IJFIRH - 2025, Volume - III, Issue - I [January - March 2025]

e-ISSN No- 3048-6270

Published by Homoeopathic Chronicles

HOMOEOPATHIC MANAGEMENT OF CHOLELITHIASIS WITH NUX VOMICA AND FEL TAURI: A CASE REPORT

A M Anusha1, Praveen Kumar P D2, Veerabhadrappa C3, Mahabubali Nadaf4

1MD Scholar, Department of Practice of Medicine, Government Homoeopathic Medical College and Hospital, Bengaluru- 560079

2Professor and HOD, Department of practice of medicine Government Homoeopathic Medical College and Hospital, Bengaluru- 560079

3Professor, Department of Practice of Medicine, Government Homoeopathic Medical College and Hospital, Bengaluru- 560079

4Associate Professor, Department of Practice of Medicine, Government Homoeopathic Medical College and Hospital, Bengaluru- 560079

Article Received: 1 February 2025 - Accepted: 14 March 2025 - Article published online: 22 March 2025

DOI: https://doi.org/10.59939/3048-6270.2025.v3.i1.8

ABSTRACT

Cholelithiasis, or gallstone disease, is a common hepatobiliary disorder characterized by the formation of stones in the gallbladder. The condition affects a significant proportion of the population, with risk factors including obesity, rapid weight loss, hormonal changes, and dietary habits. Although many individuals with gallstones remain asymptomatic, symptomatic cases can manifest as biliary colic, nausea, and dyspepsia. Conventional treatments often involve surgical interventions like cholecystectomy, which, while effective, may lead to complications or long-term metabolic concerns. This case report discusses the use of homeopathic remedies, specifically Fel Tauri and Nux vomica, for managing symptomatic gallstone disease. The patient, a 42-year-old woman, presented with pain in the right upper quadrant of abdomen since 2 weeks with occasional nausea and vomiting, which worsened after exertion, food and at night. The administration of Fel Tauri was aimed at improving bile function, while Nux vomica was given in infrequent repetitions to address digestive disturbances. The case demonstrates promising results with symptom relief, highlighting the potential of homeopathy in managing gallstone-related complaints.

KEYWORDS

Cholelithiasis, Nux vomica, Fel Tauri, gallstones, Homoeopathy

INTRODUCTION

Cholelithiasis, or gallstone disease, is a prevalent gastrointestinal condition characterized by the formation of gallstones within the gallbladder or biliary ducts.1 Gallstones form due to an imbalance in bile components, primarily cholesterol, bile salts, and lecithin, leading to supersaturation of bile and subsequent stone formation. These stones are categorized into cholesterol stones, pigment stones, and mixed stones.2 Risk factors for cholelithiasis include obesity, female sex, pregnancy, rapid weight loss, advanced age, and metabolic disorders such as diabetes and dyslipidemia.3,4 Although many individuals with gallstones remain asymptomatic, symptomatic cases can manifest as biliary colic, nausea, and dyspepsia. Complications such as acute cholecystitis, cholangitis, and pancreatitis can arise if gallstones obstruct the cystic or common bile duct.5

Globally, the prevalence of cholelithiasis varies significantly, ranging from 10% to 20% in Western populations to less than 5% in Asian and African populations.6

Diagnosis involves imaging such as Ultrasonography which has high sensitivity and specificity.5 Advanced imaging techniques such as magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) are employed for complicated cases.7

Allopathic management of cholelithiasis primarily focuses on symptomatic relief and definitive interventions. Non-surgical options include the use of oral bile acid dissolution therapy which limited applicability.8 In symptomatic or complicated cases, laparoscopic cholecystectomy is employed.9 Despite these advancements, recurrence and post-cholecystectomy syndrome are notable concerns, emphasizing the need for complementary approaches that address the disease holistically.10

