Encopresis
The patient is an 8 year old boy, pretty tall and lean, with pale skin. He looks older than he is. He is the only child in his family. He speaks very sophisticatedly and often corrects his mother. His speech shows his high intellect. He complains of encopresis, constipation and frequent acute respiratory viral infections.
His case as given by his mother, July 7, 2008
“The main problem is his constipation. Actually it is not just constipation. He also has encopresis, in other words when he has desire for stool after a constipation - he cannot control himself and he soils his underpants. The problem started when he entered elementary school (when he was seven years old).
He also had frequent acute respiratory viral infections. Due to the past history of bronchitis he has taken antibiotics very often.
My pregnancy and delivery were normal. His birth weight was 3kg 600g, and ht. was 52 cm. Childhood development history is without complication. He was toilet trained by 3 years of age and did not have any problem with his bowels until seven y.o.
He also has a past history of bruxism (grates teeth).
He received all of the immunizations that were required by seven y.o. and he did not have any health problems after them.
In the last year he did not receive any shots due to our choice.
He completed his 2nd grade with excellent marks, but I had to make him do his homework all the time. He is very smart but at the same time very lazy and demanding and he often complains to me. He tends to argue and never obeys easily .
He does not have friends at school because he has his own point of view and he does not want to yield.
Another reason that he has no friends is that he only wants to be friend with the two best students in his class, but they do not want it. He does not want to play with other regular students”.
During my conversation with mother the boy interrupted us: “I am not very excited about going to the sea side with my family. I won’t stay in the small humble hotel with cockroaches. I want to stay in a luxury hotel, and refuse to go unless my parents provide me with what I want”.
Mother: “He already starts growing hair in his armpits and he smells like an adult man”. The boy interrupts us again and says:”I prefer to have a woman as a doctor”. When I ask why - he just smiles and does not want to explain. I ask his mother when he was out of the room if she ever saw him play with his genitals. She says “No, but I guess it is possible. Sometimes he locks the door of the bathroom and stays there for a long time.
Also he has a fear of ghosts and due to that he sleeps in my bed. Every night he gets nightmares.
He likes to play computer games and sometimes plays them for 4 hours or more.
His face is always pale even though he is not anemic”.
He can tolerate hot and cold weather pretty well. I can not find out anything specific about his thirst.
Initial Assessment:
For me it was obvious that the center of pathology was in his mind and nervous system. The gastroenterologist recommended to put him in a hospital for an investigation. He thought that the boy may have a malformation of the rectum. I proposed a homeopathic remedy for him and wait at least for two weeks.
The boy was smart but at the same time had a lot of troubles with his mind. He was very haughty, stubborn and disobedient, tends to oppose and argues a lot. He was unable to keep good relations with others and does not have a friend. He has nightmares every night, and a fear of ghosts.
In my opinion he was also precocious both mentally and sexually.
I did not think that he has malformation of the rectum because he did not have any problem with his stool before 7 years of age.
Thus, the homeopathic treatment was the best choice for him and gave him a chance to avoid an invasive investigation procedure.
The remedies seriously considered based on this Repertorization were Hyoscyamus, Lachesis and Lycopodium.
Hyoscyamus covers all the rubrics that were presented in the case: involuntary stool (for 3 marks), constipation, pale face and all mental symptoms. At the same time Hyoscyamus corresponds to central theme of the case: on the one hand a highly and premature developed intellect and on the other hand an imbalance of the mind and nervous system.
Also Hyoscyamus is one of our most important remedies for behavior disorders of children and for sexual precocity.
His often acute respiratory infections were also covered by Hyosciamus, in rubric “Chest, Inflammation, Bronchial tubes, bronchitis” Hyosc listed in italic type.
I thought Hyoscyamus is a strongest choice for this boy.
Lachesis was another remedy that came to my mind in relation to his behavior problem and precocity. Also Lachesis patients are often very smart and at the same time lazy and may have a bunch of problems with peers. But Lachesis was not listed in the rubrics “Mind, Dreams, nightmare” and “Mind, Fear; general; ghosts, of”. Lachesis more typically is associated with fear of snakes, fear of being poisoned or fear of heart attack.
