Introduction

Dr. Med.Richard Schader

A large number of patients attending general surgeries are suffering from acute or chronic gastrointestinal conditions. Conspicuous however is the increase in the number of those presenting with functional gastrointestinal conditions such as irritable bowel syndrome, f'unctional stomach disorders, dyspepsia, recidivating diarrhoea or chronic obstipation. Many of these patients have already been through the classic gastroenterological diagnosis procedures without an organic correlate having been found. The odyssey of some of these patients ranges from multiple endoscopic gastrointestinal investigations through to the prescribing of psychopharmaceutical drugs. This group of patients represents a promising group for treatment with natural remedies, specifically homotoxicology. As very often the cause of the condition derives from many factors, particularly in the case of functional gastrointestinal diseases, a carefully established case history and diagnosis are essential. Of course, before any diagnosis - of a functional gastrointestinal condition - can be made, organ related processes, in particular tumour formation, must be excluded. Many patients who consult us for treatment with natural remedies have fortunately already been diagnosed by orthodox medical practitioners, thereby reducing the number of diagnostic steps that need to be taken. The homotoxicological treatment of gastrointestinal conditions is an ideal form of therapy, particularly where the condition is of a chronic nature, which does not of course mean that proven, orthodox medical treatment is in any way to be excluded. Quite the contrary, homotoxicological therapy is an extension, albeit a significant one, of the whole spectrum of diagnosis and treatment. In the diagnostic evaluation of functional gastrointestinal conditions, a holistic approach to diagnosis - i.e. the integration of mental factors in the development of usually painful gastrointestinal diseases - is of special importance. Very often, it is these multi-causal and multi-functional keys to the approach which in many cases reveal chronic pathology at its initial development stage and which enable appropriate and very effective therapy to be applied which, in turn, enables the condition to be relieved, and indeed often completely cured, particularly when it is of a chronic nature. Today, the anatomical system comprising gastrointestinal tract, liver, pancreas and gallbladder, is one of the most over-stressed system of organs. One has only to consider the daily intake of foodstuffs, environmental toxins, alcohol, allopathic medication, organic and inorganic pollution and increased mental stress, for it to become patently clear that this organ system in particular is over-stressed in many patients with a tendency towards acute and chronic complaints. It is not the single contact with a substance, but the ongoing, day-to-day battle of the organs with a wide range of substances foreign to our bodies which overstretch our intestinal immune system. The cause, for example, of many skin diseases, immunological weakness and mental defects is thus often to be found in impairment of the intestinal system. The outstanding and, may I say, unique manner in which the Reckeweg theory deals with the excessive strain caused by toxins, their study and their treatment, makes the causal treatment of many of these toxin related illnesses possible.

DISEASES OF THE MOUTH

These primarily involve local inflammation (stomatitis simplex) and aphtous ulcers.

Therapy 

Local treatment by brushing with pollen extract preparations

 Myrrh tincture, JHP, Symbioflor 1.
HOMEOPATHIC TREATMENT
Mercurisheel tablets
Candida infection of the mouth 
Treatment Nystatin lotio, symbioflor 1, propolis pollen extract.  In addition basic candida treatment.

GASTROESOPHAGEAL REFLUX -REFLUX OESOPHAGITIS

Dyspeptic oesophagitis is a regurgitation of stomach acid as a result of cardia insufficiency.
The patient's symptoms are a strong retrosternal burning, particularly when bending forward and lying down, always accompanied by heartburn and acidic repeating following meals. In addition to classical, non-invasive therapy with H2 blockers (e.g. Antra), supplementary homotoxicological treatment should always be tried. As, in virtually every case, the illness is long-term, this treatment attempt is always indicated (cost saving, side effect rate).

Homotoxicological therapy
Gastricumeel, Nux vomica.

Patients with reflux oesophagitis usually present with a latent to manifest hyperacidity of the tissue. This can be established by regular urine pH monitoring or the production of a titration graph. In order to achieve success over the longer term, a basic anti-acidotic course of treatment is necessary. This treatment comprises initially the prescription of base infusions, 3.4% hydrogen carbonate in 25O ml NaCl. The follow-up antacid treatment is achieved using a base powder (Bullrichs Vital, Neukeonigsfelder mineral tablets). The accompanying impairment of the liver function is very successfully treated in these patients with Galium-Heel. The patient should of course also be instructed on the usual dietary and bed position measures.
Additional therapy
Acupuncture, neural therapy.

