Lichen planus and Homeopathic treatment

 - Dr Sunitha Devi Vannemreddy M.D(Hom)
 drsunithavannemreddy@gmail.com
Lichen planus is a cell mediated immune response of unknown origin. It is fairly common skin rash that thought to be triggered by autoimmune system. There may be several contributing factors and each case is different. Main causes includes viral infection, allergen or stress and genetics.It may be found with other diseases with altered immunity such as ulcerative colitis, alopecia areata, vitiligo, dermatophysotos, morphea, lichen sclerosis and myasthenia gravis. Lichen planus has been found to be associated with Hepatitis C virus infection, chronic active hepatitis and primary biliary cirrhosis.

Many people get lichen planus. This disease can develop on one or several parts of the body. It appears on skin or on oral cavity. Lichen planus can change the way of person’s fingernail and toe nails look. It can also appear on genitals and on scalp too.

It may be uncomfortable but in most of the cases lichen planus is not a serious problem. Lichen planus is not contagious. You cannot get this disease from someone else and you cannot give it to anyone. Lichen planus is not a type of cancer. 

Lichen planus can occur in anyone at any age, skin form of lichen planus occurs in men and women
equally but oral form of LP develops twice more in women. It is very rare in young and elderly people and most commonly occurs in middle aged people.


Other risk factors include having other family member with lichen planus, viral diseases like hepatitis c, or being exposed to chemical or allergens like certain antibiotics, arsenic, gold, iodide compounds, diuretics and certain kinds of dyes. 

Signs and symptoms:

Common symptoms of lichen planus includes:
·         Purplish coloured lesions or bumps with flat tops mostly found on wrist, inner forearm and ankles.
·         Blisters, which become scabby after bursting.
·         Thin white lines over the rash (wickham’s striae).
·         Itching at the site of the rash.

Description of lichen planus well known as “6ps” includes,
Planar (flat topped), purple, polygonal, pruritic, papules and plaques.

This rash after regressing likely to leave an area of hyperpigmentation that slowly fades.
Lesions initially developing on flexural surfaces of the limbs, with generalized eruption developing after a week or more and maximal spreading within 2-16 weeks.

Pruritus of varying severity, depending on type of lesion and extent of involvement.
Oral lesions may be asymptomatic, burning or even painful. Ulcer formation with intense burning and painful. Won’t allow talking and chewing anything and burning on taking food. Sometimes bleeding in nature.

In cutaneous lesions, lesions typically resolve within months to 18 months; chronic disease is more likely oral lichen planus or with large, annular, hypertrophic lesions and mucus membrane involvement. 

Structures involved in lichen planus:

·         Mucous membranes like affecting the lining of gastrointestinal tract like mouth, pharynx, oesophagus, stomach and anus, larynx and other mucosal membranes.
·         Cutaneous type, involves extremities, face and nape of neck. Sometimes occurs in palms and soles (intertriginous area); which is called as  “ inverse lichen planus”
·         Genitalia; causes lesions on glans penis or skin of scrotum in males. Vulva or vagina in females. Symptoms includes lower urinary tract infection associated with stenosis of urethra, painful sexual intercourse and itching.
·        
Nails characterised by irregular longitudinal grooving and ridging of nail plate, thinning of nail plate, pterigium formation, shedding of nail plate with atrophy formation. A sand papered appearance is present in individuals with nail lichen planus. 
·         Scalp; which is also known as planopilaris and peripilaris. Characterised by violaceous, scaly, pruritic papules. It also causes scarring alopecia if not treated. 

Occasionally, lichen planus is known to occur with other conditions like,
·         Lupus erythematosus: lesions are usually large, hypopigmented, atrophic and red to blue coloured with minimal scarring. Telengectasia may be present.
·         Lichen sclerosus: lichen planus overlaps on lichen sclerosis by sharing the both symptoms more or less equally.

Clinical presentation of Lichen planus are;

·        ·         Hypertrophic LP
·         Atrophic LP: mostl present as atrophic oral lichen planus may also manifest as desquamative gingivitis.
·         Erosive or ulcerative LP: it is the second most common oral lichen planus. It is characterised by oral ulcers with persistent, irregular areas of redness, ulcerations and erosions covered with yellow slough. Gums also involved described as desquamative gingivitis.
·         Follicular LP
·         Annular LP
·         Linear LP
·         Reticular LP: the most common presentation of oral LP. It is characterised by net like or spider web like appearance of lacy white lines called as “wickham’s striae”
·         Vesicular and bullous LP: appears as fluid filled vesicles which projects from the surface.
·         Actinic LP
·         Lichen planus  pigmentosus
·         Lichen planus pemphigoides: characterised by the development of tense blisters atop lesions of lichen planus or the development of vesicles de novo on uninvolved skin.
·         Keratosis lichenoides chronica: it is a rare form of dermatosis characterised by violacious popular and nodular lesions, often arranged in linear or reticular pattern on dorsal and, feet, extremities and buttocks.
·         Lichenoid keratosus: also known as benign lichenoid keratosus, a cutaneous condition characterised by brown to red scaling maculopapules, found on sun exposed skin of extremities.