Homeopathy offers a holistic and individualized approach to treating cholelithiasis, addressing both acute symptoms and underlying constitutional predispositions. Fel Tauri, a homeopathic preparation derived from ox bile, is traditionally employed for its specific action on the biliary system. It facilitates bile secretion and helps mitigate the formation of gallstones.11 Nux Vomica, a constitutional remedy derived from the seeds of Strychnos nux-vomica, addresses lifestyle factors and digestive complaints such as dyspepsia, nausea, and intolerance to rich or spicy foods, which are commonly associated with gallstone disease.12

This article explores the combined use of Fel Tauri as a specific remedy and Nux Vomica as a constitutional remedy in a case of cholelithiasis, emphasizing the importance of organo-specific drugs in homoeopathy, along with constitutional medicine.

CASE REPORT

A 42-year-old Hindu married female, who works as a labourer in  Basaveshwara Nagar, Bengaluru presented with the complaint of pain in the right upper quadrant of abdomen since 2 weeks, on 13th March 2024.

History of Presenting Complaint

Patient was apparently well 2 weeks back. She gradually started with pain in the right upper quadrant of abdomen which is gradually progressing. Complaint is aggravated on exertion, after food, at night and is slightly better on rest. She also has nausea and vomiting occasionally. There is decreased appetite and disturbed sleep along with the complaints.

There is no h/o palpitation, chest pain, giddiness, headache, nausea, vomiting, restlessness, tremors, tingling, numbness in the extremities.

Past Medical History

Dengue 10 years ago

Family History

Elder brother – Type 2 diabetes mellitus

Personal History

Patient follows a mixed diet and has experienced a decreased appetite for the past two weeks. She drinks about 1-2 liters of water daily and has a strong desire for spicy food, with no aversions. Her bowel movements are regular, occurring once a day without any difficulty. She urinates 4-5 times a day and once at night. Perspiration is generalized, and she has been experiencing disturbed sleep for the last two weeks. She is thermally more towards chilly and has no history of addiction.

Life space investigations

Patient belongs to poor socio- economic family. Her Father was a farmer and mother is a housewife. She has 1 elder brother who is a who is a worker in a factory. Her childhood was uneventful, was moderate at studies. She studied up to 8th std, after which she discontinued due to financial difficulties. She got married at the age of 18, it is an arranged marriage. Relationship with husband is good. She has 2 children, 1 daughter and 1 son who are studying.

As a person, she is anxious about her health and about her family, prefers company, gets irritated if any work is not done on time.

General Physical Examination & Vitals

Moderately built and well nourished

Conscious & well oriented with time, place, and person

No signs of pallor, cyanosis, clubbing, icterus, oedema, lymphadenopathy

BP- 120/70mm Hg, Right arm supine position

Pulse rate - 86 beats/ min, regular rhythm, moderate volume, vessel wall not palpable

Respiratory rate- 16 breaths/ min

Temperature - afebrile at the time of examination

Systemic Examination

Respiratory system

B/L normal vesicular breathing sounds- heard all over the lung fields

No added sounds

Cardio-vascular system

S1 & S2 heard, no murmurs

Central nervous system

No focal neurological deficits

Gastrointestinal system

Tenderness present over right hypochondrium

Murphy’s sign- negative

Normal bowel sounds heard

PROVISIONAL DIAGNOSIS

Cholelithiasis

Investigation & Findings

13/03/24

-          USG abdomen & pelvis

Gallbladder is distended with few calculi largest measuring 6mm.

