The treatment plan of different digestive disorders as per allopathic guideline is described here :
For Constipation
Though I am prescribing stool softners, but one should use these softners only when there is great requirement otherwise don’t make a habit to use these softners, instead under-mentioned mild purgatives may be used :
1. Take Isabgol, Agar-Agar or Methyl cellulose. These drugs take 12-24 hours to act, help to absorption of water so as to, increase bulk of all the three devices mentioned above.
2. Isabgol husk (one tsp dissolved in lukewarm/hot milk) is, by far, the best and most effective medicine which can remove both recent, acute and chronic varieties of constipation.
3. If Agar-Agar is preferred, its dose is 4-16 gm, and for methyl cellulose 1-6 gms, spread over a period of 24 hours.
4. Consume plenty of fruit and vegetable juices or take in raw form, plenty of water and other liquids, moderate milk, ghee/ butter, whey, curd, papaya, coconut (green) water.
Stool Softeners
Cremaffin : Take liquid Cremaffin to soften hard stools but it must not be taken regularly and habitually. First, continue with 2 tsp dose at bed time for 3-4 days but do not continue consecutively giving a dose on each alternate day. Some patients pass loose motions which indicates softening of stools but, then the dosage should be reduced.
Liquid Paraffin : 3-5 tsp at night, but must not be taken regularly as it is a habit forming medicine. Use it also after operation of piles, knotty and hard stools, to remove tenesmus and pain. Its action starts after 12-24 hours, hence do not expect an instant or quick results.
Milk of Magnesia (Magnesium Hydroxide) : Liquid Cremaffin contains Milk of Magnesia and former is decidedly a better option. Usual dose being 2-4 gms. Its action starts after 2-6 hours. It may produce flatulence in some patients. Avoid using in chronic renal (kidney) disease.
Magnesium Sulphate : It is taken in the morning (5-10 gms) as a single dose. But being a strong purgative, it causes total evacuation of bowels with in 2-3 hours. I do not recommend it because, even if a minute quantity of it reaches blood (from intestines), it may cause depression serious dehydration, anuria, Instead of this, castor oil can be taken.
Note : There are irritant purgatives like, Bisacodyt, Phenolphthalein, Senna Glycosides etc. which deserve to be discarded due to serious side-effects.
Caution : Consult your doctor while giving any purgative to an infant, child, pregnant lady, anaged person, person having some serious complaints and health problems, operated cases etc.
For Diarrhoea
Lomotil : One tablet thrice daily. It may colour the urine. Do not use for children below 10 years, pregnant ladies and elderly people. Causes dryness of mouth, blurred vision, bitter taste. If taken for a longer period, it may cause addiction, respiratory depression, coma, and even death may ensue.
Furoxone : Its advantage being that it effectively controls diarrhoea and micro-organisms but do not become resistent to it. It is also of value in infections and gastro-enteritis. It is more effective than Tetracyclin, Chlorumphenicol, Sulphadiazine or Sulphathiazole. Its usual dose is 100 mg 4 times a day. Nausea, vomiting, headach low urine, skin rashes or other allergic reactions may surface but, all the same, it has minimal side effects. If nausea, vomiting or allergic reactions supervene, either taper/reduce the dose or else withdraw it.
Wotinex : Take one tablet twice daily. Do not given to children below 12, pregnant ladies and persons with liver problems. It may give bitter or coppery taste in the mouth.
Ampicillin : 250 mg 4 times daily or 500 mg twice daily. In certain patients it causes diarrhoea, hence persons with sensitive digestive system should not use it.
Neomycin : This is an antibiotic drug of choice and is specifically used for infants due to its local action. Consult a doctor for suitable and requisite dose and frequency.
For Dysentery
1. Tablet/Capsule of Nalidixic Acid (150-300 mg) + Metronidazole (200 mg). Adult dose 2-3 tab/cap 3-4 times daily, depending on intensity and severity of the case. Do not give to infants, nursing and pregnant ladies. If nausea and vomiting persist take a tablet (thrice daily) of Perinorm or Stemitil or Avomine also. Trade brand names of Nalidixic and Metronidazole being Bactomed, Enterodix-M, Genogyl-M, Microneg, Enterodix-M. Do not scared if yellow/pale coloured urine is passed, in addition to bitter tase in the mouth.
