Clinical Cases

Rheumatoid Arthritis with Severe Constipation

x whats rheumatoid arthritis video
Written by Santosh Kothari

Dr. Santosh Kothari presents a case of rheumatoid arthritis and persistent constipation in a woman of 43.


Being a student of George Vithoulkas I adapted his method of treating patients by classical homeopathy right after I completed my IACH course in 2000.  Exercising this method I am able to cure a number of cases dramatically, day in and day out.  One such case which is still under my treatment since 24/02/16 is that of Rheumatoid Arthritis along with severe constipation.   The pathology of R.A. brings on the symptoms, like morning stiffness in and around joints, swelling of soft tissue, swelling of the inter-phalangeal, metacarpo phalangeal, or wrist joints, and subcutaneous nodules and a +ve test for RA factor.

The patient who came to me was already under treatment with a renowned rheumatologist and taking medicines since 2014. She was taking HCQS 1 od and Folic Acid.  For the last two years of taking these medicines there was hardly any improvement seen in this patient.

A word of caution is necessary here. While homeopathic medicines cure Rheumatoid Arthritis, the attending doctor must have experience and knowledge regarding the dangers posed in these cases and the possible complications if anything goes wrong.

Here is presented a recent case of R.A. in which such a healing is evident. The important take-home points from this case are as follows:

  • a condition that can be treated with homeopathy, therefore avoiding the allopathic mode of medication which usually makes it worse.
  • Homeopathy can be used even in very serious pathologies when the

theory is understood and applied well.

  • ‘Levels of health’ as taught by Prof Vithoulkas is a concept that is

vital to understanding curability and prognosis in a given case.

  • ‘Strategies of prescription’ as taught by Prof Vithoulkas (2) help in

determining the exact approach to a given case, hence preventing a

lot of roundabout work and delay in understanding a case.

  • When applied right, homeopathy can exhibit miraculous powers of healing and show the theory come alive in practice step by step.

In this case of advanced pathology the patient belongs to group 3 of the health level as taught by Vithoulkas. In this level of health the immune system is low and it is very difficult to get a clear picture of the remedy as there are a lot of suppressions from allopathic drugs.  Therefore we should keep in mind that the patient may require a few remedies before we get him back to level 2 in the levels of health.  Here we will see him having recurrent problems of the same illness, and in this case, the patient started s/f recurrent colds, the joint pains have completely gone and the patient if off all allopathic medications including his HCQS tablets.  I was able to control his colds also and now, though she is not yet cured, she is in much better health than she was. The treatment is continuing.

Patience on the part of the treating doctor and proper advice before starting the treatment as per the bylaws of homeopathy, if given initially, helps the patient to undergo the treatment without any hindrances from allopathic medication, though she suffers from the symptoms for a certain length of time.  In this case there was original aggravation of joint pains; then there was severe leucorrhea which was there for almost 2/3 months, which subsided and along with this the joint pains also subsided. Only after the appearance of leucorrhea  could I completely stop her HCQS drug. This was followed by severe recurrent attacks of cold with severe sneezing, up to 40 to 50 sneezes at a time and severe nasal obstruction. A that point I had to

advise her to continue with the nasal drops to relieve her obstruction. Eventually the nasal drops were not required.

A thorough knowledge of the laws is necessary while treating these complicated cases. The severity of the patient’s complaints can make us think of some acute remedy or some other remedy but caution is required as to when to prescribe and when to wait and watch.


A female patient aged 43 came for consultation on 24th of Feb 2016.  Her main complaints were her fibroid for last 6 years causing heavy bleeding, and long standing constipation for which she took laxatives every day.  She had suffered from hypothyroid from 2007 to 2014 and had stopped taking the medicine since 2014.  But the thyroid problem disappeared and she developed R.A.

History of presenting complaints:

  • Fibroid of 8.5 cms since 2000 causing heavy bleeding during the periods
  • Constipation since 2006 with no desire and has to take laxatives
  • Indigestion
  • Hypothyroid from 2007 to 2014 from which she stopped taking thyroid medication and the thyroid is normal
  • During the course developed joint pains and was RA +ve in


  • Forgetfulness increasing day by day
  • Pain in joints wandering in nature and very severe incapacitating the patient with RA test +ve

Past history of piles being operated on.

Recurrent colds which were suppressed with medication.

1 child C section – Child is now 17 year of age

Family history: Mother has high blood pressure.


This female 43 years of age came to me with the above complaints.  After marriage she went into a lot of crisis because of her in-laws and husband.  She felt completely vulnerable and alone in the new atmosphere after marriage.  In laws were very dominating and she was under constant pressure from them while she was staying there.  She is reserved by nature and has a brooding tendency.  As she was under allopathic medication there were no particular modalities that I could take into account.  Even her cravings and aversions were also affected so that was not of any help to me. She is a very sensitive woman.

Taking into consideration the dominating nature of her in laws and her husband I put her on Carcinosin 30 for a month once daily and told her to continue with HCQS and Folic acid for some time.

01/06/16:  General improvement in the joint pains with increase in the appetite.  Sleep not better.  Constipation ++ with first stools very hard followed by normal stools.  As her sleep got disturbed I decided to give her Nat mur 30, taking into consideration her sensitivity and brooding nature and suppressed emotions.

