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Dumping Syndrome and Homoeopathy

© Dr. Rajneesh Kumar Sharma M.D. (Homoeopathy)

Dr. Swati Vishnoi B.H.M.S.

Dr. Preetika Lakhera B.H.M.S.

For well formatted and illustrated article, please see attached file

Dumping Syndrome and Homoeopathy.pdf

Contents

Definition. 2

Etymology. 2

Anatomy. 2

Organ systems 2

GI blood supply. 3

Nerves 3

Digestive Processes- Mouth, Pharynx & Esophagus 3

Functional Anatomy of Stomach. 3

Digestive Processes in Stomach. 3

Regulation of gastric secretion. 3

Cephalic Phase. 3

Gastric Phase. 4

Intestinal Phase. 4

Pathophysiology. 4

Regulation of Gastric Emptying. 4

Role of the Pylorus in Controlling Stomach Emptying. 4

Within the Stomach. 5

Within the Duodenum.. 5

Enterogastric Nervous Reflexes 5

Outside the digestive tract 6

Types 6

Early dumping syndrome. 6

Late dumping syndrome. 6

Causes 7

Symptoms 7

Early symptoms 7

Late symptoms 8

Diagnosis 8

Treatment 9

Management 9

Dietary plan. 9

Homoeopathic treatment 9

Bibliography. 15

Definition

Dumping syndrome is the rapid emptying of undigested gastric content into the small bowel which can be complicated by malnutrition and associated with poor quality of life (Psora).

Etymology

The term “dumping” was introduced by Andrews and Mix in 1920.

Anatomy

Organ systems

  • Major digestive organs
    • Mouth, pharynx & esophagus
    • Stomach
    • Small intestine
    • Large intestine
    • Accessory digestive organs
      • Teeth
      • Tongue
      • Gall bladder
      • Salivary glands
      • Liver
      • Pancreas

GI blood supply

  • Blood supply: about 25% of cardiac output
  • Arterial: Abdominal aorta (celiac trunk)
  • Celiac trunk (Hepatic, splenic & gastric branches which serve the liver, spleen & stomach)
  • Celiac trunk (superior & inferior mesenteric branches serve small & large intestine)
  • Intrinsic: (Local): Short reflex
    • Submucosal nerve plexus: regulates glands & mucosal muscle
    • Myenteric plexus: controls GI wall & GI motility
    • Extrinsic: (CNS): Long reflex
      • Parasympathetic NS: enhances gut motility & secretion
      • SNS: inhibits gut motility & secretion
      • Ingestion
      • Mechanical digestion: chewing
      • Chemical digestion: mixing food with saliva
      • Propulsion: swallowing & initiating peristalsis
      • Cardiac region: narrow, receives food bolus
      • Fundus: bulge, extending superolaterally to the cardia, reaches the diaphragm
      • Body: mid-portion
      • Pyloric antrum: funnel shaped portion narrows to form the-
      • Pyloric canalà Pylorous àPyloric sphincter à small intestine
      • Rugae: Longitudinal mucosal folds
      • Volume about 4L
      • Acts as a holding vessel for ingested food
      • Participates in mechanical & chemical digestion
      • Propulsion: Delivers its product (chyme) to the small intestine
      • Protein digestion: HCl denatures protein
        • HCl activates pepsinogen to pepsin
        • Pepsin breaks peptide bonds of proteins
        • Rennin: an enzyme that breaks down casein (milk protein) secreted in infants
        • Intrinsic factor required for Vit. B12 absorption which needs to mature RBC Absence of B12 results in pernicious anemia

Nerves

Digestive Processes- Mouth, Pharynx & Esophagus

Functional Anatomy of Stomach

Digestive Processes in Stomach

Regulation of gastric secretion

There are three phases of gastric secretion regulation-

Cephalic Phase

  • Stimulation- CNS response to presentation of food; enhances gastric gland secretion
  • Inhibition- Loss of appetite; satiety / depression
  • Stimulation- food entering stomach, causing stretch which causes-
    • Increase in pH
    • Increase in Peptides
    • Increased gastric gland secretion
    • Reflex arc causes increased acetylcholine release which then causes increased gastric gland secretions
    • Increased pH / polypeptides / caffeine- all enhance Gastrin secretion by enteroendocrine G cells
    • 3 chemicals cause enhanced HCl secretion through 2nd messenger systems-
      • Gastrin
      • Acetylcholine
      • Histamine
      • Inhibition- pH <2.0 inhibits Gastrin secretion, SNS inhibits Gastrin (G cell) activity
      • Stimulation- As chyme enters the duodenum the mucosa secretes enteric gastrin which stimulates secretion by gastric glands
      • Inhibition- more chyme filling the small intestine triggers enterogastric reflex which-
        • Inhibits CNS stimulation
        • Inhibits local reflexes
        • Controls gastric emptying
        • Activates sympathetic fibers that tighten the pyloric sphincter

Gastric Phase

Intestinal Phase

Pathophysiology

Regulation of Gastric Emptying

  • Stomach emptying is promoted by intense peristaltic contractions in the stomach antrum (Psora)
  • At the same time, emptying is opposed by varying degrees of resistance to passage of chyme at the pylorus (Psora)
  • The thickness of the circular wall muscle becomes 50 to 100 percent greater (Psora)
  • It remains slightly tonically contracted almost all the time (Psora)
  • The constriction usually prevents passage of food particles until they have become mixed in the chyme to almost fluid consistency
  • Controlled by a very complex set of neural and hormonal signals

Role of the Pylorus in Controlling Stomach Emptying

Gastric emptying takes about 3 hours and very closely regulated so that nutrient absorption is maximized and H+ in the duodenum has time to be neutralized. Fat and high H+ (acidic) content slow gastric emptying.

