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Case Study

Case 47: A quick but lasting result in chronic IBS
Dr Pankaj Dere

Abstract: An anxious personality with irritable bowel syndrome got relieved with single dose of the homoeopathic remedy. It demonstrates the importance of the characteristic symptom in selecting the most similar remedy in the Repertorisation, and the efficacy of the single dose of that most similar one.

Preliminary Information
Mr L S, 45 yrs, a tailor by occupation, belonging to Hindu community, hails from a small town in UP. He has studied upto 12th, and then got married at 15yrs, in 30 yrs he has had 6 children - 1 son, 5 daughters.

Chief Complaints
Burning and pricking pain peri-umbilically, altered bowel habits ie dry hard stools once every 2-3 days with ineffectual urge, flatulence+, burning retrosternal. Burning in the rectum worse after stools. All complaints > cold drinks +++, < after eating++, > fasting. All complaints started since 1 year and are increased since 4-5 days. Has been treating himself by every other possible medicine, without relief.

Radiological Findings: USG Abd and XR Abd: Standing were normal.

Life Space
The economical condition in his home was not so good as he has 2 brothers and 2 sisters and father was a military man with low salary. Patient still regrets over those conditions and cried once during interview while telling about his childhood. He would go to an ashram school in the day as well as in night time though the school was 7-8 kms away from home. Meanwhile he used to work in the farm to earn some money and help out his father. IPR with all family members was good. Father would pamper him but mother was an irritable lady who would constantly shouts at the patient. Though patient would get angry over it, he never back answered mother because of respect for her.

Academically an average student, once failed in mathematics as he was not having books. Though all other students were cheating in the exams he didn't cheat as he does not like it. He again appeared in the exams and got his subject cleared. When he became teacher he used to teach students not to cheat in the exams, those who cheats can not progress in the future, he even teaches his own son the same thing.

Patient had a conversation with physician over having 4 daughter and 1 son, where patient was very rigid in saying that its all God's gift, you cannot deny it, and was not responsive to physician trying to make him understand about poor economical conditions at home because of big family. (Ed: In these cases with fixed ideas, the physician should only give an indication and then leave the topic as it is not possible to change religious beliefs in short time and rather it will make pt unco-operative)

Patient by nature is sensitive to insult, irritable with short lasting anger, fear of being alone, fear of darkness, fear of water, has brooding tendency for past events, has anticipatory anxiety for his health. He had already shown himself to various physicians, has got his sonography and X- ray done for that. Patient can mix easily with new persons even he made very good relations with PP and consultant.

Physical Generals

·         Thin built, stooped shoulders

·         Dry cold palms

·         Perspiration, specially over forehead ; staining ++ white

·         Appetite reduced since 4-5 days

·         Craving for pungent ++ meat ++ green chillies ++, cold drinks ++

·         Hard dry stools

·         Chilly patient

Physical Examination
General Examination: N
Systemic examination: RS: Normal. CVS: Normal. P/A: vague tenderness all over abdomen.

Investigation Done Previously: CBC: N. STOOL ROUTINE: N. USG ABDOMEN: N.

Family History: Mother: Suppurative tendency. Daughter: Renal stone.


·         Fearful ++, fear of being alone, of darkness, of water

·         Conscientious ++

·         Desire for company ++

·         Brooding ++

·         Anxiety about health ++, about family, more of anticipatory type

·         Mixes very easily with new persons++

·         Short lasting anger

·         Perspiration over forehead staining white

·         Craving spicy and chilly things, cold drinks

·         Dreams elephant pursuing and he himself drowning in water

Reportorial Result: Calc-carb 13/8, Phos 12/8, Kali-carb 10/6, Natrum-mur 10/6

Remedy Selection
Phosphorous was selected on the basis of reportorial result, as the person has great desire for company, he mixes well with new people and most importantly, the burning in the abdomen- chief complaints which is better by cold water. Phos also is a chilly patient.

Susceptibility: Moderate to High
Sensitivity: High
Miasm: Tubercular

Action Taken: Phosphorous 200, infrequently- single dose.

With single dose of Phosphorous there was significant reduction in the subjective distress. Since 1 year he had tried every possible medicine without relief, but after this medicine patient himself came and told physician that there is improvement in his appetite and he is feeling much better. With further two doses of Phosphorous which were required to boost up when the improvement stalled, patient stated that there is no aggravation in his complaints even if he has spicy food. He is still under observation with placebo being given weekly.

What does Prisma say about the remedy- or rather element Phos?