2. Also try ‘Inseptin-MF’. One tablet for adults six hourly; for children over 5 years 1/2 tablet 8 hourly or as required. Urine may be passed yellow or pale, and taste of mouth also may be bitter.
Read relevant literature or consult a doctor for contra-indications, Drug interactions/reactions, side-effects. Eliminate the factors that have caused this malady. Avoid recurrence by taking corrective and pre-emptive measures. Take only khichri and curd, boil drinking water. Take plenty of oral liquids ORS and above all, maintain and ensure highest standard of personal hygiene. Avoid eating or drinking anything outside your home.
For Nausea/Vomiting
Branded tablets like Avomine, Domstal, Draminine, Ern- idoxin, Gravol, Perinorm, Reglan, SiquiI, Stemitel, Tomid, Vertin any one of the drugs can be given according to symptoms, in tablet or injection form. Normally 1-2 tablets, will suffice—given at an interval of 4-12 hours but, if an injection is given, there is hardly any need of repetition. Some drowsiness and/or sedation may also set in, hence do not drive any vehicle or operate any machinary, move out alone. The referred dose is for adults only. In case of infants, children, young and aged persons, lactating and pregnant ladies, consult a doctor for dosage and frequency, alongwith other instructions and guidelines.
If ORS is not available, boil a little water and put in a tbsp. of sugar and 1/8-1/4 tsp of table salt in a tumblerful of water, and let the patient drink/sip the same as frequently as needed.
For Colic and Flatulence
1. First of all take two tablets of Digene/Diovol and suck or crush them in mouth, taking some water to push the medicine down the gullet. Repeat after 2-3 hours.
2. If no relief follows and pain is severe, take a capsule of Spasmo Proxyvon, 6-8 hourly. Do not use in colic of infants, children, pregnant, lactating ladies, elderly and those having hepatic problems or Sudhinol tablet 3-4 times or Tab Tidigesic, Torolac, Walgesic, Wygesic—one tablet 6 hourly.
Note : Above-mentioned medicines can also be tried in renal colic—dosage, frequency and cautions remained the same. For further information read relevant literatures or consult a doctor. If pain and flatulence are caused by constipation, take a mild laxative or suitable drugs as suggested under ‘consitpation’ earlier. In any case do not ever exceed the stated dose nor/get panicky, rather wait patiently for some time, enabling the ingested medicine to act. In severe and acute case, take an injection (3 ml) of Voveron which is now freely used for all types of pains, including arthritis, menstrual pains etc.
For small children and infants use paedriatic preparations only and never any adult dose.
Acidity and Heartburn
1. Alkaline products can offset acidity and a tsp of Alkasol liquid or Alkacitron or any other such medicines will remove acidity and heartburn. Once it was told by a habitual drunkard that he mixes one or two tsp of Alkasol with whisky and he never suffered from the two complaints. I think this may be an individual’s personal experiment/opinion which might not carry medical man’s nod. All the same, it may be tried when alcohol is the root cause of acidity and heartburn.
2. Take two tbsp of Digene, Polychlor forte gel, Gelusil, Diovol straight away as soon as symptoms of acidity or heartburn appear.
3. If you want to get rid of Reflux oesophagitis, benign gastric duodenal u1cres, hyperacidity disorders, chronic episodic dyspepsia Zollinger-Ellison Syndrome, take a tablet of Ranitidine (brand names Aciloc, Histac, etc.) 150 mg twice daily or 300 mg at bed-time daily for 4-8 weeks. Maintenance dose is 150 mg at bed time. Do not stop treatment suddenly or in-between. Do not give in pregnancy, lactation, gastric malignancy, children below 12 years and infants.
4. Another drug of choice is Famoticdine (brands names Farntac, Fudone, Famonit, Farnocid, Blocacid etc.) 20/40 mg tablets. Usual dose is 20 mg at night for 4-8 weeks.