Within the Stomach

Gastric Factors that Promote Emptying

Effect of Gastric Food Volume on Rate of Emptying
  • Stretching of the stomach wall elicit local myenteric reflexes in the wall that greatly accentuate activity of the pyloric pump and at the same time inhibit the pylorus (Psora)
  • Degree of fluidity of chyme
  • Release of gastrin from the antral mucosa enhance the activity of the pyloric pump (Psora)
  • When food enters the duodenum multiple nervous reflexes are initiated from the duodenal wall that pass back to the stomach to slow or even stop stomach emptying if the volume of chyme in the duodenum becomes too much. (Psora) 
  • Directly from the duodenum to the stomach through the enteric nervous system in the gut wall (Psora)
  • Through extrinsic nerves that go to the prevertebral sympathetic ganglia and then back through inhibitory sympathetic nerve fibers to the stomach (Psora)
  • Slightly through the vagus nerves all the way to the brain stem, where they inhibit the normal excitatory signals transmitted to the stomach through vagi (Psora)
  • The degree of distention of the duodenum
  • The presence of any degree of irritation of the duodenal mucosa
  • The degree of acidity of the duodenal chyme
  • The degree of osmolality of the chyme
  • The presence of certain breakdown products in the chyme, especially breakdown products of proteins and perhaps to a lesser extent of fats
  • Hormone released from the upper intestine
  • Stimulus for releasing these inhibitory hormones is mainly fats entering the duodenum (Psora)
  • Bind with “receptors” on the epithelial cells (Psora)  
  • Carried by blood to the pylorus and increase the strength of contraction of the pyloric sphincter (Psora) 
  • Emotions can influence gastric motility (Psora)
  • Influence gastric emptying through autonomic nerves by influencing the gastric smooth muscle contractility (Psora)
  • Intense pain can also inhibit the gastric motility by stimulation of sympathetic nerves (Psora)
  • Inhibitory Hormonal Factors (Psora) (Syphilis)
  • Cholecystokinin
  • Secretin
  • Gastric inhibitory polypeptide (GIP)
Effect of the Hormone Gastrin on Stomach Emptying

Within the Duodenum

Enterogastric Nervous Reflexes

Factors responsible for enterogastric inhibitory reflex

Role of Fats and Cholecystokinin

Outside the digestive tract

Types

Dumping syndrome is caused by problems with the storage of food particles in the stomach and emptying of particles into the duodenum.

Dumping may be of two types-

Early dumping syndrome

It results from rapid movement of fluid into the intestine following a sudden addition of a large amount of food from the stomach.

Late dumping syndrome

It results from rapid movement of sugar into the intestine, which raises the body’s blood glucose level and causes the pancreas to increase its release of the hormone insulin. The increased release of insulin causes a rapid hypoglycemia.

Causes

  • After a gastrectomy – the surgical removal of all or part of the stomach, usually for ulcer disease (Causa occasionalis)
  • Functional dyspepsia (Psora)
  • Surgery to remove or bypass a significant part of the stomach (Causa occasionalis)
  • Bariatric surgery (Causa occasionalis)
  • Nerve damage caused by esophageal surgery (Causa occasionalis)

Symptoms

The symptoms are divided into two types-

Early symptoms

Begin during or right after a meal.

  • Nausea
  • Vomiting
  • Cramping
  • Diarrhea
  • Dizziness
  • Fatigue
  • Abdominal pain
  • Feeling uncomfortably full or bloated after a meal
  • Sweating, weakness, dizziness
  • Flushing, or blushing of the face or skin
  • Rapid or irregular heartbeat

Late symptoms

These occur 1-3 hours after eating.

  • Hypoglycemia
  • Weakness
  • Sweating
  • Dizziness
  • Abdominal cramps
  • Rapid or irregular heartbeat
  • Flushing

Uncontrolled severe dumping can result in fear of food or eating called as sitophobia and weight loss leading to under and malnutrition.

Diagnosis

  • An oral glucose tolerance test
  • A gastric emptying scintigraphy test
  • An upper GI endoscopy
  • Based on patient with a history of stomach surgery.
  • Blood tests,
  • Upper endoscopy,
  • Gastric emptying test.
  • A Sigstad’s scoring system helps differentiate dumping syndrome from other GI problems. The scoring system assigns points to each symptom and the total points result in a score. A person with a score above 7 likely has dumping syndrome.