Diagnosis:
Lichen planus lesions are diagnosed clinically by “lichen” like appearance.
A biopsy can be used to rule out conditions that may resemble lichen planus.  
Direct immunoflouroscence study reveals globular deposits of immunoglobulin M (IgM) and compliment mixed with apoptotic keratinocytes.

Management:

Lichen Planus is self limiting disease that usually resolves within 8-12 months. Mild cases treated with topical steroids and severe cases especially those involve scalp, nails and mucous membranes needs intensive therapy.

In Allopathy, first line of treatment is corticosteroids, vitamin D3 anologues and antibiotics.
Cosmetic treatments includes, laser surgery, cryotherapy and phototherapy.
Patients with wide spread Lichen planus will be responds with, Narrow band or broad band UV-B therapy and Psoralen- ultraviolet –A (PUVA therapy) treatment.   

Lichen planus and Homeopathic treatment:

Homeopathy is deep acting constitutional treatment which helps in stabilizing the person in emotional, mental and physical plane. Inheritance is the condition in which some diseases runs along the family. Homeopathy helps in the limiting the progression of the disease by acting on miasmatic level which lessen the impact of the disease. Autoimmune conditions are self acting conditions against its own immunity. So with the homeopathic treatment, these autoimmune conditions are somewhat limited in its progression and symptomatic relief by strengthening the person’s immunity.
Homeopathy helps in relieving the symptoms and reducing the impact of the condition and also helps in reducing the recurrence of the disease.

Homeopathic treatment also helps in relieving the side effects of corticosteroids and other allopathic medications used for the treatment of lichen planus.

Lichen planus caused by allergens like gold, chemicals and medications are effectively treated by homeopathic medication.

So homeopathic medication helps in effective treatment of lichen planus, by relieving from the symptoms, reduces the recurrence of the disease. It also helps in lightening of the pigmentation left by the disease.

Rubrics to be useful in treatment of Lichen planus:

Skin, Lichen planus
Skin, discoluration, purple
Skin, eruptions, purple.
Skin, eruptions, papules
Skin, eruptions, blisters
Skin, eruptions, blisters, scalding of skin from
Skin, eruptions, itching
Skin, eruptions, chronic
Extremities, eruptions, forearm
Extremities, eruptions, wrist
Extremities, eruptions, ankles
Skin, eruptions, dark
Skin, eruptions, desquamating
Skin, eruptions, crusty
Mouth, ulcers
Mouth, abscess
Mouth, ulcers, irregular
Mouth, ulcers, painful
Mouth, ulcers, painful, burning
Mouth, ulcers, painful, sore and smarting
Mouth, ulcers, painful, biting
Mouth, ulcers, painful, touch to
Mouth, ulcers, gums, discharging of blood

Some of the indicated remedies for lichen planus:

Antimonium crudum, Anthrakokali, Arsenicum album, Arsenicum iodum, Borax, Juglans cinerea, Kali bichromium, Merc sol, Plantago, Sulphur, Sulp.iodatum, chininum arsenicosum, thallium metallicum and Thuja.

Antimonium crudum: One of the best homeopathic remedy for both oral and cutaneous lichen planus. Cracks in the inner corner of mouth with canker sores in the mouth. No thirst with slimy mucus. Tongue is white coated or white washed. Best remedy for thick, hard and honey coloured scabs. Papules with burning and itching aggravated by cold bathing and night.

Anthrakokali: Best remedy for the treatment of lichen planus if eruptions on hands and feet. It shows effect on popular eruptions especially on hands and legs. It helps in the treatment of papules on scrotum in males. It is a best remedy for the lichen planus over the skin of tibia.

Arsenicum: It is one of best remedy for the treatment of lichen planus associated with great exhaustion and anxiety. Great anguish and restlessness associated with skin complaints. Fear of death is prominent in this drug. Popular eruptions which are dry and scaly, worse by cold weather and scratching. Ulceration of mouth with dryness and heat sensation in mouth.

Borax: Best remedy for oral lichen planus with rashes inside cheeks and on tongue. Aphthae, white fungus like growths in mouth. Painful gum boils. Ulcers bleed on touch and eating. Mouth is tender and hot with bitter taste in mouth.

Juglans regia: It is best remedy for lichen planus which affects the scalp. Scalp is red with violent itchy eruptions. Chanker like ulcers and with more itching in the night. Associated with enlarged axillary glands which suppurates.  

Kali bichromicum: it has more affinity towards mucous membranes like oral cavity. Mapped tongue which is red, shining and dry. Sensation of hair on the tongue. Also useful in skin ulcer with punched out edges. Associated with prostration and burning pain.

Merc sol: Best remedy for oral lichen planus.  Especially effective in the treatment of lichen planus where gums are involved. Gums spongy, recede and bleed easily. Sore pain on touch and on chewing. Furrow in upper surface of tongue. Tongue is moist, coated yellow with teeth indented, feels as if burnt, with ulcers. Complaints worst at night with great thirst.

 Plantago: Best remedy if whole oral cavity affected with lichen planus. Toothache with soreness and sensitive to touch. Swollen cheeks. Profuse saliva. Complaints are worse by touch and cold air and relieved by pressure. External application of Plantago mother tincture relives the pain.  

