Chronic Calcific Pancreatitis

A 24-year-old male adult consulted me on 1st July, 2020 with a history of recurrent abdominal pain since August 2017.  Pain starts in the pit of the stomach, mostly the upper part of the abdomen. Intolerable pain and he used to think it is better to die than bear each episode, which would last 3-4 days.

In 2 years, he had four episodes. Pain is aggravated by standing, walking, and lying legs stretched or straight on back. He used to get angry during pain. On lying down and standing with arms raised he used to get pain with a feeling as if his “intestines were stretched “.

Pain ameliorated by Sitting with legs folded in a chair or lying on the side with limbs folded. Dreams of ghosts, quarrels, the death of known people including relatives and friends and amorous dreams with pollutions.

After each diagnostic procedure he would get heartburn in sternal area and pain in left hypochondrium for next 2-3 days and he would take antacids to counter these.

1. Diagnostic ERCP ( Endoscopic Retrograde Cholangiopancreatography ) Report

3oth May 2018 –  Chronic Calcific Pancreatitis, Status Post ESWL  (Extracorporeal Shock – wave Lithotripsy ), Pancreatic Stent exchanged.

30 th November 2018 – Post-ESWL, Pancreatic Sphincterectomy, and ballon sweep done, pancreatic duct cleared, pancreatic stent exchanged.

4th April 2019 –  Pancreatic stent exchanged

November 1^st, 2019 –  Previous Pancreatic stent in minor papilla removed. Pancreatic duct selectively cannulated vis minor papilla. Pancreatogram showed pancreatic duct calculi in the head region. Pancreatic duct balloon sweep done and a few stones removed.

2. X-Ray Abdomen on 25th May 2020 – Radioopaque densities in left hypochondrium

3. Real-time Ultrasonography of abdomen on 20th May 2020 – Marginally enlarged pancreas showing changes of chronic calcific pancreatitis, speenomegaly. Few small para celiac lymph nodes, minimal interloop free fluid in the pelvis

Ultrasound scan whole abdomen on May 23, 2020 at some other center – Multiple tiny pancreatic calcifications. Chronic pancreatitis.

4. Side view endoscopy on 20th June 2020 – Duodenal edema with luminal narrowing

All the above tests are done at a famous gastroenterology institute in India. The patient is the son of agricultural laborers and both parents used to earn hardly 400 US $ a month. He spent about 3000 US $ for his treatment and went into total debt.

Based on totality of symptoms he was prescribed Colocynth 30 ch, single dose on 1 July 2020.

1. Pain ameliorated by sitting with legs folded in a chair or lying on the side with limbs folded.

• The strongest characteristic calling for the use of Colocynthis is an agonizing pain in the Abdomen causing the patient to bend over double ( A Dictionary of Practical Materia Medica, vol 1, page 572 by John Henry Clarke M.D
• Homeopathic Medical Repertory by Robin Murphy, ND

Generals, Bending general, double ameliorates – COLOC

2. Pancreatitis

Glands, Pancreatitis Coloc

3. Agonising pain

Pain Glands, Acute pain –  COLOC,

4. Pain aggravated by walking, Clarke page 575, para 1

5. Amorous dreams, frequent Clarke  page 576, para 6.

The pain had incapacitated him for more than 15 days this time and at the gastroenterology institute, they postponed doing ERCP to remove stones because of duodenal edema dated 20th June 2020 shown in endoscopy. After colocynthis, he felt a sensation as if ” intestines were boiling” for 3-4 days. Then pain started reducing on the right side, then center, and lastly left side of the abdomen.

Review on 25^th, July 2020: — The pain was completely gone and he never experienced such agonizing pain in the last 18 months  He complained of a few new symptoms (all ref from Murphy rep. revised 3 edition)

Heaviness after eating food
Feels hunger and wants to take food again between 5-6 PM
Anticipation anxiety
Pain after eating vegetables
Trembling of hands when hungry
Based on the above symptoms he was prescribed Lycopodium 30, single dose

Review on 14th September 2020 – No pain, no digestive problems, wants to eat  more and has gained weight. Before his problem, his weight was 48 kilograms. During sickness he lost weight came to 39 kgs, and felt miserable, no desire to do any work or study. He said he ” regained hope” that he can do anything in life and ultimately he regained his lost weight and he weighs 50 kgs now.

3rd November 2020 –  Complained of sharp pain, sometimes like touching fire if he eats more food, ameliorated after passing stool. Trembling during hunger, agg. by emotions, Flatus after eating. Based on these symptoms he was given Lycopodium, Natrum muriaticum, and Zincum in 30 potency single dose.

5th  January 2021 – No pain, passed small worms in stool, complains of loose motions 4-6 times a day, and flatus. Lycopodium 200 ch single dose.

11th  April 2021 – Sharp pain left side of abdomen if he eats heavily for 5-10 minutes. Stool frequency reduced. Asafoetida 30 ch single dose.

6th  August 2021 – mild pain persisting associated with flatus and trembling when hungry. Lycopodium 200 ch, single dose repeated.

31 December 2021 He is pain free and enjoying life

After homeopathy treatment he never needed any of the above investigations or complicated procedures and he had spent only 100 US $.

Summary
Colocynth was the main remedy that removed his main symptom of intolerable pain. Lycopodium was used as symptoms pointed to it in subsequent consultations, The rest of the medicines were used depending on minor symptoms.