A total score >7 is suggestive of dumping syndrome, whereas a score <4 suggests other diagnoses

Shock

+5

Fainting, syncope, unconsciousness

+4

Desire to lie or sit down

+4

Breathlessness, dyspnea

+3

Weakness, exhaustion

+3

Sleepiness, drowsiness, apathy, falling asleep

+3

Palpitation

+3

Restlessness

+2

Dizziness

+2

Headaches

+1

Feeling of warmth, sweating, pallor, clammy skin

+1

Nausea

+1

Abdominal fullness, meteorism

+1

Borborygmus

+1

Eructation

-1

Vomiting

-4

Treatment

Treatment for dumping syndrome includes changes in eating, diet, and nutrition; medication; and, in some cases, surgery. Dumping syndrome have mild symptoms that improve over time with simple dietary changes.

Management

Changes in eating, diet, and nutrition are necessary and the following may be needed-

Dietary plan

  • Smaller and more frequent meals.
  • Slow eating and chewing.
  • Upright position while eating.
  • Limitation of fluid consumption during meals. Must drink liquids 30 – 60 minutes before or after meals instead of with meals.
  • Foods high in simple sugar should be avoided because they pass through stomach quickly and may cause diarrhea and cramping.
  • Avoid or limit high sugary foods and beverages including fruit juices/drinks, soda, cakes, pies, candy, doughnuts, cookies etc.
  • More complex carbohydrates such as whole grains, pastas, potatoes, rice, breads, bagels, unsweetened cereals, etc. must be encouraged.
  • More foods high in soluble fiber should be used. Foods high in soluble fiber slow stomach emptying and prevent sugars from being absorbed too quickly e.g. apples, beets, Brussel sprouts, carrots, oats, spinach, pears.
  • High fats may help to slow the stomach emptying prevent to develop dumping syndrome.
  • High protein diet should be used e.g. Eggs, meat, poultry, fish, milk, yogurt, cottage cheese, cheese, peanut butter.
  • If milk causes distress, lactose-free milk can be used.
  • Adequate calcium and vitamin D should be eaten in the diet.

Homoeopathic treatment

ABDOMEN - FLATULENCE - empty stomach; on cassia-s.

ABDOMEN - PAIN - Hypochondria - left - empty stomach; on cassia-s.

GENERALS - EMPTINESS, sensation of - Stomach; of - agg. glycyr-g.

GENERALS - FAINTNESS - empty stomach - amel. pitu-gl.

GENERALS - FOOD and DRINKS - food - aversion - accompanied by - Stomach; feeling of emptiness in Bar-c. carb-v. carbn-s. Chin. Cocc. coff. dulc. Grat. Hell. Hydr. hydrog. mur-ac. Nat-m. Nux-v. podo. Rhus-t. Sil. stann. Sulph. verb.

GENERALS - SHUDDERING, nervous - emptiness in stomach, after phos.

HEAD - PAIN - accompanied by - Stomach - emptiness in stomach cocc. dig. Ign. kali-p. kola Nat-m. nit-ac. ozone Phos. ptel. Sang. SEP.

MIND - DELUSIONS - faint; he would - emptiness of stomach; with bufo

SLEEP - YAWNING - emptiness of stomach, from ammc.

STOMACH - APPETITE - wanting - accompanied by – emptiness tub.

STOMACH - EMPTINESS - accompanied by - acidity of stomach elaps

STOMACH - EMPTINESS - accompanied by – hunger hep.

STOMACH - EMPTINESS - accompanied by - Lips; dryness of ozone

STOMACH - EMPTINESS - accompanied by – weakness Alst-s.

STOMACH - EMPTINESS - afternoon - 13 h fago.

STOMACH - EMPTINESS - afternoon - 14 h Grat.

STOMACH - EMPTINESS - afternoon - 15 h phys.

STOMACH - EMPTINESS –afternoon ambr. borx. calc. caust. fago. lac-loxod-a. lach. puls. ruta sulph.

STOMACH - EMPTINESS - agg. Ign. Phos.

STOMACH - EMPTINESS - air; in open - amel. bapt.

STOMACH - EMPTINESS - amel. dig.

STOMACH - EMPTINESS - brandy - amel. olnd.

STOMACH - EMPTINESS - breakfast - after - agg. am-m. coca colch. Dig. lyc. mez. puls. thuj.

STOMACH - EMPTINESS - breakfast - after - amel. mag-m.

STOMACH - EMPTINESS - breakfast - before - agg. aesc. alumn. apoc. arg-met. calc-p. carb-v. cimic. Kali-bi. lac-c. murx. sulph.

STOMACH - EMPTINESS - breathing deep - amel. ign.

STOMACH - EMPTINESS - chill; during ail. Ars.

STOMACH - EMPTINESS - convulsions; before epileptic HYOS.

STOMACH - EMPTINESS - cough; with croc. ign. mur-ac. stann.

STOMACH - EMPTINESS – daytime ap-g. nat-p. stann.