 Sulphur: Best remedy for Lichen planus with papules and extreme skin dryness. Eruptions are dry, scaly and unhealthy. Every little injury suppurates. Complaints of skin eruptions after local medication. Papular eruptions with hand nails. Excoriation in folds of skin. Complaints are with itching and burning and worse by scratching and washing.

Sulp.iodatum: Best remedy for lichen planus on face and arms. Popular eruptions on face. Itching at nose and ears. Arms covered with itching eruptions.

 Chininum arsenicosum: It is indicated in oral lichen planus after affections of malaria and neuralgia. Tongue is thickly furred, yellow and slimy coated with bitter taste. Complaints associated with profound prostration and loss of appetite after malaria.

 Thuja: Best homeopathic remedy for lichen planus of pigmented variety. Eruptions only on covered parts with profound itching, worse after scratching. Very sensitive to touch. Brown spots on hands and arms. Nails crippled, brittle and soft.
With these some indicated remedies for the treatment of lichen planus.

Constitutional treatment with homeopathy not only relieves the complaints of lichen planus, it also helps in reducing the recurrences. 



Homeopathic Treatment for Clear and glowing skin

- An article by Dr Sunitha Devi Vanemreddy M.D(Hom)
Skin is the largest and major sensory organ in the human body. Everybody wishes to have a clear and glowing skin. Skin contains sweat glands and sebaceous glands to protect from the ultraviolet rays and other conditions. Depending on the region we live skin colour changes and texture of the skin also alters from one person to another. Skin condition varies basing on the weather and health condition of the person. Clear and glowing skin affected by both internal and external factors.

The condition occurs to skin are not life threatening one but most of the people especially youngsters feels it is life altering condition. Sometimes skin loses its glowing effect and become dull and lifeless. It might be because of external factors like pollutions, chemicals and other toxins and internal factors like hormonal shift and other metabolic and systemic diseases which affect the skin.

Two years back a young guy came to my clinic with complaints of acne and dirty oily skin. He also complaining of dandruff. He started telling me that he wanted clear and glowing skin as he is stepping back in his career. He is pursuing degree in hospitality field, as in that field external looks matters more than intelligence. He came to start treatment as his instructor forced him to get the treatment as he is not looking good and people don’t appreciate his external appearance. He said he loves his profession but he is de motivated by the way people are treating him. Nowadays not only woman are worried about the external looks even men wanted flawless skin.

In adolescents the skin become dull and lifeless may be because of tremendous hormonal shifts. It causes acne, allergic dermatitis, contact dermatitis which makes the skin become dull and oily. This leads to feel inadequate and loss of self confidence.

In mid age between thirties to fifties, skin loses its texture and become dull, dry and wrinkled. It makes the person to feel lifeless and becoming old. Even though these are not life threatening conditions but people more worries about the changes they are undergoing. People are more conscious and bothered about their skins rather than anything. For that they choose to go for chemical abrasion and other external skin treatment using the chemicals. This in turn leads to contact dermatitis and allergic dermatitis. This problem is more with the sensitive skin.

Why we give more importance to skin and outer texture? After all we are living in the materialistic world where more importance given to outer texture than intelligence and confidence. We are all affected by first looks and good looks than knowing the person deeply, which makes the person to bother more for unimportant one and they are in turn making the skin to suffer more by applying the chemicals and other cosmetics. Application of cosmetics and chemical products may give temporary relief but long term haphazard use leads to skin infections like allergic dermatitis, contact dermatitis etc,.

Conditions that causes skin dull and lifeless are,

·         Dust and pollution

·         Sun exposure

·         Improper diet

·         Improper cleansing

·         Stress

Skin conditions that causes marks and rashes on skin are,

·         Acne and pimples

·         Allergic dermatitis

·         Contact dermatitis

·         Pigmentation

·         Melasma

·         Vitiligo

·         Vitamin deficiency white patches

·         Bacterial and fungal infections

Systemic conditions that causes skin dull and unhealthy are,

·         Hyperlipidaemia

·         Hypothyroidism

·         Hyperthyroidism

·         Hypopituitarism

·         Cushing syndrome

·         Porphyria

·         Systemic lupus erythematosis (SLE)

·         Rhumatiod arthritis

·         HIV

·         Diabetes mellitus

·         GI diseases like inflammatory bowel diseases

·         Liver diseases like jaundice, hepatitis


Treatment:
Home remedies:

Every woman dreams for clear and flawless skin. Facial skin divided into dry or greasy. Sometimes skin will alter its texture because of external and factors. Some people have oily dark shades of skin only on fore head and cheeks but dry around the mouth and nose. Skin moisture alters depending upon different factors. Most of woman prefers to try home remedies rather than consult a doctor.
Some tips for clear and flawless skin are,

·         Healthy diet and regime is the major part for everything. Digestive problems results in skin impurities. Consuming the diet with vitamins and micronutrients is the only option to get clear and glowing skin. Natural protein foods like fish, grains and omega three fatty foods like fish, walnuts helps in the healthy and glowing skin. Taking more vegetables and fruits gives flawless skin. Avoid processed and oily stuff.

·         Drinking water will help to purify the skin. Water cleanses the body and eliminates toxins and waste.  It hydrates the body and drains excess dirt and oil from skin. It rids the skin from dryness and wrinkles. It also boosts the immune system.

