IBD, Inflammatory bowel disease

Clinic

• IBD is a group of inflammatory conditions of the colon and small intestine
• It causes inflammation and ulcers (sores) of digestive tract.
• Crohn's disease and ulcerative colitis being the principal types.
• Crohn's disease affects the small intestine and large intestine, as well as the mouth, esophagus, stomach and the anus
• Ulcerative colitis primarily affects the colon and the rectum.

Sign / Symptoms

• It may seem that Crohn's and UC are very different diseases, but both may present with similar following symptoms:

	Crohn's disease	Ulcerative colitis
Defecation	Often porridge-like, sometimes steatorrhea	Often mucus-like and with blood
Tenesmus	Less common	More common
Fever	Common	Indicates severe disease
Fistulae	Common	Seldom
Weight loss	Often	More seldom

GI tract	Extra GI	Static Complication
Abdominal pain Rectal bleeding Mucus covered Stool Severe internal Cramps/ Spasms in pelvis region Diarrhea mixed with Bloody Mucus discharge Weight loss, Anemia /Malabsorption /Steatorrhea(Crohn> UC) Bowel movements Increased Proctitis (UC> Crohn): Urgency or rectal tenesmus + Little stool Tenesmus may be misinterpreted as constipation Fecal incontinence Terminal ileum involvement (Crohn> UC ) Cholangitis (UC> Crohn) Crohn involve GI mucus membrane in patchy but deep form which ends in Stenosis/ Abcess / Fistulae but UC involvement is Shallow and Continuous.	Anemia is the most prevalent extra intestinal complication Episcleritis / Iritis/ Uveitis Primary sclerosing cholangitis (UC> Crohn) Ankylosing spondylitis / Sacroiliitis / Poly-Arthritis Pyoderma gangrenosum (Crohn> UC ) Erythema nodosum (Crohn> UC ) Non-thyroidal illness syndrome (NTIS) Deep vein thrombosis (DVT) Bronchiolitis obliterans organizing pneumonia (BOOP)	Mega colon Colon cancer (UC> Crohn)

Miasms

• CMV : Sclerosing Cholingitis, Fistula, Uveitis, Colitis
• MTB: Ankylosing spondylitis / Sacroiliitis / Pyoderma gangrenosum, Arthritis, Uveitis, Cholingitis, Colitis and GI tract Ulceration
• HSV-1: Proctitis

New Idea

• Crohn involve GI mucus membrane in patchy but deep form which ends in Stenosis/ Abcess / Fistulae but UC involvement is Shallow and Continuous.
• Does it mean UC entity is Colitis and Crohn's is Ulceration.
• If so, I can say Crohn's miasm is only MTB and UC's is CMV. If Rectum / Anus is involved, then HSV is the only miasm
• Due to high prevalence of Bloody, painful stool in UC, I suggest HSV-1, In comparison MTB / CMV is good candidate of Crohn because of Fistula.

Definition

• Ulcerative colitis and Crohn's disease are both IBD sister diseases.
• Both have Autoimmune / General identity, therefore contain Digestive / Extra-digestive entities.
• Because of deep ulcers, I think MTB is its best Miasm

Remedies

Diseases - CROHN'S, disease Aloe, ars, chin, merc-c

Banerji protocols
First line	Tub C200 one dose daily Lyc C200 + Plb C200 two doses daily in Hard / Difficult stool (Same protocol with constipation)
Second line	Staph C200 one dose every 3 days FP 3X + MP 3X , Mix of them two doses daily

