A Case of Acute Abdominal Pain

Homeopath Tama Prahlow presents a case of acute abdominal pain. Two visits to the emergency room yielded no diagnosis. A sensation of razors inside from groin to sternum was among the symptoms that led to a simillimum.

A Case of Acute Abdominal Pain

Patient TC – Age 16

Phone Consultation May 7, 2018: Lasted about 15 minutes.

Patient’s Timeline:

Sunday at 12am TC went to the emergency room with severe abdominal pain. Twelve hours later, TC still had pain. The MRI was inconclusive, so no diagnosis was made.

Monday at 12 noon: The family returned TC to the emergency room where the child had a repeat, 2nd MRI. No new or different information. No medical diagnosis resulted from the MRI. On Monday at 3pm TC took an OTC. The result: every 15-30 minutes bowel discharges would be clear, watery. It felt bubbly like stuff moving around in the stomach a lot. There were noises of pouring watery discharges into the toilet.

Tuesday, the TC’s pain returned suddenly mid-day.  7:15pm the homeopathic student was phoned. An acute case was taken.

Homeopathic Consent: Both parents and child gave verbal consent to the second year homeopathy student for homeopathic treatment.

Patient Introduction and Personal History:  TC is 16 years old and lives in a nuclear family on a farm with chickens and cats, in the North American continent.

Medications: Dulara Steroid inhaler; bid.
Monthly allergy injections for cat dog dander.

This child was familiar with the professional homeopathic student, since they shared in a mutual hobby. When consent for homeopathy was given, TC was “really ready to try homeopathy”.

Chief Complaint: A sensation of “razors inside from groin to sternum” for three days off and on.

Location: “In a box shape, the sides of TC’s abdomen from the sternum to groin”. (3) If you would put an apple there, it would be two inches above my belly button. That’s where the worst pain was”.

Times: What time today? 1:00 pm.

Pace: “The pain started up all of the sudden”.

Sensation & Intensity: “I thought it was bad gas. Stabbing”. “A bad gas feeling”. “8” on 0-10 scale, when at its worst.

Modalities: “I laid down on my back with my legs bent, and a little propped up (1) with a pillow behind my back. I took off my shirt during the worst pain”. (2) “If I move I’ll have that pain. I’m on my back propped on pillows, legs tucked in”; “feet are a foot away from my butt flat on the bed”. “I am in a ball. I can get my hands around my legs”. Went outside during the day. (1) Doesn’t like tight clothes. Can’t poop.. Wants warm water and eats strawberry and fruity popsicles.

Physical symptoms: Can you pass gas? Yes. Any bowel movements since Sunday’s pain? Yes, Normal bowel movements. Small amount today. Described it “…as an [ascending] pain from below up toward my throat”.
“Suddenly, on Tuesday, TC got really bad. I felt like I had to have a poop. (3) I just felt like I had to. Pain started, I started to faint”. Did you sweat with the pain? “No, I was not sweating. My throat got tight like it does when I have to throw up. The pain that started in my right lower side, had been there since Sunday. The level of pain goes up and down”. Today the Right side pain started at 0-1. “It wasn’t [initially] that bad. It was still there a bit”.  I was in the hospital two times for the “8” pain”. The number of hospital  visits (2) in 12 hours. 2 MRIs. No diagnosis.

Mom’s Summary: “Neither found an appendix. There was something enlarged on a kidney.”

Description: “Feels tired in that area. Sore in that area. Moving makes it hurt again like razors. So I don’t move around”.

Paatient Summary: “In a box with the borders being both hips, sides, up to sternum; and the hurt moves upwards and less going downwards. It hurts in that box”.

Case Analysis: Today’s pain onset was after eating lunch and is associated with urge to poop, but only a small amount. Then, there was a tight throat and nausea associated with the pain. The pain was ascending from groin up to the sternum.

Rubrics:

STOMACH PAIN Gastralgia extending over abdomen

GENERALITIES CLOTHING loosening amel.

GENERALITIES AIR open desire for

ABDOMEN PAIN stool urging, during

ABDOMEN PAIN cramping, griping, Umbilicus region of, bending body, forward amel.

Remedy Differential

Nux-v : Clark MM: As if pharynx were contracted.  Stitches in region of liver, <motion or . Sharp and drawing pains in the umbilical area and in hypogastrium. Sensation as if parts were raw. Necessity to lie down. Stomach: Flatulent colic. Great flatulency which is incarcerated in the hypochondria, or mounts toward chest. Stool: small portion of fecal may be passed with urging. Right sided affections, of right hypochondria and right inguinal.