·         Even though sun is the great source of vitamin D, it is only in the early morning and evening sun. Exposure to sun from 10am to 2 pm contains ultraviolet rays which makes the skin harsh and dry, may also lead to skin cancer. Try to avoid sun in the harsh hours and wear cloth on the face, use SPF creams which helps in rejecting the UV rays to absorb into the skin.

·         Hydrating the skin from inside and outside is essential. Cleaning the skin with cold water helps in reducing the dryness of the skin. Skin produces oil naturally to provide the moisture for skin; cold water helps to retain it. The hot water may reduce the oil production and opens the pores which produce the bacterial infections.

·         Excessive accumulation of wastes and toxins leads to dullness and causes acne or pimples. It is important to flush out these products with the help of the detoxification. Natural detoxification programme is to take more vegetables and fruits detox diet plan which stimulates the body to cleanse and purge itself. It also enhances the function of liver, kidneys and colon. One of natural way of detoxification is taking warm water with lemon daily in the morning.

·         Leave the stress behind it is natural beatification of skin. Proper rest or sleep and maintaining the healthy lifestyle is helpful to get glowing and flawless skin. Stress hormones leads to excess oil production which in turn lead to ugly skin. Taking warm bath, short sleep, ten minute meditation gives relaxation for the body which rejuvenate the stress hormones.

·         Physical activity helps in maintaining the flawless skin along with the losing the weight and stay fit. Exercises or physical activity increases the blood flow and oxygen to the skin cells that neutralises the harmful effects of free radicals and carries away products from cells. It helps in the flushing the cellular debris from the system.

·         One of the most important vitamins for the healthy and flawless skin is vitamin C. Vitamin c helps in enhancing the complexion and avoids the skin aging. Regular intake of vitamin C improves collagen production, enhances the brightness of skin. It keeps away age spots and pigmentation and also has ability to protect from damage caused by harsh UV rays of sun.



Homeopathic treatment for the healthy and glowing skin:

Homeopathy is the holistic conceptual treatment in which we look person as a whole, but not in separate entity. If we want healthy and flawless skin, Homeopathy does not focus on only skin. Homeopathy believes in personal well being and constitutional treatment. If person is healthy in mental, emotional and physical levels, then skin automatically healthy and glows itself. Homeopathy enhances the natural detoxification process of the body and it will boost the mechanism by removing the obstacles from the immune system in cellular level. So that natural mechanism helps in functioning properly and regains its effects.

