2. ABSTRACT
Haemorrhoids or piles are fairly common during pregnancy. They are
caused in large measure by constipation and elevated pressure in veins
below the level of enlarged uterus. Constipation is because of atonicity of
gut which occurs due to high levels of circulating progesterone during
pregnancy. The relaxation of smooth muscles affects the entire
gastrointestinal tract which causes gastro oesophageal reflux and
oesophagitis. Delayed small bowel transit and increased water absorption
causes constipation and passage of hard stool.
In general, modern medicine advocates no drastic medicine should be
given in pregnant women. But constipation can be relieved to some extent
by use of laxatives occasionally. Constipation is sometimes refractory till
the delivery of the baby. Whereas in Homoeopathy, the medication is
smooth and harmless relieving the pregnant women of their distress from
constipation and also the resultant ill effects of haemorrhoids, making the
patient comfortable.
This is an open study comprising of 50 pregnant women who were treated
with homoeopathic medicines for constipation and haemorrhoids. The
remedies were prescribed by individualizing each case with encouraging
results. 2
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3. INTRODUCTION
It is essential to guard the health of the mother during
pregnancy-mental and physical if the best possible child is to
be born. The disabilities of the mother may have an adverse
effect on the unborn infant.
Constipation in pregnancy is a common trouble. Where it exists
toxic absorption is bound to follow, and while it persists the
patient is in danger of the severe complications.
Piles is a varicose condition of the veins distributed to the
lowest portion of the rectum or lower bowel, with more or less
hyperplastic growth of connective tissue.
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4. ABOUT CONSTIPATION
Constipation may be due to a great variety of causes, and due regard must be had
to these if it is to be successfully treated.
Five leading factors in the physiology of the function are:
(1) The muscles of defecation, chiefly the diaphragm and the abdominal
muscles;
(2) The muscular wall of the intestines, and chiefly of the lower portion;
(3) The mucous membrane of the bowels;
(4) The secretions of the liver and pancreas which are poured into the
bowel; and
(5) The condition of the anal orifice.
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5. ABOUT HAEMORRHOIDS
If piles occur outside the sphincter muscle which constricts
the orifice they are called external, if within the muscle they
are internal. Piles are essentially varicose veins (with a
covering of skin or mucous membrane) depending on the
state of the venous system.
Any affection, which impedes the blood-flow through the
veins of the rectum may give rise to piles, or if piles already
exist, may aggravate their condition.
One prolific source of piles must not be overlooked, and
that is that habit of constantly taking purgative drugs for the
relief of constipation.
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6. MATERIAL & METHOD
This is an open study comprising of 50 pregnant women
who were treated with homoeopathic medicines for
constipation and haemorrhoids. The remedies were
prescribed by individualizing each case. The pregnant
women were followed till delivery and during post partum
period.
Adjuncts in Treatment:
Diet is a matter of great importance. Foods rich in fibre
especially green leafy vegetables, fruits, whole grains and
soups were advised to be taken as they are relaxing.
Mild exercise – walking is best for pregnant women as it
helps to relax her body and mind without any tiredness.
Advised plenty of water intake.
In patients with haemorrhoids, Sitz bath with warm water
was advised.
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7. CASE ILLUSTRATION
Case - 1
Patient Mrs. P, aged 26 yrs, 2nd gravida, came with h/o. 2 months amenorrhoea,
complaining of pain in stomach, stitching, < after fatty and rich food. Water brash.
Eructation sour or of the food taken. Sleep disturbed due to her gastric complaints.
Pain in anus stitching while passing and after stool. H/o. Bleeding piles during her
1st pregnancy. She was afraid to continue this pregnancy for fear of haemorrhoids
and gastric irritation with which she suffered during her previous pregnancy. I
coaxed her and she was assured that her troubles would be reduced by
homoeopathic treatment. After that she continued her pregnancy.
O/E : P/R 1st degree haemorrhoids noted. Tenderness on palpation of anal margin.
Anal skin tag +.
28-12-04: Puls.30/4d once daily followed with placebo for 1 week.
18-01-05: Feels better with pain in stomach. Pain in anus reduced. Placebo for 10
days.
01-02-05: C/o. persists in mild form. Puls.30/4d once daily.
15-02-05: feels better. No complaints. Placebo for 10 days.
She came for other acute ailments and she delivered a male baby.
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8. CASE ILLUSTRATION
Case - 2
Patient named Mrs. S, aged 27yrs, primi, came with c/o. haemorrhoids during her 8th
month of pregnancy. Pain stitching, < during and after stool. < pungent food. Pain
was so severe preventing the patient from sitting and other activities. Stool,
unsatisfactory with ineffectual urge.
O/E : P/R – Pile mass 3rd degree with strangulation. Warmth and tenderness
present. It was irreducible.
15-07-05: Nux.vom.30/tds for 3 days. Advised local fomentation with ice cubes to
reduce the strangulation.
18-07-05: Patient feels better with pain.
O/E: P/R- pile mass 2nd degree with reducibility. Warmth and tenderness reduced.
Nux.vom.30/bd for 1 week.
28-07-05: Feeling much better.
O/E: P/R- pile mass 2nd degree with reducibility. No warmth or tenderness noted.
Nux.vom.30/ od for 1 week.
03-08-05: Patient was happy and continued her pregnancy and delivered a female
child. 8
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9. RESULTS
Complaints No. of cases
Constipation 22
Constipation with haemorrhoids 28
Name of the drug No. of cases
Bryonia 8
Nux vomica 28
Pulsatilla 4
Sulphur 10
Response to treatment No. of cases
Improved 46
Drop out 4
No. of cases studied
Drugs used
Improvement after treatment
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10. DISCUSSION & CONCLUSION
Evidence of altered liver function, reduced intestinal secretion and
motor sluggishness of the gastrointestinal tract is the main cause for
constipation during pregnancy. (4) The enlarging uterus with its
pressure effect upon the venous system contributes as a causative
factor for haemorrhoids.
In modern medicine, constipation is considered to be refractory till
the end of pregnancy. Excess of progesterone during pregnancy is
the main reason for the constipation and piles during pregnancy. (4)
“It is indispensable for mothers in their pregnancy by means of a mild
antipsoric treatment to destroy the psora within themselves and in the
foetus – producer of most chronic diseases given to them hereditarily.
This is true of pregnant women thus treated have given birth to
children usually more healthy and stronger”.
Symptoms during pregnancy – expressions of latent psora- given due
importance in treatment for the birth of healthy & intelligent baby.
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