Clinical Cases

A Case of Abdominal Pains Caused by Antibacterial Medication

no antibiotics

Drs. Olesya Vereykina and Dimitry Chabanov present a case of abdominal pains caused by antibiotics.

Olesya Vereykina

under supervision of Dmitry Chabanov

The state in the beginning of the treatment (8 April 2015):

The patient P.K. was a 3.8 y.o. girl. The parents applied for a consultation on 8, April 2015 for the reason of torturing pains in the abdomen that had lasted for a month. The pains were extremely intense, coming in fits, localized in the umbilicus area. They appeared for the first time after a prolonged antibacterial treatment, prescribed for both vulvovaginitis and acute respiratory infection. The girl got infected in March 2015: she had coryza, voice loss, her fever being normal yet. Furthermore she had some redness in the perineum, buttocks, with vaginal smear showing a pronounced increase of E. Coli. A gynecologist prescribed Flemoclav. One day later the patient’s voice returned, but her fever raised up to 39С, persisted for 3 days, with antipyretics having lowered it for only 3-4 hours. Flemoclav was replaced by Suprax. On the very first day of Suprax intake the girl’s body temperature normalized, but on the 2nd day she developed some urticarial-like eruptions all over her body. A week later, against the background of antihistamines intake, the eruptions were gone, but abdominal pains appeared. The girl screamed, showing her abdomen and anus area and she couldn’t sleep because of the pain. She was afraid to sit on her pot and had no stool for 4-5 days. During defecation there was some mucus with an offensive odor coming out.

She was hospitalized repeatedly into a surgical department to exclude an acute surgical pathology, and into an infectious department and a pediatric department of different hospitals of Novosibirsk. The following diagnostic tests were done:  abdominal cavity plan X-ray, fibrogastroscopy (FGS), both abdominal cavity and kidney USI, common blood analysis, biochemical investigations of blood and urine. There were no pathological changes found. Furthermore an acute intestinal infection and pseudomembranous colitis were not confirmed. Every time the girl was given some symptomatic treatment, giving a temporary amelioration, the pain returned. As a result the following diagnosis was arrived at: large intestine functional disturbance, fecal impaction as a result of antibacterial treatment.

Anamnesis

Before the age of 2 years the patient was rarely sick. Since the age of 2, as she started visiting a kindergarten, the girl was very frequently sick with acute respiratory infections (ARVI).  At the age of 2.5 years she developed a constant and severe cough which lasted for 6 months, along with a few episodes of  larynx constriction. That time the girl got antibiotics many times and also cortisone inhalations together with bronchodilators for a long period. All the vaccinations were done according to the schedule. At the age of 1 year she got a flu vaccine additionally. There were no specific vaccination reactions noticed, except the positive Mantoux test reaction. Diaskintest result was within norms. The girl’s mother in her childhood used to have a positive Mantuox test reaction for a long time and had been regularly observed by a tuberculosis specialist and got a treatment for tuberculosis for 6 months. Furthermore, the mother has suffered from chronic sinusitis, tonsillitis and gastritis. In the period from 1985 to the 1990s the mother lived in the city of Cherkassy, not far from the region where the Chernobyl nuclear accident had happened; she earlier lived close to a uranium factory. The father of the girl has had duodenal ulcer. He had worked at a nickel factory for some years.

Other symptoms:

Till the age of 3 years the patient was very fearful of head washing. She was afraid of water (2) and could only take a shower, being scared to take a bath. Falling asleep usually took a lot of time. She was grinding her teeth in sleep (3). Her head perspired in sleep (3). The extremities were always ice-cold (3); the girl was chilly in general. Her appetite was very good, even increased. She never refused to eat, but there was no weight gain. She loved sweets very much (3), she also had desire for meat (2-3), eggs (3), pastry (3), sausages, including the smoked ones (2). She didn’t like milk.

The first two prescriptions were done after a telephone call with the patient’s mother, while the girl was in the surgical department. Given her bending backwards during the fits, showing almost a gymnastic bridge, the patient was given Dioscorea C30 every day from 8.04.15.  On the background of Dioscorea intake the pain got much less intense. The girl quit bending backwards and on the 6th day of the remedy she had her stool without screaming for the first time. But the pains in the umbilical area appeared daily, becoming more intense with stool mass accumulating and decreasing after the defecation. Her stool most often looked as a fecal bolus, with yellow-brownish color, containing some drops of blood at times. Still the appetite was increased. While eating the girl was in a better mood, not complaining about the pain, but after the meal her state was worsen again.

She was weak, had a tendency to lie down (usually on a side with her knees drawn to the abdomen), she avoided showing an urge to defecation, being afraid of pains. She didn’t stay alone, was cautious to have either her mother or grandmother close. She asked to have her abdomen rubbed. The girl was aggressive with her brother, sent him away, raised her hand against him. She would grind her teeth excessively. On the 14.04.15 she was prescribed Stramonium C200 (2 doses) by telephone call.