Homeopathy helps in improving the health in the miasmatic level so that there will be no side effects from the treatment. Treating the person as a whole and using the internal medication with healthy diet and regimen helps the person to have healthy clean and glowing skin. This kind of effective treatment helps both for dry as well as oily skin. The natural skin conditions are not being altered but helps in improving the defence system and regulate the mechanism. 
However, some of the important remedies which help to get healthy clear and glowing skin are given below.
Homeopathic remedies for healthy, glowing skin:
Berberis aquifolium: It is one of the homeopathic remedies which help in enhancing the skin complexion. It brightens the skin; it improves the glow of the skin. This remedy can be used for any kind of skin types, both oily and dry. It balances the skin moisture and improves the fairness of the skin. It helps in lightening the scar marks on face caused by acne and pimples. It is indicated in scaly, dry rough skin. Berberis helps in skin conditions like acne, psoriasis, dry eczema and pruritis.
Sulphur: Sulphur is one of the good remedy in skin conditions where skin is dirty and scaly. It is deep acting remedy which acts in the core of the skin affections. Sulpur skin looks like dirty, dull, unhealthy and scaly. Every little injury suppurates. There is severe itching and burning especially in skin folds, more from warmth, evening and worse by scratching and washing. That’s why person dislikes towards washing and bathing.  Sulphur helps to improve the glow of the skin. It is also indicated for various eruptions, but this remedy helps in clearing the pimples and any scars left by them. It is also one of the good remedy for helps in reducing the side effects from allopathic topical ointments and soaps.
Psorinum: Psorinum is an antipsoric remedy which acts deeply into the cellular level. It is appropriate remedy for greasy, dirty, dingy looking skin. It is helpful in the people whose sebaceous glands secrete too much making the skin dark and dirty. Suits to the persons who has tendency to pimples and skin eruptions with high activity of oil and sweat glands. It deeply cleanses the skin pores and helps in clearing the pimples and controls the excessive oiliness of skin. It helps in clear and glowing skin. Person needing this remedy are highly sensitive to cold air and offensive perspiration.  
Bovista: Bovista is an excellent remedy to treat the side effects from excessive use of cosmetics and tar products. It antidotes tar. It helps in treating the skin conditions like pimples, eruptions and skin rashes after excessive use of chemical cosmetics. It clears the skin and improves the facial complexion. Indicated in conditions like pruritis, worse by warmth; eczema, moist, with intolerable itching and acne all over the body.
Sepia: It is an excellent remedy for the skin complaints in menopausal women. During the menopause women experience cholasma; a dark or black discoloration on the face with menstrual irregularities and hormonal imbalances. It is also indicated in dark discolorations on face post pregnancy. It works well in women with dark discoloration especially on nose and cheeks with uterine affections. It is only remedy to help in chloasma and it clears the skin and returning the healthy glowing charm of the skin without any side effects. Also indicated in herpetic eruptions around the lips, itching not relieved by scratching and sweat with intolerable odour.
Silicea: It is indicated in deep seated acne containing offensive pus resulting into disfiguring scars on the face. It also works for the deep pits caused by acne. Every injury suppurates. It helps in clearing the skin, removing the scars caused by acne and discoloration. It promotes healthy and glowing skin.
Kali bromatum: It is indicated in cases of hard indurated pimples resulting in the facial scarring and discoloration. It helps in bringing back the facial fairness and clearing the scar marks caused by pimples. Kali brom is one of the good remedy for reducing the disfigurement.
Natrum mur: It helps in the treatment of freckles. Freckles are the pigmentation of the skin due to prolonged exposure to sun caused by accumulation of melanin pigment. The pigmentation may vary from brown to black in colour. Natrum mur is indicated in treatment of freckles in the person who are intolerant to sun exposure, craves salty things and reserved and shy natured person. Not easily opens up with chronic grief.
Lycopodium: Lycopodium indicated in acne leaving the scars with discoluration. Skin is hard and indurated. Indicated in freckles worse on left side of the face and nose. Eruptions with violent itching. It is indicated in persons who desires sweets, warm food and drinks. Conditions also associated with gastric troubles.
Phosphorus: Phosphorus indicated in skin conditions where wounds bleed much. Acne and other skin troubles heal and break down again. Indicated in freckles. It helps in reducing the acne and scars because of it. It gives clear and bright skin to person who is sensitive to external impressions; crave for ice creams and cold drinks.
Rhus tox: It is post operative scars. It acts on fibrous tissue and helps in reducing the scars. It is indicated in red swollen, intense itching vesicles leaving behind the scars. It helps in clearing the skin and disfigurement. Complaints worse by cold application; wet weather and relieved by warmth application.   
Graphites: It is an anti psoric remedy with tendency to skin affections and constipation. Dark and tendency to obese. It is indicated in early stages of keloid and fibroma. Acne and pimples with sticky exudations. Every little injury suppurates. It helps in clearing the skin and brightening of the skin in early stages. Complaints worse by warmth.
Pulsatilla: It is indicated to young girls who attained puberty. Acne with intolerable pain. Sensitive mentally and physically. Girls who are immature and easily affected by anything. Weeps easily and mentally imbalanced. Wants consolation. It is indicated in girls who are in early stages of puberty with menstrual irregularities. Craves for sweets, rick food. Pulsatilla helps in clearing the acne and scars and helps in healthy and glowing skin.  
These are some of the indicated remedies for clear and glowing skin. Constitutional treatment gives more better and permanent results. After all clear and glowing skin is every one’s wish. 





The One - About the Vital force and Hypostasis

- Dr Mirjana Zivanov
space-time continuum-homeopathy
Space-time continuum-homeopathy
Everything that was created in the space-time continuum, the Cosmos, is unique. Nothing can ever be exactly the same as any other thing, only similar.
This was obvious even to the earliest Greek philosophers. A maxim by Heraclitus: “Everything flows - Panta Rhei” - summons up this subject perfectly.
Accordingly, every person is a singular event in history.
Matter and energy are changing in time and space, but the rules of change, their relations, are constant - unchangeable and we know them as physical and mathematical constants (like number π (Pi), the Avogadro’s number (NA), the Gravitational CONSTANT(G) etc.). These constants are infinitesimal numbers, so Symbols are used to represent them (π (Pi), NA, G etc.) in their true meaning, while their approximate values (like 3,14159 for Pi) are used in calculations.
These constants and Laws of nature are the pillars of the Cosmos, an invisible web - the Hypostasis that holds it together. To paraphrase Hermes Tresmegistos - it’s center is everywhere, the circumference nowhere.
The therm Hypostasis (Greek ὑπόστασις) means underlying state or underlying substance, the fundamental reality that supports all else, known in Christian Europe for almost 2000 years as the Holy Spirit.
Finding and understanding the Laws of Nature is the “raison d’être” for every branch of Science.
The  Hypostasis can be seen all around us if we are looking for patterns behind similar but, in appearance, still quite different events and forms.
It would be wrong to assume that the existence of something Constant, something that shapes and rules the Cosmos, wasn’t obvious to most of the cultures and civilizations that predated ours. The main difference between us and them is that we only except the existence of something that can be quantified, expressed in numbers, while they mostly recognized analogies and marked them with Symbols.
It took us thousands of years to mathematically define nonliving nature, while the living nature is ever more elusive. This is why the scientific fields are commonly divided into two major groups - natural sciences and social sciences.
The living nature is so much more complex then the nonliving, that hermetic philosophers used to define every living being as a Microcosm - nowadays we would say a unique living system. All of these countless microcosms are in an endless diversity of interactions. It is far more challenging to find the web of patterns, the Matrix, that pervades the nature and relations of the living.
A human being is not just ruled by the Laws of physics, but also by the unconscious. This interaction between the physical world and the world of unconscious is what makes human beings so complex. The unconscious also has it’s constants but they can’t be defined in numbers – they are archetypes, Symbolic images that may only be partially expressed in words or works art, just as the physical constants (like Pi) can be expressed in approximate number (3,14159).
Consequently the health of a human being is also both physical and psychological, so right in-between natural and social sciences. The physical and psychological phenomena of a human being are so interconnected that any attempt to deal with a single phenomena with disregard to the others, may result in a serious collateral damage. That is why in homeopathy every phenomena, symptom, presented by a human being is observed as a disorder in the system as a whole - a holistic approach.
For 200 years Homeopathy looks for the underlying patterns in symptoms of disorders, hypostasis of a human being - the way we feel and experience everything that happens to us emotionally and physically, as well as how our minds react on that.
Hippocratic medicine, as the dominant medical system in Mediterranean and Middle East for two millennia, has introduced the term Vital Force. It is the Spirit (Pneuma) combusted and infused into the body, primarily blood, creating the Vital Force (Pneuma zoticon), that gives life to every part of human being. Vital Force is the hypostasis of a person - the One in a human being, and every symptom is it’s reaction. Since the Vital Force is personal, unlike the Spirit (Pneuma) that is general, universal, the symptoms are the reflection of what is underlaying in the Vital Force of a person - the essence of a person.