CLINICAL DIAGNOSIS: Cholelithiasis

ICD- 11 code for diagnosis13: DC11.Z

Classification of Disease: Chronic Miasmatic disease

Fundamental and dominant miasm: Sycotic

School of philosophy: Kent school of philosophy 

Repertorization proper

·         Nux v 19/8

·         Kali-c 14/7

·         Sep 13/7

·         Ars 14/6

·         Phos 14/6

DISCUSSION

This case report upholds the efficacy of specific remedies in homoeopathy along with individualised homoeopathic medicines. In this case, Cholelithiasis was completely cured after administration of homoeopathic remedy. Homoeopathy offers a holistic approach, addressing both the acute pathology and the patient's constitutional tendencies. Fel Tauri is known in homeopathy for its action on the biliary system, specifically regulating bile composition and supporting the dissolution of gallstones.11,14 This remedy was employed in this case to alleviate biliary colic and improve overall gallbladder function.  Nux vomica, as a constitutional remedy, is particularly effective for individuals with sedentary lifestyles, stress, and digestive irregularities, addressing the predisposition to gallstone formation.11,14 The combined use of these remedies highlights the dual strength of homoeopathy in offering symptomatic relief while preventing recurrence. However, while the case report demonstrates the efficacy of homoeopathic remedies in the treatment of cholelithiasis, as this report is based on a single patient’s experience, it limits the generalizability of the findings. A larger sample size is required to establish the consistency and effectiveness of the treatment. Potential areas of future researches like Randomized Controlled Trials (RCT), larger cohort studies can help to establish the treatment’s effectiveness. The improvement of complaints was assessed with the help of ultrasound imaging technique.

CONCLUSIONBottom of Form

Homoeopathy offers a holistic approach to cholelithiasis, addressing both acute symptoms and underlying predispositions. The use of Fel Tauri to regulate bile composition and Nux vomica for constitutional support highlights the effectiveness of this dual approach in managing gallstone disease. These remedies provide symptom relief while potentially preventing recurrence. Further research is needed to validate their role in mainstream treatment, emphasizing homoeopathy as a safe, non-invasive alternative for cholelithiasis management.

Conflict of interest - Nil

Funding - Nil

Consent for publication - written informed consent was obtained from the patient for publication of this case report.

REFERENCES

1.  Das S, et al. Gallstone Disease: A Comprehensive Review. IJRH 2023; 17(3):123-130.

2.  Lammert, F., Gurusamy, K., Ko, C. W., et al. (2016). Gallstones. Nature Reviews Disease Primers, 2, 16024.

3.  Méndez-Sánchez, N., & Romero-González, M. (2010). The metabolic syndrome as a risk factor for gallstone disease. Annals of Hepatology, 9(Suppl), S28–S32.

4.  Stinton, L. M., & Shaffer, E. A. (2012). Epidemiology of gallbladder disease: Cholelithiasis and cancer. Gut and Liver, 6(2), 172–187.

5.  Hunter, J. G. (1999). Gallbladder and the biliary tract. In Schwartz's Principles of Surgery (8th ed.).

6.  Shaffer, E. A. (2005). Epidemiology and risk factors for gallstone disease: Has the paradigm changed in the 21st century? Current Gastroenterology Reports, 7(2), 132–140.

7.  Cohen, M. M., & Cello, J. P. (2015). Biliary imaging techniques. Gastrointestinal Endoscopy Clinics of North America, 25(4), 679–694.

8.  Portincasa P, et al. Management of Gallstones and Their Complications. Best Pract Res Clin Gastroenterol 2006; 20(6):1097-115.

9.  Strasberg SM. Laparoscopic Cholecystectomy and Its Complications. Gastroenterology Clinics of North America 2010; 39(4):869-94.

10.  Tazuma S, et al. Postcholecystectomy Syndrome: Pathophysiology and Management. World J Gastroenterol 2009; 15(29):3666-71.

11.  Boericke W. Pocket Manual of Homeopathic Materia Medica. New Delhi: B. Jain Publishers; 2020.

12.  Chattopadhyay S. Fel Tauri in Homeopathy: An Overview. IJRH 2022; 16(2):85-89.

13.  International Classification of Diseases, 11th Revision (ICD-11). DC11.Z [Internet]. Geneva: World Health Organization; 2018 [cited 2024 Mar 13].

14.  Clarke JH. A dictionary of practical materia medica. Vol. X. London: Homeopathic Publishing Company; 1900.