16/7/16: Nat mur brought on her leucorrhea, which was very severe, but this helped her joint pains about 40%.  Still no improvement in the constipation whatsoever and she was still continuing her laxatives on a daily basis. She was advised to take HCQS on alternate days as the joint pains had reduced considerably.  As there was no improvement in the constipation, with first stools hard, I increased the potency to Nat mur 200, 3 times a day

17/9/16: Leucorrhea is still persistant, profuse bleeding during the periods++; sleep is much better but now she has developed pain in right thigh laterally from above downwards. It was severe with difficulty in walking.  I just gave her a single dose of Nat mur 200 and placebo.

24/11/16: USG abdomen showed no improvement in the fibroid.  Constipation ++, Leucorrhea++ with extreme dry stools. I gave her Alumina 30.  Here I was not sure whether to continue Nat mur as her constipation was not at all improving.

25/12/16: Alumina 30 had not helped her at all.  Brooding had increased; joint pains on and off in some areas, but it was not disturbing or incapacitating her. I gave her Nat Mur 1m 1 dose and placebo

13/2/17:  The food she ate started tasting very spicy to her and therefore she had to switch to bland food, and sugar with every morsel.  Extreme dryness of mouth and desire for cold drinks++. She started adding extra salt to her diet, which made me think of Phosphorus which I prescribed in 200 potency.

10/4/17: Phosphorus 200 tds for 15 days helped her, > her food tasting spicy. Also she felt much >  with the dryness of mouth, so I thought of increasing the potency and to give Phosphorus 1m 1 dose only and placebo.  But Phosphorus brought back her Urticaria now.

24/5/17: There was < of complaints again, with severe abdominal pain and the leucorrhea came back.  As Nat mur had helped her before I decided to go back to Nat mur 200 as the constipation was still there with first stools extremely hard.  Gave her Nat mur 200 tds .

13/9/17: Abdominal pains were much >, leucorrhea improved but it broght back her old symptom of Recurrent colds, with severe sneezing, nasal obstruction, extreme dryness in the nose causing her a lot of trouble with difficulty in sleeping.  Again started using nasal drops.  There was waterbrash and gases had increased, but got a new symptoms of BURNNG OF SOLES, Right sided headache and with her colds.  I gave her Sang Can 30 tds x 1 month

30/10/17: Sang can 30 did not make any change and the colds were still there , nasal obstruction ++, extreme dryness of lips, has started coughing also now, food started tasting spicy again and she has started adding extra salt. Constipation increased, Severe pain in the rt. hip joint with difficulty in folding the legs; desire for open air and to rub her eyes constantly, which was so severe that it started disturbing her.  For the first time there was an < OF SYMPTOMS FROM 5 TO 8 PM.  With rt. sided complaints and the above < timing, I decided to give her Lyc 30tds x 15 dys.

6/12/17: Lips were much >, but now had started severe burning in eyes, with no desire to open the eyes at all. Cough and cold is ++, constipation is ++, extreme heat of palms and soles, with a desire to keep them on cold surface.  She felt a lot of internal heat, so Sulphur 200, 2 doses was given along with placebo.

20-12-2017  Heat is much >, but no difference in the lips, food tastes spicy, has developed blisters on the tongue, constipation increased, desire for sweets has increased. Drinks water constantly sip by sip to relieve the dryness of the lips and the tongue. Stools are extremely dry and hard.

Lyc 30 tds x 15dys

15-01-2018 : She is feeling much better; no joint pains and the cold is also much better. Constipation is +++

Lyco 30 tds  x 15 days.

So now the colds are under control, the food tasting spicy has gone completely, there are no joint pains as such and overall she is feeling much better physically and mentally.  So far the remedies given were Carcinsoin, Natrum mur, Alumina, Phosphorus, Sang can, Lycopodium and Sulphur.

To bring the patient from level 3 to level 2 and now on the upper plane of level 2, it took me almost 2 years. There were lot of symptoms and the patient had to undergo a lot of suffering, as I had to wait many times to see the result. In the course of her treatment her old symptoms came back.  I think I made haste in prescribing her Alumina and Sang Can which absolutely made her no difference.  But taking into consideration the suffering of the patient and my desire to help her immediately, the above mistakes were made. I feel I could have avoided those remedies as the previous remedies given were working.  The patient has now come into a psoric state and the deep acting anti psoric remedies will bring her to level 1 of health as per Vithoulkas’ teachings of Levels of Health.

Hopefully she might require another 3 to 6 months to get back to her normal health after which I can stop her all homeopathic treatment and she will not require further medications.

If you are aware of all the difficulties that the patient is going through and tell the patient about them, then they are ready to go through the suffering to find an ultimate cure.

Still her constipation has to improve and also the fibroids.  I will keep posting about it again after I stop the treatment.

About the author

Santosh Kothari

Dr. Santosh Kothari L.C.E.H.(MUM); B.H.M.S.(PUNE), DIP.I.A.C.H.(Greece) is a practicing Homeopathic Physician with over 35 years of experience. Earlier he worked as an assistant to one of the leading homeopaths, Dr. Anil Bhatia, Mumbai and he was a lecturer in Homeopathic Medical College, Solapur, Maharashtra. Dr. Kothari also completed a 4 year training course in Greece, under Dr. George Vithoulkas.

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