic medicines for Irritable bowel syndrome are given below:

Argentum Nitricum: Indicated in gastrointestinal conditions accompanied by nervousness & anxiety. Upper abdominal affections brought on by undue mental exertion. Belching accompanies most gastric ailments. Flatulence; painful swelling of the pit with colic. Painful spot in the stomach that radiates to all parts of the abdomen; < slightest pressure. Stool is watery, noisy, flatulent; green like chopped spinach, and shreddy mucus with enormous distension of the abdomen. Diarrhoea immediately after drinking water and eating too much sweet or salty food. Impulsive, anxious and nervous persons. Withered up, old looking people with marked emaciation especially in the lower extremities. Craving for sweets and desire for salty food. Intolerance of heat. Desire for open air. Worse fear, fright, mental strain, cod food, ice cream etc. Better cold open air; hard pressure etc.[9]

Cinchona Officinalis: Indicated in persons who suffer from painless watery diarrhoea with great bloating, indigestion, and general weakness. Sensation as if the abdomen is full of gas which is not relieved by eructation. Slow digestion. Weight after eating. Hungry without appetite. Hungry, longing for food which lies undigested. Flatulence; belching of bitter fluid or regurgitation of food gives no relief; worse eating fruit. Bloatedness better by movement. Undigested, frothy, yellow, painless stool; worse at night, after meals, during hot weather, from milk. Suited to apathetic, indifferent, despondent & gloomy persons in which there is debility from exhausting diseases; from loss of vital fluids and nervous erythrism. Periodicity of complaints. Weak and oversensitive persons. Sensitiveness to draughts. Chilly person, sensitive to draughts of air yet wants to be fanned; face pale with sunken features.[9]

Lycopodium Clavatum: Indicated in dyspepsia with great flatulence and fermentation. Much noisy flatulence< lower abdomen, gurgling and rumbling esp. in the region of transverse colon. Fullness not relieved by belching. Constant sensation of satiety; good appetite but a few mouthfuls fill up to the throat. Inactivity of bowels. Ineffectual urging to stool. Constipation since puberty, last confinement, when away from home. Small stool, with the sensation as if much remained behind, followed by excessive and painful accumulations of flatulence. Everything tastes sour, eructation, heartburn, water brash, sour vomiting. Sensitive, intelligent, dominating, dictating and headstrong. Peevish and depressed in mind. Miserly and cowardly. Irritable, contradiction aggravates. Adapted to old persons or children who age prematurely and have a weak body but sharp mind (intellectually keen but bodily weak). Earthly complexion and yellowish spots on skin with or without vertical furrows on forehead. Desire sweets, warm drinks. Aversion to bread. All complaints < 4-8 pm Better: warm drinks, food, cold applications, eructation.[9]

Natrum Carbonicum: Indicated in persons with very weak digestion, caused by slightest error in diet. Gastrointestinal trouble from various types of foods esp. dairy products which lead to gas formation and spluttering diarrhoea with an empty feeling in the stomach. Intolerance of milk, and dairy products. Old dyspeptics, always belching, have a sour stomach and rheumatism. Ill effects of drinking cold water when overheated. Bitter taste. Inability to think or perform any mental labour. Melancholic and apprehensive. Great debility caused by summer heat; chronic effects of sunstroke. Thin emaciated persons with milky, watery skin and very weak ankles. Worse from music, in the sun, mental exertion, thunderstorm.[10]

Nux Vomica: Flatulent distension with spasmodic colic. Constant nausea after eating. Pressure in stomach an hour or two after eating as from stone. Cannot use mind for 2-3 hours after meal. Constipation with frequent ineffectual desire, passing small quantities of faeces, sensation as if not finished. Constant feeling of uneasiness in the rectum. Suited to excitable, hypochondriacally, zealous, ambitious and workaholics who become prone to anger, spite and deception. Debauchers prone to indigestion and haemorrhoids. Craving for spicy foods, alcohol, tobacco and other stimulants & worse from having them, oversensitive to external impressions are other indications of this remedy. Worse in the morning, from mental exertion, after eating, touch. Better at rest, damp wet weather.[10]

Pulsatilla: Dyspepsia with great tightness, all gone sensation in stomach & water brash with foul taste in mouth. Bitter belching, indigestion and heartburn worse at night. Excessive flatulence with great rumbling, difficult to expel. Colic with chilliness in evening. Stool changes from constipation to diarrhoea during the course of a day. Diarrhoea: only at night or usually at night; watery, greenish yellow, changeable, as soon as they eat, from fruit, cold food and drinks, ice cream… Persons who desire company, mild, gentle, affectionate, yielding, weeping disposition. Hot patient; marked changeability; thirstlessness with great dryness of mouth. Desire for cheese, pungent things, highly seasoned food; aversion to fat, warm foods and drinks; tongue coated yellow or whitish; worse towards evening and in the warm room, always better in open air, by slow, gentle motion and cold applications.

Sulphur: Indicated in complete loss of or excessive appetite. Drinks a lot, eats little. Great acidity, sour eructation. Burning, painful weight pressure. Abdomen is very sensitive to pressure. Weak empty all gone sensation in the stomach around11A.M. Early morning diarrhoea, which drives out of bed. Diarrhoea is frequent, painless. At the other time, person may suffer from constipation where stool large, hard as if burnt, painful and suffer from gas with an offensive smell. Redness around the rectum, with itching and burning. Suitable to quick motioned, quick tempered, irritable persons who are mentally egoistic, dwell on philosophical and religious speculations (ragged philosopher). Hot patients who desire sweets and in whom milk disagrees. Aggravation from rest, warmth of the bed, washing, 11am, night, early morning, standing. Amelioration dry warm weather lying on right side, drawing limbs. Burning all over the body especially in all the orifices e.g. nose, ear, rectum vagina, urethra etc.; flushes of heat on face.[11]

References:-   

1.  https://emedicine.medscape.com/article/930844-overview/
2. https://accessmedicine.mhmedical.com/content.aspx?bookid=390
3. https://sites.google.com/view/homsidhmedics/homeopathy/standard-treatment-guidelines-in-homoeopathy.
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644864/
5. https://emedicine.medscape.com/article/930844-overview
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033441/
7. https://drlauryn.com/wellness-knowledge/the-5-biological-laws-of-german-new-medicine-an-in-depth-explanation/
8. https://drlauryn.com/wellness-knowledge/german-new-medicine-101-3-steps-to-rewire-the-gut-brain-connection-heal/
9. http://www.homeoint.org/books/boericmm/a/arg.nit.htm
10. http://homeoint.org/books/allkeyn/allkeyss.htm#Sul
11. http://www.homeoint.org/clarke/p/puls.htm/

Guide

Dr. Ajay Singh Parihar

Professor & Hod,

Department of Pediatrics,

Government Homoeopathic Medical College And Hospital, Ayush Parisar, Near Kaliyasot Dam, 

Bhopal, Madhya Pradesh, India.

Guide

Dr. Vijay Baraiya, 

Assistant Professor

Department of Preventive And Social Medicine,

Government Homoeopathic Medical College And Hospital, Ayush Parisar, Near Kaliyasot Dam,

Bhopal, Madhya Pradesh, India.

Corresponding Author: –  

Dr. Arpit Singh Thakur 

Post Graduate Trainee, Department of Paediatrics, 

Government Homoeopathic Medical College And Hospital, Ayush Parisar, Near Kaliyasot Dam, 

Bhopal, Madhya Pradesh, India.