Diarrhoea Marked Urgency to Pass Stool	Aloe	Loose stools Feling of constant bearing down in the rectum Urge to pass stool immediately after drinking or eating. Rumbling and gurgling in the rectum, Yellowish, brownish, lumpy Excess water stools Involuntary passing of stools while passing flatus Development of anal fistula	Urgency to pass stool is markedly present in the morning; also soon after eating or drinking. Burning in the anus and rectum may also be intense. Passage of jelly-like mucus in stool.
Loose Stool + Rectal Bleeding	Merc	Loose stools with excessive bleeding. Stools are very frequent. Bowels feel weak, holds them Even after passing stool a number of times, there is no satisfaction. Feel chilly all the time. Stool painful, scanty; greenish slimy Acrid stool; then tenesmus or chill	Intestines feel bruised when lying on right side, or as if they fall to side on which one is lying. Rectal tenesmus, with tenesmus of bladder.
Loose Stool + Mucus	Merc-c	Tenesmus / Continuous urging of rectum and bladder. Foul-smell stool Dysentery: Tenesmus that does not amel with defecation and has become permanent Painful flatulence: Bloated, Painful to least touch (Feeling of constriction) Severe Cutting colic; below navel. Stool is hot and offensive. Burning in the rectum while passing stool may arise. There may be cutting, colicky pains in the abdomen	Internal burning in throat, stomach, rectum, neck of bladder, kidneys etc. Acrid discharges Hot, Bloody, Slimy, Foul-smelling /Split stools + Tormenting tenesmus. Severe epigastric sensitivity /Pain / Bruising esp in area of cecum and transverse colon. Unceasing green bilious vomiting
Weight Loss	Chin	Weight loss along with diarrhea. Loose stools Undigested food particles in feces, Flatulence during excretion, Bloated abdomen	Weakness and frailty.
Weakness	Ars	Excessive weakness along with diarrhea is present. Foul smelling, Profuse watery stools Vomiting, nausea and Burning sensation in the abdomen, Sores or ulcers in the mouth	Gnawing, burning pains in abdomen like coals of fire; relieved by heat. Painful, spasmodic protrusion of rectum. Tenesmus. Burning pain and pressure in rectum and anus. Worse at night Dysentery dark, bloody, very offensive. Burning thirst. Body cold as ice.
Abdominal Cramps	Coloc	Predominant, intense colicky abdominal Pain/ Cramps. Abdominal pains agg from slight eating or drinking. I Bending-over double or putting hard pressure provides relief. Watery, sour-smelling, yellowish-greenish stool Vomiting of bitter fluid.
Mouth Ulcers Intense Pain in Rectum on Passing Stool	Nit-ac	Ulcers in the soft palate with sharp, splinter-like pains. Slimy, offensive diarrhea. Irritability and exhaustion follow after stools. Bleeding from the bowels is profuse and bright red.	Rectal pain may be tearing or cutting in nature. It may continue for hours after stool is passed.
Sharp Abdominal Pain Bloody Diarrhea Marked Weakness	Phos	Sharp cutting pains in Abdomen. Very weak, empty, all gone sensation in the entire abdominal cavity. Diarrhea in the morning Discharge of blood from rectum while passing stool Proctitis	Stool is copious, gushing, and watery. Blood is bright red. He feels exhausted after passing stool. Cramping pain in the rectum on passing stool.
Constant Urge to Pass Stool + Marked Tenesmus	Nux-v	Frequent, scanty stool and Tenesmus due to constant ineffectual urge The stool is scanty. Abdomen pain before passing stool Agg: Spicy food/ Alcohol Strains hard at stools; Feeling as if part remained unexpelled; passes small quantity at each attempt. Dysentery; stools amel pains for a time.	Ailments of sedentary life, Doing much mental work, Remain under prolonged Job stress , Business cares and worries. Typically he is thin, spare, quick, active, nervous and irritable. Craves piquant food; beer; fat food, chalk; stimulants. Bruised soreness of abdominal wall.
Arthritis	Colch	Stool with mucus and pain in the rectum. The pain in rectum continues for long after stool is passed. Highly offensive flatus may attend the above symptoms.	Joint pains + Swelling + Stiffness + Slightly touching the joints agg the pain.
Other remedies
	Orni	Feeling of struggle and twisting in the chest and stomach that started from the pyloric valve of the stomach + Flatus passing + Feeling of a ball rolling from one side of the abdomen to another Pain increases when food passes through the pyloric valve Coated tongue Anorexia + Nausea / Vomiting + Weight loss Stomach ulcer even with bleeding Coffee-ground Vomiting Frequent flatulence + foul-smelling flatus passing Pain and emptiness in the epigastrium Stomach: Tongue coated. Agonizing feeling in chest and stomach, starting from pylorus with flatus that rolls in balls from one side to the other; loss of appetite, phlegmy retching and loss of flesh. Gastric ulceration even with hemorrhage. Pains increased when food passes pyloric outlet. Vomiting of coffee-ground-looking matter. Distention of stomach. Frequent belching of offensive flatus. Painful sinking across epigastrium.
	Ant-c
	Ter	Bruised soreness Flatulence Profuse mucous stool Watery, green, foetid stool Bloody stools: Bleeding from intestinal ulcers Bowels were drawn towards spine. Diarrhea, with tetanic spasms.
	Carc	Family history of cancer. History of grief, domination, abuse. Patient is nice and creative.
	Ign	History of grief Colicky griping pain in one or both sides of abdomen Stools painful, difficult although soft Constrictive sore pain in the rectum, like from blind hemorrhoid's, remains one or two hours after stools. Pain shoots up in rectum. Pressure as of a sharp instrument from within outwards. Painless contractions of anus. Hemorrhage and pain worse when stool is loose.
	Nat-m	Ill effects of grief, fright and anger; agg by consolation. Cutting pain in abdomen and the abdominal ring, burning and stitching pain in the rectum after a copious diarrhoea. Epigastrium swollen and painful. Sudden distension. Tense abdomen worse groins. Pain in abdominal ring on coughing. Colic with nausea, better by passing flatus. Abdominal viscera feels loose and dragging when walking.
	Staph	A nervous personality with marked irritability andtrembling. This irritability is reflected in temper as well as in function of the digestion. The peristalsis agg with the emotional outburst. Feeling of weakness in abdomen, as if it would drop, wants to hold it up. Flatus hot, smells like rotten eggs. Dysenteric stools, worse after the least food or drink. Diarrhea from drinking cold water Morbidly sensitive; the least word that seems wrong, hurts her very much; special senses become irritable. Ill effects of anger and insults; reserved; anger, sexual; abuse, excess;  tobacco, mercury.