About Dr Mirjana Zivanov:
Dr Mirjana Zivanov
Dr Mirjana Zivanov
Dr Mirjana Zivanov graduated from Faculty of Medicine, University of Novi Sad (Serbia) and London International College of Homeopathy. Dr Mirjana has 10 years of everyday clinical practice in Classical Homeopathy, at Homeopathic clinic in Novi Sad, Serbia. Dr Mirjana is the author of the books “Homeopathy in Practice”, “Principles of Homeopathy” , “Homeopathy – The Invisible Influences”and "The Matrix Method with Tetractys Model". She is the creator of “Tetractys of Simillimum” and “The Matrix Method”. Dr Mirjana can be contacted at: dr.mirjana.zivanov@gmail.com

The Effective treatment of Urethral stricture with Homeopathy

- Article by Dr Sunitha Devi Vannemreddy M.D(Hom)
 drsunithavannemreddy@gmail.com

Urethra is the opening that allows the urine to leave the bladder. Urethra has a sphincter mechanism that holds urine inside the bladder. When urine fills in the bladder, there is both voluntary and involuntary control to open the urethra to allow the urine to come out. In men, it is thin tube like structure that starts from lower opening of the bladder, traverses entire length of penis. In women, it is a short opening coming off lower opening of bladder and between 2.5 to 4 cms length.


Urethral stricture refers to narrowing of urethra for any other reason, whether or not it actually impacts the flow of urine out of the bladder. Urethral stricture caused by injury, instrumentation, infection and some non inflammatory causes of urethritis or by formation of scar tissue. Scar tissue can be result of many factors. 

Causes of urethral stricture:

It can be caused by many factors. It is mostly affected to males than females. Young boys who has hypospadias surgery (procedure to correct the underdeveloped urethra). And men who has penile implants have higher chance of getting urethral stricture.

A straddle injury is the common type of cause for urethral stricture. Examples of straddle injury are getting hit from cycle bar, falling and affecting on scrotum. Other specific causes including pelvic fracture, catheter insertion, radiation and surgery performed on prostate.



Urethral stricture after blunt trauma can be divided into,
  •           Pelvic fracture associated urethral disruption occurs in severe pelvic fracture.
  •           Blunt trauma to perineum compresses the bulbar urethra against pubic symphysis, causing a crush injury.


Tumors located in close proximity of urethra, untreated urinary tract infection, lichen sclerosis and sexually transmitted diseases like gonorrhoea also causes urethral stricture.

Surgery to address hypospadias can result in delayed urethral stricture, even decades after original surgery. 

Signs and symptoms:

·          Hallmark sign of urethral stricture is weak urinary stream.
·         Splaying of urinary stream
·         Urinary frequency
·         Urinary urgency
·         Straining for urination.
·         Pain during urination
·         Urinary tract infection
·         Prostatitis
·         Inability to empty the bladder
·         Urinary retention
·         Urinary incontinence
·         Blood in urine (hematuria)
·         Semen in urine (semenuria)
·         Discharge from urethra
·         Reduced ejaculation force
·         Penile swelling

Risk factors of urethral stricture:

·         Mostly men are at risk compared to women.
·         Who have had one or more STI’s (sexually transmitted infections)
·         Who have used a catheter
·         Who have urethritis
·         Who have prostate enlargement.

Complications:

·         Urinary retention
·         Prostatitis
·         Bladder dysfunction
·         Urinary diverticulum
·         Periurethral abscess
·         Fournier’s gangrene
·         Urethral fistula
·         Bilateral hydronephrosis
·         Urinary infection
·         Urinary calculus

Diagnosis:

To diagnose the urethral stricture,
·         Reviewing the complaints, medical history and past illnesses.
·         Performance of physical examination. Observing the penis for redness, hardness and swelling.