STOMACH - EMPTINESS - diarrhea, with Fl-ac. Lyc. Petr. Stram. Sulph.

STOMACH - EMPTINESS - dinner - after - agg. ail. eucal. graph. lyc. ptel. thea zinc.

STOMACH - EMPTINESS - dinner - amel. mag-c.

STOMACH - EMPTINESS - dinner – before lyc. mag-c. nux-v. phos. SULPH.

STOMACH - EMPTINESS - drinking – tea lac-h.

STOMACH - EMPTINESS - drinking - water - amel. kali-m.

STOMACH - EMPTINESS - drowsiness; during corn.

STOMACH - EMPTINESS - eating - after - agg. - two hours after ulm-c.

STOMACH - EMPTINESS - eating - after - agg. agar. alum. arn. bell. bov. calad. calc. carb-v. chin. chlol. CINA coloc. Dig. Grat. Hydr. kali-p. lach. Laur. Lyc. Myric. nat-p. olnd. op. petr-ra. phos. plan. ptel. puls. raph. sang. sars. sil. Stann. sul-ac. thuj. VERAT. zinc.

STOMACH - EMPTINESS - eating - amel. Anac. ap-g. brass-n-o. Chel. iod. mag-c. mur-ac. nat-c. petr. phos. Sep. sulph. tritic-vg. verat.

STOMACH - EMPTINESS - eating - before - agg. alumn. bamb-a. crot-t. Sulph.

STOMACH - EMPTINESS - eating - must eat graph. lach. petr. spong.

STOMACH - EMPTINESS - eating - not amel. By abel. abies-c. agar. alum-p. alum-sil. alum. Ant-c. Arg-met. Ars. asc-t. aur. calc-p. calc-sil. calc. cann-i. Carb-an. castor-eq. cic. CINA coc-c. coloc. dig. haliae-lc. ham. Hydr. IGN. kali-bi. kali-c. kali-i. kali-m. Kola LAC-C. LACH. LYC. mag-m. med. medul-os-si. Merc. MUR-AC. nat-m. Nux-m. olnd. op. par. petr-ra. PHOS. phyt. plut-n. sang. sars. SEP. sil. Staph. staphycoc. stront-c. Teucr. VERAT.

STOMACH - EMPTINESS - eating - while - agg. crot-t. verat. zinc.

STOMACH - EMPTINESS - Epigastrium - accompanied by – nausea lac-c.

STOMACH - EMPTINESS - Epigastrium - accompanied by – vertigo adon.

STOMACH - EMPTINESS - Epigastrium - eating agg. myric.

STOMACH - EMPTINESS - Epigastrium - fever; during polyp-p.

STOMACH - EMPTINESS - Epigastrium - urination agg.; after apoc.

STOMACH - EMPTINESS - Epigastrium - walking fast amel. myric.

STOMACH - EMPTINESS – Epigastrium agar. ant-c. ant-t. apoc. ars. calc-p. carb-an. cimic. cocc. Dig. fl-ac. glon. hydr-ac. hydr. Ign. ip. Kali-ar. kali-bi. kali-c. lat-m. lob. mur-ac. nat-m. olnd. Op. podo. rhus-t. sep. silphu. stann. stroph-h. sulph. tab. verb. vib. zinc.

STOMACH - EMPTINESS - eructations – after ambr.

STOMACH - EMPTINESS - eructations - amel. Sep.

STOMACH - EMPTINESS - evening - 18 h pitu-gl.

STOMACH - EMPTINESS - evening - 20 h kali-c. kalm.

STOMACH - EMPTINESS - evening - eating; after - amel. SEP.

STOMACH - EMPTINESS - evening - sleep; before dig.

STOMACH - EMPTINESS - evening - supper, before graph.

STOMACH - EMPTINESS – evening am-br. ambr. calc-p. coca-c. ham. lac-c. olnd.

STOMACH - EMPTINESS - extending to – Heart LOB.

STOMACH - EMPTINESS - fasting; sensation as from prolonged am-m. anac. ars. bov. bry. carb-an. caust. chin. cocc. ign. laur. lyc. mag-m. mez. nat-c. phos. plb. puls. sars. sep. stann. teucr. verat.

STOMACH - EMPTINESS - fever; during zinc.

STOMACH - EMPTINESS - forenoon - 10 h - evening; until mur-ac. Nat-c.

STOMACH - EMPTINESS - forenoon - 11 h - dull pain, with hydr.

STOMACH - EMPTINESS - forenoon - 11 h alumn. Asaf. aur-s. coloc. hydr. ign. ind. lach. Nat-c. nat-m. nat-p. op. petr-ra. petr. Phos. sep. SULPH. visc. Zinc.

STOMACH - EMPTINESS - forenoon - 9-10 h hep.

STOMACH - EMPTINESS – forenoon caust. jatr-c. mag-c. Nat-c. nat-m. nicc. puls. sulph. tritic-vg.

STOMACH - EMPTINESS - fruit agg. nat-c.

