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.
What to do next: Arsenicum 200C is recommended for cold and after acute is resolved, go back to Carc 30C, 6 succussions, 3 drops, 6 oz cup and 3 drops from the cup, once a week for the next 3 weeks and then email with report.
Remedy and dosage: Carc 30C 4 succussions.
Type of communication with client: Email report: Bowels get irritated at night and gets diarrhea off and on” – he did not increase succussions to 6.
What to do next: Carc 200C, 3 drops into 5 oz cup and 3 drops from the cup. After the first dose, continue with 2 succussions as needed.
Remedy and dosage: Stayed with Carc 30C and did not take 200C.
Type of communication with client: Third follow up appointment: He has been taking Carc 30C with 6 succussions and everything is good. Girlfriend situation is not great. He has some difficulty in expressing his feelings.
What to do next: Staph 30C, prepare a bottle with 2 pellets and 8 oz of water. For the first dose, give 0 succussions, put 6 drops into a 5 oz cup and take 6 drops from the cup.
Remedy and dosage: Staph 30C as directed.
Type of communication with client: Email update: Remedy is good but does not last a whole week.
What to do next: Increase succussions to 5, 6 drops into a 5oz cup and take 6 drops from the cup.
Remedy and dosage:
Type of communication with client: Fourth follow up appointment: No pain. He does not get as upset about things as before. He is more straightforward, more able to talk. He has started to speak in classes and is more confident. He’s been in a good mood when he would have been upset previously. Other people’s hurtful comments are less irritating. He finds this amazing, “I am no longer a kid.”
What to do next: Staph LM1, no succussion, 4 drops into a 4 oz cup and 4 drops from the cup. Continue with 1 succussion as needed.
Remedy and dosage: He did not take the remedy for 3 weeks because he was feeling great and decided that he no longer needed to take any remedies. Type of communication with client: Email update: pain started to come back because he didn’t take remedy for 3 weeks.
What to do next: Staph LM1, 3 succussions, ¼ tsp into a 4 oz cup and ¼ tsp from the cup.
Remedy and dosage: Has been taking Staph LM1, 4 succ, ½ tsp into a 4 oz cup and ½ tsp from the cup.
Type of communication with client: Fifth follow up appointment: It took 5 doses of Staph to get back on track with physical symptoms after he decided to not take the remedy for 3 weeks in a row. He uses his emotional state to decide when he needs another dose.
What to do next: Continue with Staph LM1 and increase succussions by 1 with each dose. After 8 succussions on LM1, then go to Staph LM2 and start with 0 succussions and then go to 1.
Remedy and dosage: Took Staph LM1 two times last week.
Type of communication with client: Email report: He is having some pain and is not quite back to not having any pain.
What to do next: Carc 200C, make a bottle with 2 pellets and 8 oz of water. Put ¼ tsp into a 4 oz cup and take ¼ tsp from the cup. Email after 3 days.
Remedy and dosage: Took Staph 30C, 6 succussions, 6 drops in a 4 oz cup and 6 drops from the cup.
Type of communication with client: Email Report: There was some confusion about which remedy to take so he decided to take Staph 30C. He is fine and there is no more pain.
What to do next: Continue with Staph 30C 7 succussions. Next potency will be Staph 200C.
Remedy and dosage: Staph 200C.
Type of communication with client: Email Report: He is doing very well and his gastrointestinal specialist has confirmed his cure by sending the lab results showing there is no longer any sign of Crohn’s disease.
At this time, he chose to continue with homeopathy even though his original chief complaint had been resolved. After a few more months he stopped completely and is doing well on all levels when I spoke to him in March of 2013.