Lyc

• Mentally active but grows weaker.
• Loss of self confidence; from anticipation; averse to undertaking new things; yet when he undertakes it he goes through with ease and comfort.
• Hurried. Much noisy flatulence.
• Gastroenteritis from fright.
• Diarrhea from cold drinks.
• Continued burning in rectum.

• Stomach: Dyspepsia due to farinaceous and fermentable food, cabbage, beans, etc. Excessive hunger. Aversion to bread, etc. Desire for sweet things. Food tastes sour. Sour eructations. Great weakness of digestion. Bulimia, with much bloating. After eating, pressure in stomach, with bitter taste in mouth. Eating ever so little creates fullness. Cannot eat oysters. Rolling of flatulence. Wakes at night feeling hungry. Burning eructations rise only to pharynx there burn for hours. Likes to take food and drink hot. Sinking sensation; worse night.
• Abdomen: Immediately after a light meal, abdomen is bloated, full. Constant sense of fermentation in abdomen, like yeast working; upper left side. Hernia, right side. Liver sensitive. Brown spots on abdomen. Dropsy, due to hepatic disease. Hepatitis, atrophic from of nutmeg liver. Pain shooting across lower abdomen from right to left.
• Stool: Diarrhea. Inactive intestinal canal. Ineffectual urging. Stool hard, difficult, small, incomplete. Hemorrhoids; very painful to touch, aching.

Bry

• Stomach: Nausea and faintness when rising up. Abnormal hunger, loss of taste. Thirst for large draughts. Vomiting of bile and water immediately after eating. Worse, warm drinks, which are vomited. Stomach sensitive to touch. Pressure in stomach after eating, as of a stone. Soreness in stomach when coughing. Dyspeptic ailments during summer heat. Sensitiveness of epigastrium to touch.
• Abdomen : Liver region swollen, sore, tensive. Burning pain, stitches; worse, pressure, coughing, breathing. Tenderness of abdominal walls.
• Stool: Constipation; stools hard, dry, as if burnt; seem too large. Stools brown, thick, bloody; worse in morning, from moving, in hot weather, after being heated, from cold drinks, every spell of hot weather.

Nux-m

• Stomach: Excessively bloated. Flatulent dyspepsia. Hiccough, and craving for highly-seasoned food.
• Abdomen: Paralytic weakness of intestines. Enormously distended. Stool is soft, and yet is unable to expel it, even with long straining. Faintness during or after stool. Protruding piles.

Podo

• It affects chiefly the duodenum, small intestines, liver, and rectum. Gastro-enteritis with colicky pain and bilious vomiting. Stool is watery with jelly-like mucus, painless, profuse. Gushing and offensive.

• Stomach: Hot, sour belching; nausea and vomiting. Thirst for large quantities of cold water. Vomiting of hot, frothy mucus. Heartburn; gagging or empty retching. Vomiting of milk.
• Abdomen: Distended; heat and emptiness. Sensation of weakness or sinking. Can lie comfortably only on stomach. Liver region painful, better rubbing part. Rumbling and shifting of flatus in ascending colon.
• Rectum: Diarrhea of long standing; early in morning; during teething, with hot, glowing cheeks while being bathed or washed; in hot weather after acid fruits. Morning, painless diarrhea when not due to venous stasis or intestinal ulceration. Green, watery, fetid, profuse, gushing. Prolapse of rectum before or with stool. Constipation; clay-colored, hard, dry, difficult. Constipation alternating with diarrhea. Internal and external piles.

Verat

• Stools large, with much straining until exhausted, with cold sweat. Diarrhea very painful, watery, copious, and forcibly evacuated, followed by great prostration. Evacuations of cholera morbus and true cholera when vomiting accompanies the purging.