STOMACH - EMPTINESS - heart; with weak or dilated chlol.

STOMACH - EMPTINESS - hollow feeling like a vibrating violin string coca-c.

STOMACH - EMPTINESS - hunger - sensation as if from am-m. ant-c. arg-met. ASAR. aur. bell. calad. Calc. canth. cocc. Coff. dig. euph. hell. ign. kali-bi. Mag-m. mez. Nat-c. nux-v. plat. plb. puls. ran-b. rhod. rhus-t. ruta seneg. Stann. staph. teucr. verat.

STOMACH - EMPTINESS - hunger – without act-sp. Agar. alum-p. Alum. am-m. ars. Bar-c. berb. bry. carb-an. chin. chinin-s. cocc. dulc. grat. hell. heroin. hydrog. kali-n. LACH. Mur-ac. nat-c. Nat-m. nicc. Olnd. op. phos. psil. psor. raph. Rhus-t. Sil. Sul-ac. Sulph. tax.

STOMACH - EMPTINESS - inspiration - agg. calad. petr-ra.

STOMACH - EMPTINESS - inspiration - amel. petr-ra.

STOMACH - EMPTINESS – intermittent mur-ac.

STOMACH - EMPTINESS - lying down - amel. ambr. ign. sep.

STOMACH - EMPTINESS - meeting a friend, when cimic.

STOMACH - EMPTINESS - menopause; during Crot-h. Lach. Tab.

STOMACH - EMPTINESS - menses - before - agg. Ign. sep. sulph.

STOMACH - EMPTINESS - menses - during - agg. kali-n. kali-p. spong. tab.

STOMACH - EMPTINESS - milk amel.; sips of diph.

STOMACH - EMPTINESS - morning -  anxiety with lyc. nat-m.

STOMACH - EMPTINESS - morning - menses; during castm.

STOMACH - EMPTINESS - morning - rising - after - agg. phos.

STOMACH - EMPTINESS - morning - rising - agg. nat-p. phos.

STOMACH - EMPTINESS - morning - waking; on alum. ant-c. apoc. Lac-c. mill. ozone

STOMACH - EMPTINESS – morning Aesc. agar. anac. ant-c. apoc. arg-met. bufo carb-v. castm. cimic. coloc. dios. hell. hydr. kali-bi. lac-c. lyc. mag-c. mag-m. mez. mill. nat-m. nat-p. nicc. op. orot-ac. petr-ra. phos. plat. pot-e. ruta sang. sep. tarent.

STOMACH - EMPTINESS - motion agg. dig.

STOMACH - EMPTINESS - music agg. coca-c.

STOMACH - EMPTINESS - nausea; during agar. androc. Arg-met. arg-n. asaf. bry. calc-p. caust. chel. cimic. cocc. Cycl. gink-b. Hell. hep. heroin. hydr. Ign. kali-bi. kali-c. kali-p. lac-c. lach. lyc. mag-m. meph. mosch. nat-c. olnd. phel. PHOS. rheum Rhus-t. Sep. Sil. spig. tab. thymol. Valer. verat. zinc.

STOMACH - EMPTINESS - night - midnight - after - 2 h podo. tell.

STOMACH - EMPTINESS - night - midnight - after - 4 h raph.

STOMACH - EMPTINESS - night - midnight - after - 5 h nat-c.

STOMACH - EMPTINESS - night - midnight – after mag-c.

STOMACH - EMPTINESS - night - midnight - before - 23 h nat-c.

STOMACH - EMPTINESS - night – midnight mag-c. rhus-t.

STOMACH - EMPTINESS – night dios. kali-s. lyc. petr. tarent.

STOMACH - EMPTINESS – noon fago. nat-c. nat-m. pitu-gl. ruta tritic-vg.

STOMACH - EMPTINESS - nursing the child agg.; after Carb-an. olnd.

STOMACH - EMPTINESS - pain; from anac. ars.

STOMACH - EMPTINESS – paroxysmal arg-met. glon.

STOMACH - EMPTINESS - pressure - agg. MERC.

STOMACH - EMPTINESS - pressure - amel. psil.

STOMACH - EMPTINESS - rising agg.; after coca

STOMACH - EMPTINESS - rumbling below left ribs amel. verb.

STOMACH - EMPTINESS – sighing IGN.

STOMACH - EMPTINESS - sitting agg. acon. alumn.

STOMACH - EMPTINESS - sleep – before dig.

STOMACH - EMPTINESS - sleep - during - agg. lyc. ph-ac.

STOMACH - EMPTINESS - sleep - siesta - after - agg. ang.

STOMACH - EMPTINESS - stool agg.; after Aloe ambr. dios. fl-ac. mur-ac. PETR. Ph-ac. puls. Sep. sul-ac. sulph.

STOMACH - EMPTINESS - sweets - amel. petr-ra.

STOMACH - EMPTINESS - talking agg. Rumx.

STOMACH - EMPTINESS - thinking of food, when SEP.