The 1st consultation in the office (17.04.15): T

The patient was brought for the consultation for the 1st time after her discharge from the hospital. The next day (15.04) after Stramonium C200, there was only mucus, no stool; the girl screamed while urging, could hardly sleep because of pains. 16.04 she had fecal bolus 10 times. Afterwards she felt better and slept all night. The girl began using her pot, though still screaming from pain before the stool. 17.04 her stool was very scanty and hard. The girl was sluggish, didn’t play, lying for the whole day. At the same time her appetite was still increased. After the meal she would have an urge for stool with the pains increasing. During the pain fit she would lie on a side, draw her knees to the abdomen, asked to have the abdomen rubbed. She wasn’t alone, needing her mother or grandmother to stay with her. She was shrieking, being very much afraid of any manipulations with her body. She was even afraid of cutting the nails. Her grandmother noticed a peculiar symptom: there was an abdominal muscle contraction even in sleep; during the pain the frontal abdominal wall was retracted backwards to the spine. The symptom was considered to be determinative for the next remedy choice. During the observation the frontal abdominal wall muscle tension was found – it hindered the deep palpation, bringing no additional pain while pressing.

Analysis, prognosis:

The main complaint of the girl localized on the physical level and is more functional. Both mental and emotional levels brought no significant complaints, which was even more favorable for the prognosis. Till the age of 2 years the patient was hardly sick, which showed her original level of health being high (the group A). Furthermore, the inspiring fact was the ability of the organism to increase the fever high enough. The last episode of the fever increase lasting for 3 days while the girl was taking the antibacterial and antipyretic medication showed the patient’s defense mechanism having been weak, but still able to counteract some external influence. The girl was then in the group B (approximately 5th level of health in G.Vithoulkas classification), where with the correct treatment, the prognosis would be favorable. The family anamnesis information, showing the contact of both parents with heavy metals and radiation are worth mentioning.

The remedy choice

For the case repertorisation a Radar 10.5 program with VES (George Vithoulkas expert system) was used. Below there are symptoms presented, chosen for the case analysis.

Plumbum appeared to have been the most similar remedy among all the remedies in the table. It is this remedy that in its pathogenesis shows severe abdominal colic accompanied with both abdominal muscle contraction and frontal abdominal wall retraction.

Prescription (17.04.15):

Plumbum C200 (3 doses in 24 hours). The night after the remedy the girl slept worse, complaining about the abdominal pains; she cried in the morning. During the day (18.04.15) she felt much better: there was stool 3 times a day – softer, with no pains and screaming. She asked for food often. On the 19.04.15 she didn’t complain about the abdominal pain at all for the 1st time, having her stool 3 times, painless; she became more active, went out for a walk for the first time since the beginning of March.

The next Follow-up (12.05.15)  There were no abdominal pains at all. There was daily stool 1-3 times a day, painless. The general state was good. Over 2 weeks both mother and grandmother noticed no abdominal muscle contraction. The girl’s appetite was still increased.

Prescription (12.05.15): Placebo

01.07.16: Over the past year there were no abdominal pains; the stool is regular. There were several applications for the consultations during the year because of ARVI. In September 2015 the girl had mild chicken pox (typical form). Her fever raised up to 38С for 1 day and lowered naturally. In February and June she had episodes of ARVI with her fever raising up to 39С. She was bothered by nose obstruction at times. Given pronounced anus itching, picking and scratching nose, teeth grinding Cina 30 was prescribed several times over the last months. With the remedy the redness in the anus area was gone, teeth grinding got less as well as irritability; the girl quit rubbing her nose. The emotional state of the patient, in general, got better according to the mother.

22.09.16:  Main complaint – nose obstruction. No abdominal pains. Grinding teeth during sleep became worse again (3). The head and neck perspired during sleep (2). Fear of dogs and cats (2), fear of dark (2). The girl didn’t gain weight inspite of her increased appetite (2). Desire for sausages (3). Prescription: Tuberculinum 200 two doses in 24 hours.

19.01.17: The nose obstruction went away immediately after Tub 200 and the girl felt well. But on November 25 she developed ARI with the fever of 39, accompanied with larynx constriction terminated by emergency with cortisone inhalation. During the last 2 weeks the nose obstruction reappeared. Conclusion: a very good reaction of the organism – the reversion of the old problem (larynx constriction) suppressed by cortisone and antibiotics at the age of 2.5-3 years. Relapse of the nose obstruction. Prescription: Tuberculinum 200 one dose.

19.11.17:  The girl was ok and attended kindergarten without any problems. Two times she had a short ARI with the fever up to 39, in June and September. In both cases she got 2 doses of Tub 30 with immediate good reaction. No  signs of larynx constriction. The grinding of the teeth became rare and much less intense. Still desires sausages (2). Conclusion: The girl is almost healthy. Prescription: wait.

About the author

Olesya Vereykina

Dr. Olesya Vereykina, MD, Novosibirsk Centre of Homeopathy, Russia, graduate of IACH

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