·         Tests like,
Ø  measuring the rate of flow during urination (urine analsis)
Ø  analysing the physical and chemical properties of urine (urine culture)
Ø  cytoscopy
Ø  Measuring the size of urethral opening and tests for clamydia, gonorrhoea(urethral culture).
Ø  Examination of prostate and screening for prostate cancer and measurement of prostate specific antigen (PSA)
Ø  Imaging and endoscopic studies are necessary to confirm the diagnosis and identifying the cause of urethral stricture.

·         Common imaging and endoscopic tests are,
Ø  Ultrasound of urethra
Ø  Retrograde urethrogram
Ø  Anterograde cystourethrogram
Ø  Cystourethroscopy

Treatment:

Main aim for urethral stricture treatment is, to improve the flow of urination, betterment of complaints like pain, redness, swelling and dribbling of urination and avoiding the possible complications of urethral stricture.

Treatments available in Allopathy:

·         Urethral dilatation - widening of stricture. This procedure will be done under general anaesthesia and involves passing thin metal rod into urethra. Slowly widens the stricture until no scarring.
     With this procedure, flow of urine improves; emptying bladder will reduce the urinary tract infection.
     But with this procedure, pain while passing urination, bleeding, passing urine more often are the complications. Recurrence of stricture may often occur.

·         Optical Urethrotomy – internal cutting along stricture. This procedure will be done under general anaesthesia and it is a simple surgery using the special telescopic electric knife to remove the part of stricture which is blocking the flow. Complete stricture cannot be removed with this procedure.
          With this procedure, flow of urine improved, emptying of bladder will reduce possible infections.
          After this surgery person can be recovered and back to normal life within two weeks.               Possible complications with this procedure are pain while passing urine, hematuria, infections and recurrence of stricture.

·         Urethroplasty – open repair of stricture. It is a surgical repair of urethra. Depending on length and location of urethral stricture, options available are,
Ø  Excision of stricture and reconnection of healthy urethra
Ø  Excision of stricture and reconnection with graft
Ø  Graft reconstruction alone.
                Recovery rates are better. Flow of urine and discomfort while passing urination improved and urinary tract infections are reduced. Person can go back to normal life after four weeks of surgery.
              Possible complications with this surgery includes,
Ø  Bleeding, infections
Ø  Injury to adjacent organs and structures and their functions
Ø  Chronic pain
Ø  Possible changes in sexual functions, like, poor erection, penile curvature and changes in ejactulation may occur.

·         Holmium laser endourethrotomy – It is laser operation of urethral stricture, which doesn’t require much time and less possibility of infection. In this technique, person need not to stay too long in hospital and simple procedure to remove the stricture urethra with laser.
Advantages are:
Ø  Less post operative pain.
Ø  Less bleeding
Ø  Less post operative infection.
Ø  Recovery is faster than normal surgical procedure.
Ø  Urine flow improves.
Complications are lesser than other procedures but chances of recurrence of stricture are one of the complications. 

Urethral stricture treatment with Ayruveda:

Ayurveda is mainly based on ingredients of medicinal plants. For urethral stricture treatment, they use both oral and local applicants. They claim that prescribed use of oral medication like kashyam and powders along with milk and medicinal application of oils to urethra will relieve the complaints.
They claim that, with ayurvedic medication, patients complaints like, flow of urine improves, pain and swelling and other associated complaints are completely relieved and recurrence of urethral stricture are very less.

Urethral stricture treatment with Homeopathy:

Homeopathy is constitutional and conventional treatment in which main aim is to relieve the complaints in mild, gentle and permanent way. Person to be treated mentally, emotionally and physically, as a whole, which improves the health and living style. In urethral stricture treatment, for allopathy there is no medical treatment instead of surgical interventions which leaves some complications. But in homeopathy there is wide range of medicines are there to prescribe, according to the totality of the complaints.

Advantages and aims of Homeopathic treatment are,
Ø  Flow of the urine improves
Ø  Associated complaints like pain, swelling relieved.
Ø  Urethral stricture due to injury or hurts is treated with root cause.
Ø  Urethral stricture due to urinary tract infections or gonorrhoea like STD’s are treated with homeopathic medications which relieves the stricture complaints.
Ø  Prostatic problems or other complaints which causes urethral stricture are treated with homeopathy which successfully relieves the complaints.
Ø  It eases the flow of urine, dribbling of urine and urine retention.
Ø  It acts on urinary muscles and membranes to avoid further progression and complications of complaints.
Ø  It will reduce or prolong the chances of recurrence of urethral stricture.
Ø  Homeopathy relieves the complaints after dilations and other surgical procedures.
Ø  Side effects of other conventional treatments or surgical procedures are treated with homeopathy without any side effects. 

Homeopathic rubrics for urethral strictures:

·         Urethra, stricture
·         Urethra, stricture, bruised pain in testes with
·         Urethra, stricture, convulsive, spasmodic
·         Urethra, constriction, convulsive, spasmodic
·         Urethra, constriction, urination during
·         Urethra, haemorrhages, gonorrhoea, after suppressed
·         Urethra, haemorrhages, urination, after
·         Urethra, inflammation, chronic
·         Urethra, narrowing of
·         Urethra, pain, drawing.
·         Urethra, pain, agonising
·         Urethra, pain, drawing, urination after
·         Urethra, pain, dragging, extending to bladder
·         Urethra, tumor
·         Urine, bloody
·         Bladder, urination, difficult
·         Bladder, urination, dribbling by drops
·         Bladder, urination, dribbling by drops, retention with
·         Bladder, urination, dysuria, stricture with
·         Bladder, urination, interrupted
·         Bladder, urination, unsatisfactory, bladder was not emptying, as if dribbling
·         Urethra, gonorrhoea, suppressed. 

