Acute abdominal pain and traveller's diarrhoea

Acute abdominal pain

On my second trip to Nepal one evening I had finally sat down to my dinner when there was a knock at the door. It was one of the course participants who had rushed over on his moped to ask whether I could quickly attend an emergency. I hurriedly finished my meal and jumped — equipped with a repertory and a homeopathic emergency kit — on the scooter behind him. It was getting dark and after a ride through many alleys and over bumpy tracks we finally arrived at a half‑finished house, like so many there. The first storey was complete; for the second storey the

corner pillars were in place, but the storey itself was missing. A young woman lay on a bed on the second floor and it was clear that something was seriously wrong with her. She had terrible abdominal pain and could neither keep food nor drink down. On examination I found a painful swelling in the middle of the abdomen and there was no peristalsis at all.

I assumed it was a bowel obstruction or volvulus and said she needed to see a surgeon. After much discussion with the course participant who had brought me, it became clear that hospital admission was out of the question. In that part of the world people believe that you die in hospital if you can even afford to go there. All eyes were hopefully on me. I was her doctor, the only one who could treat her, and I was expected to treat her homeopathically.
In such an acute situation I expect that a good remedy should produce a response within a quarter of an hour. I used the rubric "Intussusception" and gave her Arsenicum. Nothing happened; I sat quietly beside her bed feeling uneasy and uncertain. Of course I tried, with the help of the translator, to work out what was wrong with her, and gave her Bryonia because she lay so still. Again no change!

Then I tried Opium — again no reaction — except that she now sat up, bent forward and pulled her knees up, thereby providing a clear picture for the next remedy: Colocynthis. Meanwhile her history had come to light: something had happened in her family that had made her very angry. Within fifteen minutes the pain had gone and she asked for something to eat. Then I dared ride the scooter back and go to bed, confident that she would survive. The next day she came to the clinic for a follow‑up and her abdomen was normal!

Travellers' diarrhoea

From personal experience I always ask patients who consult me about chronic diarrhoea after tropical travel whether they experienced severe fears or shocks on their trip. Twenty‑five years ago I travelled through Nepal. One evening we felt threatened in a lodge by a group of young men who were celebrating there, and we fled. For a long time we suffered from the idea that we were being chased (which fortunately was not the case).

Thank God someone took us in for the night. It was the last day of a three‑week trek; we planned to return to Kathmandu by bus the next day. Only when we were finally seated on the bus did I feel safe. But as soon as we set off the first signs of diarrhoea came on. I shall never forget that trip: having diarrhoea on a 1950s bus jolting along narrow mountain tracks close to ravines and precipices is not a great feeling — and in my case there was also the shame...

Unfortunately I did not have a homeopathic travel kit with me then, so I had to ride it out. After a few weeks my symptoms subsided. More than ten years later I took part in a remedy proving with several colleagues. On the second night I had a dream: I was chased by three giants. I could just escape, but I was terrified.

Category: Cases

Keywords: severe abdominal pain, abdominal swelling, unable to eat or drink, extreme anger, diarrhoea after fear/shock and feelings of shame

Remedies: Arsenicum album, Bryonia alba, Colocynthis, Opium