T.F. Allen MM: Disagreeable sensation in the pit of the stomach, ascending up to the throat.  Persistent cutting colic, in the lower abdomen, rising to the upper abdomen, where it amounted to a griping. Flatulence rises and becomes incarcerated under the short ribs.

Genius of this Case: I saw that Nux-v had the ascending pain in TF Allen’s descriptions and when I did, I knew I had my simillimum: rising to the upper abdomen when it mounted to a griping.

Arnica:  Clark MM: Spasmodic contraction of the stomach, which causes a general pain with a sensation as if the wall of the stomach were forcibly pressed against the spine, and as if the spine would be made painful from that point downward. Relieved by eating. These symptoms contraindicate Arnica for these abdominal pains.

Pulsatilla: Clark MM: Constriction of Throat. Colic. Flatulence. Pain in epigastrum, < sitting. Ineffectual desire to stool. Constipation and difficult evacuations. Sharp shooting pains in abdomen > squeezing the abdomen, < movement. Lacked the ascending modality so overlooked this remedy.

Calcarea carbonica: Clark MM: Constriction in the throat. Shootings, pinching and aching in the abdomen. Abdominal pains appear after meals. Incarceration of flatus. Painful gripping and shootings in the groin. Ineffectual efforts to evacuate. Evacuations suspended, hard, in small quantities.  Walks much, moves constantly is disagreeable for the simillimum to be Calcarea.

Lycopodium:  Clark MM: Pharynx feels contracted. Abdomen > by heat of bed. Sharp pain in the dorsum liver area. Cutting pains esp. above the navel. Imperfect expulsion of flatus. Incarceration of flatus. Pain caused by flatus not passing. Small stool followed by excessive painful accumulations of flatus. Great desire for fresh air, with excessive sensitiveness to cool air. The cool outside air seemed to help, which made me pass over Lyc. as the similimum.

Remedy and dosing recommendation: Nux vomica 30C dissolved in 1 cup of distilled water. Dose once then sip by spoonful when you have pain after that. Call back 2-4 hours later.

Follow up Result:  I received a  Text at 10:21pm.  “One dose took care of the razor blade feeling. The only feeling afterwards is of soreness in the right side again, where it was before. Back to what it was like this morning before the horrible sharp stabbing pains started”.

Patient Perspective: TC has subsequently become a believer in homeopathy. And TC is a chronic patient now for asthma and cat allergies.  Puls. is a chronic of Nux-v and on Pulsatilla the patient’s lung capacity and exercise tolerance has improved 90%, much to the surprise of the allergist. A threateningly detrimental reaction was experienced with the last allergy injection a few minutes after it was given, while TC was still in the office. This family has not sought further care from the allergist at present since TC has reported such subjective improvement in asthma and allergy symptoms.

Three Journals:

  1. deSepic, Maria Luisa R., Wonders of Homeopathy III: Glaucoma-Psora, The Layman Speaks “A Layman’s Journal of Homeopathic Medicine”, March 1976, pp. 68-70.
  2. Stephenson DDS, L.Ac. David L., New England Journal of Homeopathy, Cases/Stephenson; pp. 102-103.
  3. Duskin, MD,Ronald, Chronic Prostatitis, Urethritis, Fatigue, and Brain Fog in a 52 Year-Old Physician A Homeopathic Medicine Case Report, American Journal of Homeopathic Medicine, Vol. 109 Annual 2016 Issue; pp. 22-26.

About the author

Tama Prahlow

Tama Prahlow

Tama Prahlow RN, AAHCC, CHom, CCH is a third-year homeopathic student extern at the Canadian College of Homeopathic Medicine, Toronto, Ontario, Canada, with anticipated graduation June 2019. She has worked in many areas of nursing including Emergency, Intensive Care, Coronary Care, Medical-Surgical and pre-hospital on an ambulance in her younger days. She’s been nationally certified with the American Academy of Husband-Coached Childbirth since 1994 (AAHCC-The Bradley Method®). Her certificate in homeopathy (CHom) is from Homeopathy School International 2015, and in 2019 she achieved Certification in Classical Homeopathy (CCH) from the Council for Homeopathic Certification. Tama loves swimming, kayaking, and discovering new things for health.

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