STOMACH - EMPTINESS - throbbing, with ant-t. Asaf. calad. hydr. Kali-c. mag-m. nat-c. nat-m. sep. sulph.

STOMACH - EMPTINESS – trembling am-c. cimic. lyc. zinc.

STOMACH - EMPTINESS - vomiting; after ther.

STOMACH - EMPTINESS - walking - about - room agg.; in the lyc.

STOMACH - EMPTINESS - walking - after - agg. coca ferr.

STOMACH - EMPTINESS - walking - agg. chel. chinin-s. rat. sep.

STOMACH - EMPTINESS - walking - rapidly - amel. myric.

STOMACH - EMPTINESS - wine - amel. sep.

STOMACH – EMPTINESS abies-c. abies-n. abrot. acon. adon. Aesc. Agar. agav-t. ail. All-c. all-s. allox. aloe Alst-s. alum-sil. alum. alumn. am-c. am-m. Ambr. anac. ang. ANT-C. ant-t. ap-g. apoc. Aran. Arg-met. Arg-n. arge-pl. arn. Ars-i. ars-s-f. Ars. Asaf. aster. atro. aur-ar. aur-i. aur-m. aur-s. aur. bamb-a. Bapt. Bar-c. bar-i. bar-m. bar-s. bell-p-sp. bell. beryl-m. Brom. bros-gau. bry. Bufo cact. Calad. Calc-p. calc-s. calc-sil. Calc. Camph. cann-s. canth. Caps. carb-ac. Carb-an. carb-v. carbn-s. card-m. Carl. castm. Caust. chel. Chin. chinin-ar. chinin-s. chlol. choc. Cimic. Cina cinnb. clem. coc-c. coca coca-c. COCC. coff. colch. Coloc. con. cop. corn. Croc. Crot-h. Crot-t. cupr-ar. cupr. cypra-eg. DIG. dios. diosm. dys. Elaps ery-a. euphr. fago. ferr. Fl-ac. Gamb. gard-j. Gels. gent-l. germ-met. Glon. glycyr-g. Graph. Grat. ham. HELL. hep. heroin. Hipp. hir. Hydr-ac. HYDR. Hyos. IGN. ignis-alc. ind. indg. Iod. ip. jatr-c. Kali-ar. kali-bi. Kali-c. Kali-chl. Kali-fcy. kali-i. kali-m. kali-n. Kali-p. Kali-s. kalm. Kola lac-ac. LAC-C. lac-loxod-a. Lach. lap-la. lat-m. Laur. lil-t. Lob. loxo-recl. Lyc. lyss. Mag-c. manc. marb-w. med. medul-os-si. meny. meph. merc-i-f. merc-i-r. MERC. merl. mez. moni. morph. Mosch. Mur-ac. MURX. myric. naja narc-ps. nat-ar. Nat-c. Nat-m. Nat-p. Nat-s. nicc. nit-ac. NUX-V. Olnd. oncor-t. Op. orni. ox-ac. ozone pert-vc. petr-ra. Petr. phel. PHOS. phys. phyt. plac-s. plan. plat. plb. PODO. psil. ptel. PULS. rad-br. rad-met. raph. rheum Rhus-t. rumx. ruta sabad. sacch-a. sacch. Sang. sarr. sars. sec. seneg. SEP. sil. spig. spong. squil. STANN. staph. stram. succ-ac. suis-hep. sul-ac. Sul-i. sulfonam. SULPH. sumb. TAB. Tarent. tell. Teucr. thea thuj. til. tril-p. tritic-vg. Tub. ust. valer. VERAT. verb. vib. vinc. xan. zinc-p. ZINC.

STOMACH - ERUCTATIONS - swallowing - empty – after spig.

STOMACH - ERUCTATIONS; TYPE OF - empty - afternoon - 17 h dios. hyper. ox-ac.

STOMACH - ERUCTATIONS; TYPE OF - empty - afternoon - coffee agg. nat-m.

STOMACH - ERUCTATIONS; TYPE OF - empty - afternoon - stomach is empty; while op.

STOMACH - ERUCTATIONS; TYPE OF - empty – afternoon aeth. ambr. ars. bar-c. Carb-v. crot-t. dios. hydr. hyper. iris lyc. mag-m. nat-m. op. ox-ac.

STOMACH - ERUCTATIONS; TYPE OF - empty - air agg.; in open nat-m.

STOMACH - ERUCTATIONS; TYPE OF - empty - alternating with – hiccough agar.

STOMACH - ERUCTATIONS; TYPE OF - empty - beer; after vinc.

STOMACH - ERUCTATIONS; TYPE OF - empty - breakfast - after - agg. ars. grat. hell. sulph.

STOMACH - ERUCTATIONS; TYPE OF - empty - breakfast - before - agg. Bov. Ran-s.

STOMACH - ERUCTATIONS; TYPE OF - empty - coldness; during gamb.

STOMACH - ERUCTATIONS; TYPE OF - empty - cough; after AMBR. ang. SANG. sul-ac. verat.

