A Case of Crohn’s
My client is an 18 year old male who is seeking homeopathy to help with his symptoms of Crohn’s Disease. He is tall and thin with dark hair and has a quiet and reserved disposition. Medications are no longer working for him and he is considering an anti-TNF treatment (a class of drugs used to treat inflammatory conditions). His parents have accompanied him for his initial appointment.
The Case: Initial appointment – 8/2/2010
“Symptoms began in my last year of high school when I was 17. I believe it was caused by stress relating to my school work and social life as I was trying to choose a college and complete college applications.”
“I never wanted to read/write. I was not good at it until I became interested in learning. I have a learning disability, maybe a form of dyslexia. I did feel insulted because academics are so equated with intelligence. So I felt as I was treated as unintelligent not because of my inability to think rationally and critically but because I had trouble with language and normative meaning.”
He has had many incidents in his past where he was treated with disrespect by teachers or felt embarrassed when called upon in class and did not know the answer. He’d get nervous before games and throw up or have diarrhea from anxiety before games.
When he turned 18 he started college at a very prestigious school in a different state. He finished his freshman year a few months ago and feels very excited about his school. He started a relationship with a girl in high school. They remained in a long distance relationship while they were both attending different colleges and have had the typical challenges in maintaining such relationships.
“I have abdominal pain that can be aggravated by smell or fumes of food. The consumption of dairy spicy and high fiber foods aggravate my symptoms.”
“I am worse between 5 AM to 12 PM and 10 PM to 2:30 AM. Other symptoms include gas, fatigue, and arthritic-like pain in hands, arms and especially legs. On average I have 3 to 7 bowel movements, depending on abdominal pain.”
There is no change in pain and abdominal symptoms whether he has fatty food in his stomach or not. There is pressure in the abdomen that feels like an object that can’t move. Modalities of abdominal pain are: better with heat, sitting, and empty stomach and worse when eating raw vegetables.
He had an endoscopy and colonoscopy in 2009.
At the time of the appointment he is taking these medications:
Asacol HD – anti-inflammatory, sees no difference after taking it for 1.5 years.
Avelox – for 1.5 years.
Oral steroids gave him some relief for 1 month.
He has been on antibiotics throughout and has had to switch types of antibiotics often because they stop working. When antibiotics work, pain comes 10 times a day, lasting 1-2 minutes. When antibiotics don’t work, pain comes every 15 minutes and lasts 2 minutes.
Initial Assessment: His level of self-confidence is not high and sometimes he is unable to stand up for himself. I believe his physical symptoms are an expression of his unexpressed feelings, including anger and frustration.
Both parents are highly educated and successful in their respective fields. Growing up he felt some pressure to do well. However, when asked if his parents had any specific career expectations of him, he said they support him in whatever he wants to do.
He is anxious about social situations, is shy and has anticipatory anxiety. He is a perfectionist and has high expectations of himself. He is also self-critical: “I am not working hard enough.” He generally avoids confrontation.
Repertorization of some of the emotional and physical aspects using Synthesis 9.1 – Strategy used is Sum of Symptoms Sorted by degree.
MIND – DELUSIONS – criticized, she is
MIND – AILMENTS FROM – indignation
MIND – ANXIETY – anticipation; from
MIND – EMOTIONS – suppressed
MIND – INDIGNATION – misdeeds of others; at the
MIND – REPROACHING oneself
MIND – RESERVED
EYE – INFLAMMATION – Sclera
ABDOMEN – INFLAMMATION – Intestines
ABDOMEN – PAIN – night – midnight – after – 5 h
ABDOMEN – PAIN – night – midnight – before – 22 h
ABDOMEN – PAIN – warmth – amel.
ABDOMEN – PAIN – eating – after – agg.
Remedies That Were Considered: Staph, Carc, Nux Vomica
Staphysagria: In Hering’s Guiding Symptoms, we see that there is “Great indignation about things done by others or by himself; grieves about consequences.” And “Ailments from indignation and vexation, or reserved displeasure.” He does not share his opinions until asked and even then is very careful about what he says to make sure no one will get angry with him, or to make sure he will not say anything wrong. Suppressed emotions and abdominal pain due to anxiety also belong to this remedy.
Carcinosin: He is a perfectionist and very serious and more mature than his years. He is overly responsible. Even though he is very smart, he was treated as if he needed extra help with school, just because he was not interested in the subjects most valued by traditional schooling. He suffered indignation.
Management of the Case:
Type of communication with client: Initial appointment. My client and his parents informed me that they were investigating how a liquid diet might work. I suggested that it might be difficult to assess the effectiveness of our homeopathy work if they start a new diet at the same time. I suggested that they either follow through with the liquid diet and return when they have reached a new baseline or decide to put off the liquid diet at least for the next month. They decided to start homeopathy first.
What to do next: Take one dose of Carc 30C. Prepare a bottle by putting 2 pellets of remedy into an 8 oz bottle of water. For the first dose, give 0 succussions, put 5 drops into a 4 oz cup of water, stir and take 5 drops from the cup. Email 3 days after taking this dose.
Remedy and dosage: Carc 30C, 0 succussions, 5 drops into 4 oz cup and 5 drops from the cup. Type of communication with client: Email update: “Day one felt tired and overwhelmed by internship and transition plans to go back to school. Day 2 felt much better. I woke up energized. The pain in the morning was significantly less and I was in a better mood. Pain increased around lunch time but stayed infrequent throughout the day. Day 3 I had the same pain as day 2, maybe a little more. I was not so worried about all the things I needed to do before going back to school.”
What to do next: Repeat the dose when symptoms of anxiety or pain start to come back. Carc 30C, 2 succussions, 4 drops in 5oz of water and take 4 drops from the cup. Repeat for two weeks as needed and then email.
Remedy and dosage: on 8/15/12 took dose. Type of communication with client: Email Report: “I felt better again and have felt fine until now. The end of my summer was going really well. Work did not bother me and my relationship with my girlfriend became really strong.” “Today I felt positive and excited about being back in my college town and sad about separation from my girlfriend.” “Also the abdominal pain is coming back so I’ll repeat dose tomorrow.”
What to do next: Repeat as needed with 4 succussions, 4 drops into 5 oz water and 4 drops from the cup. Write back in two weeks.
Remedy and dosage: Client has taken Carc 30C 3 times as directed. Type of communication with client: Email Report: “I am feeling good overall and school is great. Since I have been back, I’ve only needed to take the Carc 30C 3 times”
What to do next: Repeat as needed.
Remedy and dosage: Carc 30C, 2 succussions, 4 drops into 5 oz water and 4 drops from the cup.
Type of communication with client: First follow-up appointment. He is starting a new design group/club in college. In his social life, he has made a lot of friends and goes to a lot of parties. On his own he stopped taking his antibiotics two weeks ago. Had slightly more pain temporarily but repeated dose and was fine.
What to do next: Repeat Carc 30C as needed.
Remedy and dosage: Carc 30C, 4 succussions.
Type of communication with client: Second follow-up appointment: He is still off his antibiotics. He no longer has any physical symptoms. He has a cold.