IRRITABLE STOMACH SYNDROME
 It is very difficult to detect this illness - which affects many patients - using orthodox diagnostic procedures. Gastroscopy and laboratory tests are usually not successful in revealing an organic correlate. The functional upper abdomen syndrome, functional stomach disorders are often of a chronic nature causing the patient extreme discomfort. Rarely is hyper acidity of the stomach contents alone responsible. Rather more, it is motility defects, triggered by psychovegetative influences. The nerve primarily responsible for motility of the stomach is the nervus vagus, which on sympathicotonic patients is particularly unbalanced and thus mainly responsible for the development of functional gastrointestinal diseases. The cause o f functional upper abdomen syndrome is seldom to be found in the insulated malfunction of an organ such as the stomach for example, but in impairment of the stomach / pancreas /liver and gallbladder. Clinical symptoms of irritable stomach syndrome - slide Therapy The prime homotoxicological substance for the whole upper area of the abdomen is Nux vomica Homaccord.

Homeopathic properties of:

 NUX VOMICA: gastrointestinal and liver drug, result of stimulant abuse, alcohol, nicotine, nausea, spastic obstipation, haemorrhoids, deterioration of all symptoms following stimulant abuse.

BRYONIA: all serous membranes, gastritis, hepatopathy, obstipation

 LYCOPODIUM: diseases of the liver and gallbladder, loss of appetite or ravenous hunger, "full after a few bites", meteorism.

 COLOCYNTIS : sharp, sudden stabbing pains, independent of movement and rest, colic (forced bending over to obtain relief, which is also achieved by heat and hard pressure), dysentery.

The individual homeopathic components of Nux vomica Homaccord open up possibilities for the treatment of spastic obstipation, enterospasm, impairment of liver functions, meteorism, disorders resulting from alcohol, nicotine and coffee abuse. Good results can be expected in cases of colitis mucosa and diverticolitis of the colon in combination with Veratrum Homaccord and Podophyllum compositum. Nux vomica Homaccord has a very strong detoxification effect. This can be significantly enhanced by prescribing Hepeel and Mucosa compositum. With additional involvement of the pancreas, a guiding symptom tendency to diarrhoea following the intake of food, alcohol stress o f the pancreas, one additionally prescribes Momordica compositum and the obligatory pancreas enzyme substitution (e.g.Crayon 10,000 or 25,000 units 3 x daily). Any spastic component in a symptom complex is treated by Spascupreel. This preparation has both a spasmolytic effect on smooth and transverse striated muscle tissue and numbers amongst the most active spasmolytic substances in homotoxicology. If the focus of the upper abdomen syndrome is in an impairment of bile duct secretion, Cheledonium HA is prescribed in addition to Hepeel.

Supplementary Phytotherapeutic therapy

 Celandine, artichoke and turmeric. An extremely active and rapidly acting therapy is the injection in the upper right and left abdominal sympathetic nerve supplemented by homeosyniatric injection of suitable acupuncture points (slide - homeosiniatry of the upper abdomen).

ACUTE AND CHRONIC GASTRITIS - HELICOBACTER INFECTION

Acute and chronic gastritis responds well to homotoxicological treatment. The prescription of H2 blockers in the acute stage of ventricular and duodenal gastritis continues to be the treatment of choice. Thus, in the acute stage, the ulcer should be primarily treated with H2 blockers in order to avoid further complications. The treatment of chronic gastritis, on the other hand, is a main field of indication for homotoxicological therapy. Of particular interest, is a homotoxicological triple therapy in cases of gastritis with helicobacter involvement. The common triple therapy with H2 blockers, Clont and Amoxicillin not only puts a strain on the medication budget but also on the patient in the form of massive side effects and is often aborted prematurely as a result of the absence of compliance. In spite of the prescription of massive allopathic medication, recidivation often occurs. In a study, colleague Rieken (Saarlouis), was able to demonstrate explicitly the effect of the homotoxicological treatment of heliobacter infection, supported by hard facts.

Therapy

Gastricum-Heel tablets: 3 x 1 tablet daily
Nux vomica Homaccord: 3 x 20 drops
Lymphomyosot: 3 x 1 tablet
Possible supplementary treatment: Ubichinon compositum, Coenzyme compositum: 2
ampoules of each mixed with 1 - 2 ml of patient's blood.

The success of the treatment, namely a recession of the subjective stomach complaints, was apparent as early as 1 -2 weeks. A fo11ow-up endoscopic check after several weeks verified, the disappearance of the heliobacter intection, without any supplementary antibiotic treatment. We were able to confirm the success of the above treatment in our own practice on about 10 - 15 patients. Respiratory tests to demonstrate heliobacter presence were negative after 2- 3 weeks of treatment. Based on this example the effectiveness of homotoxicological therapy can be confirmed, underpinned by clinical test methods. This clearly disproved the alleged homeopathic placebo effect, to which must be added the additional factor of a massive saving on cost. In no case during the homotoxicological treatment were there side effects.