STOMACH - ERUCTATIONS; TYPE OF - empty - dinner; after alum. am-c. ars. cact. cycl. lyc. mag-m. Sulph. zinc.

STOMACH - ERUCTATIONS; TYPE OF - empty - drinking - after - agg.bism. carb-v. coloc. nat-m. rhus-t. tarax. vinc. zinc.

STOMACH - ERUCTATIONS; TYPE OF - empty - drinking - after - cold water - agg. phos.

STOMACH - ERUCTATIONS; TYPE OF - empty - eating; after Acon. ang. ars. bry. calc. Camph. carb-an. card-m. cench. coloc. cupr. cycl. grat. Hydr. kali-s. nat-c. Nat-m. Ox-ac. ph-ac. Phos. Plat. Ran-s. rhus-t. Sep. spig. SULPH. tritic-vg. VERAT.

STOMACH - ERUCTATIONS; TYPE OF - empty - evening - 18 h iris

STOMACH - ERUCTATIONS; TYPE OF - empty - evening - 19 h dios. phys.

STOMACH - ERUCTATIONS; TYPE OF - empty - evening - 21 h until midnight phos.

STOMACH - ERUCTATIONS; TYPE OF - empty - evening - 21 h until midnight - walking in open air agg.  phos.

STOMACH - ERUCTATIONS; TYPE OF - empty - evening - 21.30 h dirc.

STOMACH - ERUCTATIONS; TYPE OF - empty - evening - hiccough; during sulph.

STOMACH - ERUCTATIONS; TYPE OF - empty - evening - lying agg. verat.

STOMACH - ERUCTATIONS; TYPE OF - empty – evening abrot. am-c. coc-c. dios. hyper. rumx. sars. sulph. tritic-vg. verat. zinc.

STOMACH - ERUCTATIONS; TYPE OF - empty - fasting agg. plat. valer.

STOMACH - ERUCTATIONS; TYPE OF - empty - forenoon - 10 h castor-eq. ign.

STOMACH - ERUCTATIONS; TYPE OF - empty - forenoon - 11 h hydr.

STOMACH - ERUCTATIONS; TYPE OF - empty - forenoon - 9 h com.

STOMACH - ERUCTATIONS; TYPE OF - empty – forenoon castor-eq. colch. com. Con. hydr. ign. kali-c. myric. naja par. Pic-ac. sars. zinc.

STOMACH - ERUCTATIONS; TYPE OF - empty - headache; during aeth. apis Calc.

STOMACH - ERUCTATIONS; TYPE OF - empty – hot apis carb-v. kali-bi.

STOMACH - ERUCTATIONS; TYPE OF - empty - hysteria; during mang. tarent.

STOMACH - ERUCTATIONS; TYPE OF - empty - menses - before - agg. mang.

STOMACH - ERUCTATIONS; TYPE OF - empty - menses - colic, during menstrual mang.

STOMACH - ERUCTATIONS; TYPE OF - empty - mental exertion agg. Hep.

STOMACH - ERUCTATIONS; TYPE OF - empty - morning - 7 h dios.

STOMACH - ERUCTATIONS; TYPE OF - empty - morning- fasting, after bov. cina croc. nit-ac. Plat.

STOMACH - ERUCTATIONS; TYPE OF - empty - morning - rising - after - agg. nat-m.

STOMACH - ERUCTATIONS; TYPE OF - empty - morning - rising - agg. cedr.

STOMACH - ERUCTATIONS; TYPE OF - empty - morning - waking; on bar-c. calc.

STOMACH - ERUCTATIONS; TYPE OF - empty – morning alum. anac. bar-c. bov. bry. calc. cedr. cina cob. coloc. con. croc. dios. kali-c. mag-c. nat-m. Pic-ac. Plat. stann. sul-ac. Sulph.

STOMACH - ERUCTATIONS; TYPE OF - empty - nausea; during arn. coc-c.

STOMACH - ERUCTATIONS; TYPE OF - empty - night - 23 h sumb.

STOMACH - ERUCTATIONS; TYPE OF - empty - night - menses; before mang.

STOMACH - ERUCTATIONS; TYPE OF - empty – night dios. dirc. kali-c. mang. mur-ac. phos. phys. sumb. tanac.

STOMACH - ERUCTATIONS; TYPE OF - empty - noon - eating; while olnd.

STOMACH - ERUCTATIONS; TYPE OF - empty – noon olnd. ox-ac.

STOMACH - ERUCTATIONS; TYPE OF - empty - rising up coloc.

STOMACH - ERUCTATIONS; TYPE OF - empty - soup agg. carb-v. mag-c.

STOMACH - ERUCTATIONS; TYPE OF - empty - stool agg.; after bar-c.

STOMACH - ERUCTATIONS; TYPE OF - empty - sugar agg. raph.

STOMACH - ERUCTATIONS; TYPE OF - empty - supper agg.; after alum. lyc. sep.

STOMACH - ERUCTATIONS; TYPE OF - empty - waking; on bar-c. calc. rumx.