Best remedies for urethral stricture:

cantharis, clematis, nitric acidum, petroleum, puls, apis, berberis, conium, indigo, kali iod, merc, petroselinum, sulph iod.

Cantharis: Retention of urine with cramp like pain in bladder. Urgent and ineffectual effort to urinate, with painful emission, drop by drop. Urination is difficult, weak and scattered. Urine is pale yellow or deep red coloured. Flow of sanguineous mucus from bladder. Emission of blood. Purulent urine. Burning and smarting on urination. Incisive pain in the front part of urethra during and after urination. Sharp, tearing, incisive pains, successive pulling and pulsations in the urinary organs. Burning, stinging and tearing in kidneys. Pressing pain in the kidneys extending to bladder along ureters relieved by pressing upon glans. Exceedingly painful sensibility of the region of bladder on touching.

Clematis: Burning sensation and smarting in urethra, on commencing to urinate. Stitching sensation in urethra extending to abdomen. Contraction in urethra, with urine stopping suddenly or flowing drop by drop. Jerk like tearing pain in the front part of urethra during intervals. Purulent urine. Urine is turbid, milky with violent pain while passing last drops.

Nitric acidum: Frequent want to urinate, with scanty emission of deep coloured urine. Incontinence of urine. Painful emission of urine. Micturition in thin stream from stricture.  Urine is cold when passed. Foetid, strong smelled urine like horse’s urine. Smarting and burning pain in urethra while passing urine. Swelling of orifice of urethra. Needle like stitches in orifice of urethra. Ulcers in urethra. Discharge of mucus sanguineous kind of.

Petroleum: Constant dribbling of urine after micturition. Discharge of mucus from urine. Frequent emission of urine with scanty flow. Urine is bloody or turbid with deposits of red slimy sand. Involuntary discharge of urine especially during night. Burning pain in urethra. Stricture urethra after chronic urethritis.

Pulsatilla: Contraction of urethra with small stream of urine. Burning pain during micturition. Burning during and after urination. Pulling and pressure in urethra extending to bladder. Contraction in urethra with soreness in that region. Swelling at urethra with soreness when touched, intermittent stream of urine with violent pain dragging to bladder. Urine is watery colourless, brown and bloody. Severe alternating pains which changes position frequently. Associated with great anxiety. Old cases of gonorrhoea.

Apis: Burning and soreness when urinating. Strangury. Pain in the urethra with soreness on pressure and while stooping.  Frequent desire for urination with passage of only few drops. Urine is scant and high coloured with thirstlessness. Incontinence of when coughing and other circumstances. Burning and stinging pain in urethra, as if scalded.  Bladder is very painful after tenesmus and after urination. Urine is dark, frothy and sediments like coffee grounds.  

Berberis: Incisive pains in urethra even not urinating. Smarting pain in urethra with sensation of excoriation, even during emission of semen during coition. Motion excites and aggravates pain in urethra. Burning pain in urethra during and after urination but more after urination. Stitching and shooting pains extending to loins and thighs.  Urine is pale yellow, slimy and gelatinous.

Conium: Incisive pain in urethra during urination. Burning and shooting pain urethra especially after urination. Viscid mucus mixed with blood, which cannot be passed without severe pain. Urine flow drop by drop stops suddenly and doesn’t begin to flow for some moment. Pressure in the bladder with violent stitching pain bladder which is more while walking and better by sitting.

Indigo: suitable remedy for stricture urethra. Violent contraction of urethra with pain in bladder. Painful emission of small quantities of turbid urine. Frequent desire to urinate with difficulty in urination associated with thirstlessness.

Mercuris: Affections of urethra with continued want of urination with scanty flow. Flow of urine is like drop by drop. Urine is deep coloured, turbid and offensive smell. Thick, hard sediments of mucus from urine. Discharge of blood from urethra.  Pulsating, shooting pains in urethra even not urinating. Thick greenish discharge from urethra from gonorrhoea.

Petroselinum: constant dribbling of urine after micturition. Discharge of mucus with urine. Frequent emission of urine with scanty, bloody and foetid flow of urine. Burning of urethra. Stricture urethra after chronic urethritis.  

Sulph iod: Itching in urethra. Frequent micturitions especially in the morning with scanty and painful flow of urine. Stricture urethra. Shooting pain in bladder extending to urethra. Urine is thick, whitish and creamy.

These are some of the indicated remedies which help in urethral stricture cases. But proper case taking and drawing the personality of the patient by taking totality of mental, emotional and physical symptoms of the patient, analysing and repertorising the symptoms will give a correct constitutional remedy which suits the person. With this classical homeopathy we can treat the cases of urethral stricture by relieving from complaints, improving the well being of the person and reducing the complications of the case. But at the same time we have to understand our scope and limitations with homeopathic system of medicine. This process will give us successful cases. 
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