FUNCTIONAL GASTROINTESTINAL DISEASES
IRRITABLE BOWEL SYNDROME

 Many patients in central Europe suffer from this condition. The initiating factors are poor eating habits and stress. An additional, accompanying factor, noted amongst all patients with irritable bowel syndrome, was a significant change in the symbiotic activity of the immunoactive bowel symbiotes. As all patients presenting with irritable bowel syndrome have varying psychovegetative symptoms, a compensatory psychovegetative treatment should be built into the overall therapy concept. W e consider both relaxation exercises, Jacob muscle relaxation, autogenic training as well as such meditative procedures as Yoga and transcendental meditation, to be particularly decisive. The enormously important basic treatment lies in prescribing regular exercise training. In many kinds of  sports, endurance training has emerged as particularly helpful, primarily jogging 2 - 3 times weekly for half an hour. In winter, this training can be replaced by cross-country skiing. The regular rhythm of these two kinds of sport generates an intestinal massage effect with a psychovegetative compensatory eftect which is in evidence with the patients after a few weeks. In cases of chronic obstipation, physical exercise plus phytotherapeutic and homeopathic phases of treatment have proved successful. From an overall homotoxicological standpoint, gastrointestinal diseases require the accompanying treatment of the liver and gallbladder. These important detoxifing organs are responsible for many functional disorders of the overall system. The symptoms, which are often obscured, are described by the patients as irregular bowel movement (alternating obstipation and diarrhoea), diffused pain in the upper abdomen (particularly on the upper right abdominal area), light-coloured stool (clay-like) and meteorism. These disorders are the result of :
a) acute toxic stress: incorrect diet - too fatty, too high in carbohydrates = sugar
b) toxic stress: medication effects, alcohol ingestion.

 In these cases there is often an increased border gamma GT with otherwise normal laboratory parameters of the liver enzymes (MCV also increased). There are signs of fatty liver in the upper abdomen sonography. Because of the excess stress of the liver cells, there are intracellular oxygen deficiency conditions. These are amplified by accompanying hypovitaminosis (deficient vitamin resorption and/or deficient vitamin take-up).

CHRONIC HEPATOSES

If the above acute liver conditions persist for any period of length, chronic hepatosis (alimentary and/or toxic stress) can be the result. Chronic hepatosis following hepatitic conditions or with chronic drainage impairment of the bile duct system (e.g. gall stones) can also easily develop. As, in these cases, the extremely important detoxifing function of the liver is impaired, secondary defects occur throughout the entire gastrointestinal tract.

Therapy

Acute liver diseases: Hepeel, Chelidonium HA
Degenerative hepatoses: Hepar comp.; neural therapy (upper right sympathetic nerve, segment therapy)
Liver diseases with pancreatic involvement: Leptandra comp.
Special liver treatments (supplementary therapy) see film - in particular liver treatments -
Specific gallbladder treatments see film- gallbladder-
Functional gastrointestinal diseases are marked, in part, by different and very variable symptoms. In 60 - 7O% of all patients with functional gastrointestinal symptoms, there is motility impairment. Stomach acid secretion plays only a subordinate role in the development  of functional dyspepsia. According to Prof R. Raedsch (Wiesbaden) this affects only 10% of the patients.

 According to the latest consensus amongst gastrologists, the treatment should be directed towards the primary symptoms. Motility enhancing medication is, for example, the first choice of Prof W. Rosch (Frankfurt) for the symptoms pressure pain, bloated feeling, repeating and nausea. For these reasons, we prescribe proven phytopharmaceutical medication (e.g. Iberogast) for the treatment of functional gastrointestinal diseases. The effectiveness and tolerance has been demonstrated for functional dyspepsia in two placebo controlled, double-blind studies.  Side effects, such as those experienced with allopathic treatment, did not occur.

ACUTE DIARRHOEA

Acute diarrhoea is a condition which is very frequently encountered in general practice.  Having excluded a severe bacterial infection (e.g. salmonella, tropical disease), a rapid acting, somatic treatment is necessary. The treatment of non-specific diarrhoea with homotoxicological medication has been a proven form of treatment for many years.  Particularly in the case of virus induced gastroenteritis, the anti-viral homotoxicological preparation which addresses the cause is eminently superior to the purely symptomatic medication (e.g. Immodium). The very distressing general reaction which accompanies these diseases (e.g. fatigue, painful joints, nausea, intestinal cramps) improves rapidly. As these non-specific diarrhoea cases occur frequently, particularly amongst children, fast acting treatments, free of side effects, are called for during this sensitive development stage. If the homotoxicological treatment does not lead to a significant improvement within a few days, further diagnosis should be carried out with a view to excluding specific diseases.