STOMACH - ERUCTATIONS; TYPE OF – empty abies-n. acon. Aesc. Aeth. AGAR. all-c. aloe alum-p. alum-sil. alum. am-br. AM-C. am-m. Ambr. anac. anan. androc. ang. ANT-C. ant-t. apis ARG-N. ARN. ARS-I. ars-s-f. ARS. arund. Asaf. Asar. bapt. Bar-c. Bar-i. bar-s. bell. Berb. BISM. bov. brom. Bry. but-ac. cain. Calad. calc-i. calc-s. calc-sil. Calc. camph. cann-i. CANN-S. canth. CARB-AC. Carb-an. CARB-V. CARBN-S. card-m. carl. cartl-s. Casc. castm. caul. CAUST. Cham. Chel. Chin. chinin-ar. chinin-s. chir-fl. chlol. cimx. cina cinnb. cist. clem. cob. coc-c. coca Cocc. coff. Colch. Coloc. CON. cop. corn. Croc. crot-t. cycl. Daph. Dios. dirc. dulc. elat. erig. eup-per. euph. eupi. fago. ferr-ar. ferr-i. ferr-p. Ferr. fl-ac. gamb. gent-c. gins. Glon. gran. GRAPH. grat. Guaj. gymno. ham. hell. helon. hep. Hydr. hyos. hyper. ign. indg. IOD. IP. Iris jatr-c. Kali-ar. KALI-BI. kali-c. kali-chl. KALI-I. kali-m. kali-n. kali-p. kali-s. kali-sil. Kalm. Kreos. Lac-c. lac-d. Lach. lact. laur. Lec. led. lob. LYC. m-arct. m-aust. mag-c. mag-m. mag-s. manc. mang. med. Meny. merc-c. merc-i-f. merc. Mez. mill. mosch. myric. Nat-ar. Nat-c. nat-m. nat-p. Nat-s. nicc. Nit-ac. nux-m. NUX-V. ol-an. olnd. ox-ac. pall. par. petr. ph-ac. Phos. phys. phyt. PIC-AC. plan. plat. Plb. plut-n. podo. positr. ptel. PULS. ran-b. ran-s. raph. rhod. rhus-t. rumx. ruta sabad. sabin. sang. sars. sec. senec. Seneg. sep. sil. sin-a. sol-ni. spig. spong. squil. stann. staph. stront-c. stry. suis-pan. sul-ac. sul-i. SULPH. sumb. symph. tab. tarax. TARENT. thuj. til. tritic-vg. Valer. verat-v. Verat. verb. vinc. viol-t. xan. zinc-p. zinc. zing.

STOMACH - ERUCTATIONS; TYPE OF - water brash - accompanied by - Stomach- emptiness in cina

STOMACH - HEAT, flushes of - empty, when naja

STOMACH - HEAVINESS - empty, while Fl-ac.

STOMACH - NAUSEA - accompanied by - Abdomen - emptiness in Kola

STOMACH - NAUSEA - swallowing - agg. - empty; on swallowing colch.

STOMACH - PAIN - empty; when Anac. cina hydr-ac. petr.

STOMACH - PAIN - Epigastrium - empty stomach; on - amel. - cutting pain cassia-s.

STOMACH - PAIN - Epigastrium - empty stomach; on - amel. cassia-s.

STOMACH - PULSATION - empty; when kali-c.

STOMACH - RETCHING – empty asar. sec.

STOMACH - RETCHING - swallowing - empty - agg. Graph.

STOMACH - VOMITING - sensation of - empty stomach; with gard-j. pitu-gl.

STOMACH - VOMITING; TYPE OF - food - empty; mouthful until stomach is arg-n. bac. Ferr. PHOS.

VERTIGO - ACCOMPANIED BY - Stomach – emptiness ozone

Bibliography

 Stomach > Dumping Syndrome Schwartz's Principles of Surgery, 10e ... with delayed gastric emptying, probably on the basis of disordered motility in the Roux limb. Taking advantage of this disordered physiology, surgeons have used this operation successfully in the management of the dumping syndrome. Although this is probably the procedure of choice in the small group...

 Disorders of Gastric & Small Bowel Motility > DUMPING SYNDROME & ACCELERATED GASTRIC EMPTYING CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 3e

 Stomach & Duodenum > 6. Dumping syndrome CURRENT Diagnosis & Treatment: Surgery, 14e ... restricted to between meals. Symptoms of the dumping syndrome are noted to some extent by most...

 Disorders of Gastric & Small Bowel Motility > General Considerations CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 3e ... Altered gastric and small bowel motility result in either delayed gastric emptying or rapid transit. Among the disorders of gastric and small bowel motility discussed in this chapter are gastroparesis, CIPO, dumping syndrome, and rapid transit dysmotility of the small bowel. Gastroparesis...

 Encyclopedia Homoeopathica

 Radar 10

 

Views: 181

Comment by Debby Bruck on June 5, 2016 at 11:12pm

intriguing

Comment by Dr Rajneesh Kumar Sharma MD(Hom) on June 5, 2016 at 11:14pm

Thanks a lot...

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