Those who are liquor-addicts should consult their doctor(s) about the method, dosage, safeguards, tapering of dose and or maintenance dose. Without proper guidance and know how not only the said but other medicines must never be taken.
Before concluding, the patients should try to single out the causes and try to eliminate the same. Repeated episodes of heartburn and acidity cannot be ruled out unless preventive and corrective measures are taken. Medicines can only help a patient when the patient himself is conscious about taking preventive or corrective steps but, in any case, do not expect any magical or instant results, as it is a time-consuming complaint.
For Peptic Ulcer
1. Non absorbable antacids are preferred due to their delayed absorption. Aluminium Hydroxide (brand name Aludrox) is the drug of choice for treatment of peptic ulcers which might cause constiption. But constipation can be removed by combining Magnesium with Aluminium. Usual dose is 200-600 mg every hour when there is acute stage but dosage and frequency may be reduced as the symptoms shows a downward trend. As complete cure takes much longer time, the medicines should be continued for a month or more even when symptoms have subsided. In addition Calcium Carbonate, various Magnesium salts are available in Digene Gel Acigon, Gelusil.
2. Ranitidine, Zinetac, Zanitidine, Raniten block histamine H2 receptors. Dosage is 150 mg twice daily or a single dose of 300 mg at bed time. In order to prevent recurrence of gastric or duedenal ulcers a 150 mg dose at bed time would suffice, but has to be continued for some time.
3. Another drug is Cimetidine (800-1200 mg) to heal ulcer and 400 mg at bed time to prevent the recurrence of peptic ulcers but it has been ably replaced by Ranitidine which has less side effects.
4. Famotidine (brand names Famtac, Famdtin, Acipin, Fudone, Zactane) is 20 times stronger than Cimetidine and many times stronger than Ranitidine. Its usual dose is 40 mg at bed time and has hardly much side effects.
As for side-effects, drug reactions and drug interactions, read the relevant literature or consult your doctor. These drugs must not be given up suddenly (unless there is some serious adverse effect), rather their dose should be tapered in a phased manner. Once relieved, doesn’t and shouldn’t mean a total immunity as there could be recurrence at any time. Cimetidine must be used with utmost care as it may decrease W.B.C.s., cause sexual dysfunction in males, swelling in the breasts (gynaecomastia) of females. Do not take any other drug while taking Cimetidine. Rest of the drugs, not mentioned, should also not be taken without proper medical advice.
Unless dietary regimen is scruplously followed and all precipitatory factors/items omitted form diet altogether, no medicine can show any favourable and salutary results. Self-restraint and self-management, self-descipline, self-control are the well known traits for speeding up quicker recovery.
Omeprazole is reported to provide 100% relief after use of four weeks but in the absence of much clinical evidence, this success rate cannot be fully relied upon but other drugs, of course with requisite safeguards and cautions, may be tried with lesser side-effects.
For Jaundice
It is mostly supportive and corrective, and medicines are generally not called for. Take tablets of Liv-52 or syrup of Liv-52 (2-4 tablets thrice daily or 1-2 tsp thrice daily), alongwith heavy doses of Vitamin B-complex (Cap Cobadex or Cap Becosules 2-4 Capsules, daily)—all after meals. Consume plenty of boiled water, coconut water, radish, papaya, sugar cane juice, curd (of toned milk) or whey. Avoid all types of meats, fish, spices and condiments, fats and oils (even if of unsaturated variety), tea, coffee, alcohol, tobacco, drugs and narcotics, cocoa. Juices extracted from fresh lemon and sweetlime can also be had.
Medicines play only supportive and corrective role here.
If the complaints do not yield to any method, hospitalise the patient and let him have an indoor treatment.
Diet restriction is of paramount importance. Jaundice is fully curable provided the above-mentioned points are closely followed.
For Cirrohosis of Liver
The disease must always be treated by a qualified doctor, either at some hospital or at home, but always by a doctor and never a layman. Do, not attempt any home remedies, as they simply further complicate the problem.
