Clinical Cases

Cholelithiasis and Ureterolithiasis in a Woman of 27

Drs. Shruti Gaur and Sharma B. Shankar share a case of cholelithiasis and ureterolithiasis in a woman of 27. Pain in hypochondria extending to scapulae and vomiting after eating were among the symptoms leading to the simillimum.

Abstract: Gallstone formation and ureteric calculi are very common disorders. Surgical intervention is the conventional choice of treatment in most of the cases. In many cases, this surgical intervention can be avoided through proper homoeopathic treatment. This case of cholelithiasis and ureteric calculi treated with homeopathic medicine, reported here is such an example.

This is a case of a 27 year old female who came to our clinic on 17/9/19 with the complaint of acute abdominal pain with vomiting.

History of present illness
The patient came with complaints of severe pain in right hypochondria extending to scapular region since the previous day. She also had burning pain in epigastrium and recurrent heartburn. Distension in the abdomen was better by eructations. She also complained of vomiting after eating food. She had sour eructations. She was sensitive to the pressure of clothing.  She also had pain in the lumbar region extending to abdomen since 2-3 days.

On examination –
Tenderness of right upper quadrant of abdomen.

Ultrasound examination of the abdomen on 17/9/19:
Cholelithiasis
Mild fatty changes in liver
Right distal ureteric calculus causing mild hydroureteronephrosis
Mild bulky uterus with cervical Nabothian cysts

Past history – No history of major illness in the past

Family history:
Mother – nil
Father – nil
Grandmother – nil
Grandfather – nil

Physical generals:
Thermal reaction – hot
Desire – sweets
Appetite – normal – hungry at night
Mouth taste – sour
Thirst- thirstless
Food aversion – oily food
Sleep – sound
Dreams – not remembered
Perspiration- normal
Bowel – normal
Urine –scanty, burning and frequent urination

Menstrual history
Regular, 29/6, bright red

Obstetric history
Married 3 months ago

Mental state – She was sad and irritable and had a constant feeling of misfortune due to her ill health.

2nd visit – She also complained that her memory had become poor and she could not remember where she put things.

Physical examination
Weight – 58 kg
Temperature- 980F
Pulse – 74/min
Blood pressure – 130/80 mmHg

Systemic examination –
GIT: pain in rt. hypochondria and epigastrium
CNS: NAD
CVS: NAD
RESP: NAD
SKIN:NAD

Analysis and evaluation of symptoms
Mentals
1.irritable
2. fear of misfortune
3. sad
4. poor memory

Physicals generals
5.Appetite – hungry at night
6 Thirstless
7.Mouth taste sour
8. Desire – sweets
9. Aversion – oily food
10.Urine – scanty
11. Urine – burning
12. Frequent urination
13. Hot patient

Particulars
14.Pain in rt.hypochondria extending to scapular region
15.burning pain in epigastrium
16. heartburn
17. Vomiting after eating food
18. distension of the abdomen relieved by eructations
19. sour eructations
20. pain in lumbar region extending to abdomen
21. sensitive to pressure of clothing

Totality of symptoms
1.Mind -irritability
2. Mind – fear- misfortune, of
3. Mind – Sadness
4. Mind – memory – weakness of memory
5.Stomach – Appetite – increased – night
6 Stomach – Thirstless
7.Mouth – taste – sour
8.Generals – Food and Drinks – sweets – desire
9. Generals – food and drinks – rich food – aversion
10. Urine – burning
11.Urine – scanty and frequent urination
12. Abdomen – Pain – Hypochondria –right – extending to – scapulae – right
13. Stomach –pain – burning
14. Stomach – heartburn
15. Stomach – vomiting – eating- after
16. Stomach – eructations – type of – sour
17.Stomach – distension –eructations – amel.
18. Back – pain – lumbar region – extending to – abdomen
19. Generals – clothing – pressure of clothing

For acute abdominal pain, chelidonium30 /2 doses was prescribed on 17/9/19 and she got partial relief. On the next visit (19/9/19) all her symptoms were considered again and repertorization was done.

Synthesis repertory from RADAR software

Process of repertorization – total addition process

Remedy differentiation

Sulphur Pulsatilla Bryonia Lycopodium
Abdomen Great acidity, sour eructation, internal feeling of rawness and soreness Heartburn, dyspepsia with great tightness after a meal, painful distended, pressure as from a stone Liver region swollen, sore, tensive. Burning pain worse pressure, tenderness of abdominal walls Wakes at night feeling hungry. Liver sensitive. Incomplete burning eructations rise only to pharynx , they burn for hours.
Urine Frequent micturition, burning in urethra during micturition, lasts long after Increased desire, burning in orifice of urethra during and after micturition Red, brown, like beer, scanty, hot Urine slow in coming, must strain. Polyuria during night.

Remedy selected – after repertorization, Lycopodium scored the highest rank, covering her mental and physical generals.

First follow up (18/9/19) –   Lycopodium  200/ 1 dose

Placebo/B.D. for 7 days

Follow ups

Date Symptoms Treatment
3/10/19 Pain in right hypochondria was slightly reduced. Vomiting was cured Lycopodium200 /1 dose.

Placebo/B.D. for 7 days

18/10/19 Pain in rt. Hypochondria was reduced. Her thirst was improved. Bowel movements were regular and normal. Mental irritation was reduced. Lycopodium 200 / 1 dose

Placebo/B.D. for 7 days

2/11/19 Pain in rt. Hypochondria was reduced. Thirst – 3-4 litres a day, mentally patient became calm. Lycopodium 200/  1 dose

Placebo/ B.D. for 7days

10/11/19 Improvement Lycopodium 200/  1 dose

Placebo/ B.D. for 7days

18/11/19 Improvement Lycopodium 200/  1 dose

Placebo/ B.D. for 7days

27/11/19 Improvement Lycopodium 200/  1 dose

Placebo/ B.D. for 3days

U.S.G. of Whole Abdomen on 30/11/19 –

Hepatomegaly with mild fatty changes in liver / bulky uterus

Discussion: From the repertorization, Lycopodium 200 was prescribed based on the symptom totality. The issue of gall bladder calculus and ureter calculi was resolved with the help of homoeopathic treatment.

Conclusion: This case demonstrates that even a case of cholelithiasis and ureterolithiasis can be cured with homoeopathy and surgical intervention can be avoided.

BEFORE

AFTER

Bibliography:

1.Shenoy K. Rajgopal, Manipal Manual of Surgery, CBS Publishers and Distributors (Pvt.) Ltd., 2009
2.Nan A.K., Undergraduate Surgery, Academic Publishers(P) Ltd., 2007
3. Murphy Robin., Lotus Materia Medica, B. Jain Publishers(P) Ltd.,2014
4. RADAR software version 10

About the author

Shruti Gaur

Dr. Gaur Shruti, MD Scholar Part II, M.N. Homeopathic Medical College and Research Institute, Bikaner.

About the author

Bhawani Shankar Sharma

Dr. Sharma Bhawani Shankar, MD Part 1, M.N. Homeopathic Medical College and Research Institute, Bikaner.

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