Therapy

DIARRHEEL: chronic and acute diarrhoea, gastrointestinal, not only to stop diarrhoea but also to detoxify the intestines.
NUX VOMICA HA
MUCOSA COMP: membrane regeneration, detoxification
 SPASCUPREEL : spasmolytic components (particularly successful with children)
COLINA SPECIAL: 3 x 1 bag daily = "'healing earth"
PENTEROL FORTE: 3 x 2 capsules daily
Suplimentary Therapy in Acute stage: infusion 250 ml NaCl plus 2 ampoules Centramin plus
ampoules magnesium (supplementary treatment for electrolyte loss syndrome)

DYSBIOSlS


  In the event of therapy resistance or poor reaction to the anti-diarrhoea treatment, it is essential that a thorough stool examination be carried out. The Institute for Microbiology in Herborn carries out this quantitative and qualitative testing for dysbiosis in addition to a mycosis diagnosis, exhaustively and reliably. Particular in the case of chronic gastrointestinal illnesses, these tests are helpful and essential for a differential diagnosis. Non-physiological intestinal flora can be regenerated and stabilised by the prescribing of symbiote germ. The objective of this symbiosis control is to restore the normal intestinal flora. This will reestablish the correct functioning of the intestinal immune system and reduce the susceptibility to infection. This treatment concept also includes the substitution of vitamins, mineral substances and the balancing of enzymes. Chronic dysbiosis leads to the formation of endotoxins (indole-scatole phenols, ammonia and fusel alcohols). This results in acute metabolic stress of the liver and ammonia stress of the brain. Intestinal dysbioses are linked to a reduction of secreted immunoglobulin A, not only in the membranes of the intestine but also in those in the respiratory tract and in the ureters. Impairment of the internal immune system will trigger.

a) increased susceptibility to infection
b) increased severity of allergic diseases (bronchial asthma, hay fever)
c) allergic skin diseases, e.g. neurodermatitis
d) acute phases of colitis ulcerosa, Crohn's disease and other chronic intestinal diseases

  For the treatment of a dysbacterial condition of the gastrointestinal tract (dysbiosis) to have any promise of success, it is essential that all the factors affecting the small intestine environment, in particular the pH value - be taken into consideration and, if necessary, eliminated. These include
 - correction of anacidity and subacidity
 - correction of fermentation impairment by stimulating the excretory activity  of the pancreas and substitution of the pancreas fermentation products
 - protection of parenchyma of the liver from endotoxins generated by the dysbacterial condition, and treating the hepatopathy
 - actively influencing the formation of a physiological pH value in the small intestine as a precondition for physiological intestinal flora
 - encouraging the re-establishment of the symbiosis by reducing the pathogenic intestinal flora .
 - stabilisation of the results of the treatment by administering physiological intestinal germ.
 As the recommendations for symbiotic regulation are often very detailed, very cost-intensive and also very time consuming, we have developed a shortened treatment regime which has proved most useful over the last few years.
2 - 3 weeks Prosymbioflor. 3 x 20 drops.
 Provided Prosymbioflor is tolerated, addition of Symbioflor 1 : 3 x 20 drops orally and intranasally .
In the case of impairment of the small intestine flora, Paidiflor (Acidophilus and Bifldus germs). Restoration of the large intestine flora by Mutaflor capsules 100 mg, 1 - 2 capsules daily. This symbiotic therapy should be carried out for at least 3 - 4 months. A supplementary canalisation of the affected lymph drainage system is effected by means of simultaneously prescribing Lymphomyosot drops or tablets (especially successful with children). The correction of the lymph drainage effects and lymph involved stress is aimed at mesenchymal purification and thus of the ability of autoregulative processes to function.

 The treatment of the most varied of gastrointestinal diseases in both acute and in chronic stages by total homotoxicological therapy, has met with outstanding success in our practice over the last few years. Alongside the acute classical allopathic therapy, it provides a second successful track which makes the treatment of therapy resistant diseases possible, a fact that, with the increase in chronic gastrointestinal diseases, is today more important than ever before.

 As the causes are very often multi-factorial and accompanied by extensive involvement of the psyche, holistic treatment concepts like homotoxicological medicine are a very successful therapy approach.