Auxiliary Measures
Eliminate alcohol, liquors, quinine, indigestible foods, spices, condiments and fats, milk products (except curd/whey of toned milk). Try to keep functionably of all the eliminating/excretory organs. Maintain high standard of personal hygiene and the patient be advised to take rest-in-bed, but must not lead a totally sedentary life—let him have stroll, in the morning and evening, attend to personal needs (if he can), visit the closet/bathroom.
For Hepatitis-B
It will depend upon the kind of infection imbibed and presence of symptoms. In some cases, infection is so serious as to cause death even though only 5-20% patients die due to such an infection.
Young infants, pregnant ladies, drug addicts, persons of weak constitution are more likely to be infected easily, though no person, or sex is immune to it. Hence, precaution is the only way to stay free of such blood transmitted infections.
For Worms
Anthelminthics and other anti-infestive drugs are used for killing different types of worms, such as
1. Pyrentel 2. Diethylcarbimazine
3. Piperazine 4. Niclosamide
5. Bepheniurn
Pyrantel : It has a neuromuscular blocking action that produces spastic paralysis in the worms. It is safe, effective and alternative to Mebendazole but must be used with utmost caution as there can be liver impairment.
Piperazine : It causes a flaccid paralysis of threadworms and roundworms and causes their expulsion by way of peristalsis. Both the drugs are mutually antagonistic.
Bephenium : It is an alternate drug for the treatment of round and hookworms but is poorly absorbed, hence its toxic effects are qutie rare. It is also less effective than Mebendazole.
Diethylcarbamazine : It is used for treating Fialariasis but must not be used unless advised by a doctor, due to its severe hypersensitivity reactions.
Niclosamide : It is an effective drug against tapeworms. It should also not be used unless a doctor advises; as it may cause vomiting or constipation.
Drug Therapy
Albendazole 400 mg tables (Trade names ABZ, Albezole, Alminth, Emanthal, Idibend, Mebex, Tagazole, Wormin, Zentel, Zumin)
Used for : Roundworm, hookworm, whipworm, tapeworm, threadworm infestations.
For Threadworms : For adults and children over 2 years 400 mg (single dose only), to be followed by 100 mg dose after 2-3 weeks.
For Tapeworms : 400 mg once daily for 3 consecutive days.
For Hydatid : 400 mg twice daily with meals for 28 days. This therapy, may be repeated after a lapse of two weeks for a total of 3 cycles.
This drug is also available in suspension form of which 5 ml. suspension contains 200 mg. Dosage is the same as mentioned earlier in the case of tablets.
Note : This therapy is also an adjunct to hydated cysts or primary treatment, especially when surgery is not possible.
1. Do not use in pregnancy, hormonal contraceptive, child bearing women, malfunctioning of liver, breast-feeding.
2. It may cause headache, gastro-intestinal disturbances, fever, rashes, dizziness, alopecia (baldness), convulsions and meningism in cerebral disease.
Now-a-days only a single drug treatment is given for all the worm infections and it is quite convenient also for the patient.
Auxiliary Measures
1. Clip nails of hands and feet and keep them clean.
2. Before going, coming back, before and after eating, after defecation wash hands with soap.
3. Wash thoroughly all fruits and vegetables.
4. Take plenty of roughage to ward off chances of any constipation.
5. Observe yourself and also educate children about personal hygiene.
6. Ensure that the cooks and servants also observe requisite level of cleanliness and personal hygiene.
7. Do not eat/drink any foodstuff which is exposed to dust, flies, insects, is impure and contaminated, stale, foul smelling or rotten.
For Cancer of Stomach
Operation is the only option left, but chances of full recovery are not very encouraging. Anyway, one has to take a chance of operation, when no other option is left.
For Piles
Liquid Cremaffin : 1 tbsp should be taken at night before retiring to bed, otherwise mix 1-2 tsp of Isabgol husk to milk which should be taken at bed-time. Locally apply ointment Anovate or Proctodsedyl in the rectum with the applicator at night, before and after defecation (each time) so as to facilitate smooth passage of stools or use rectal capsules of Proctosedyl-M. Main emphasis should be to ensure smooth passage of stools. In some persons hypersensitivity to the ingredients may cause some problems in which condition stop using the local ointment etc., in such cases consult your doctor.
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