Another point was that in spite of the fact that Lachesis also covers the rubric “Inflammation, bronchial tubes” in italic type, I expected to see some problems with the throat. Pain and inflammation in throat as well as pharyngitis, tonsillitis and a choking sensation are striking traits of the remedy. But that was not presented in the case.
There are still many similarities to the case and it is my second choice remedy.
Lycopodium matches up with part of his mental symptoms: obstinacy, a tendency to argue and contradict and a high intellect. Also constipation is a very common symptom of Lyco. Lyco patients can be full of fears including a fear of ghost and nightmares. The desire to sleep in his mother’s bed as well indicates his desire to be protected by his mother and that is very close to Lyco. But Lyco does not cover two very important rubrics: involuntary stool and sexual precocity. I guess it is too superficial remedy for the case and could not treat the case deeply.
Based on my evaluation Hyoscyamus was selected.
I gave it in 200C potency. I usually give to children 30C after the first consultation if the disease is more physical in nature and 200C if the pathology goes more deeply in mind or nervous system.
Follow up – August 22, 2008.
He took a single dose on July 7, 2008.
His mother reports: “He did not have encopresis during all this time except one day when he ate bad food in the country house and got diarrhea due to this.
He has a bowel movement every day, now he does not have any constipation.
The gastroenterologist was happy about this because now he does not recommend that I put him into the hospital for investigation!
He prescribed Maalox and Cholenzim (Bile+pancreas&jejunum mucosa powder). His diagnosis was “Biliary dyskinesia and dysfunction of intestinal tract”.
The boy got coryza with white-yellowish mucus during 10 days only in the morning. Now it has stopped.
He is still stubborn and disobedient. I tried to limit his computer games and he seems ok with it.
He does not have nightmares now and has started to sleep alone”.
My assessment based on this information was that the Hyoscyamus was acting.
His deepest and miasmatically syphilitic symptom – encopresis – has gone.
He got coryza that I think was a sign of elimination. Before he used to get acute respiratory viral infections and bronchitis that were suppressed with antibiotics. In Kent’s Lectures on Homeopathic Philosophy written that if some discharges were suppressed they should come again after right remedy.
His mental state also improved: he does not have nightmare and started to sleep alone. He agreed to cut time of his computer game, not with pleasure, but without arguing a lot as before.
He has bowel movement every day, it indicates that his intestinal tract now acting well and I do not see a necessity to give him another allopathic medicines.
Although he is still stubborn and disobedient I did not expect that his personality will change completely and he becomes mild and submissive after the remedy. I think he slowly comes to the state of compensation and can communicate with peers and parents better.
I felt the action of the remedy was in progress and now better wait and watch. No remedy was given and follow-up was scheduled.
Follow up – September 29, 2008.
His mother reports:
“He has stool almost every day. One or two times during a week he has constipations but there was no encopresis.
He continued to sleep alone in his room and had a sound sleep.
He plays his computer game just a little because there is a lot of homework at school. He starts taking ballroom dances classes.
He is lazy and does not complete his homework without being pushed. But now he agreed to do it easily and he does not argue as much as before.
He still does not have a friend at school.
Cold season in Moscow starts and I am anxious that he may catch cold or get acute respiratory viral infections as before.”
My assessment was that his condition is improved further.
Although he had constipation 1 or 2 times per week his mental state becomes better: he continued to sleep alone, had a sound sleep, he did not argue a lot with his mother as he used to do. He starts taking ballroom dances classes and it was no problem with his behavior during them. His main problem , encopresis, was not there.
So I decided wait and watch. I said mother that she can contact me by phone if he gets cold or bronchitis.
Follow up – November 11, 2008.
His mother reports:
“He got cough with rale and coryza for last 3 days. Physician prescribed antibiotics and Salbutamol to relieve his breathing.
There was no encopresis. He got constipations every 2 days. He sleeps alone and has a sound sleep without bad dreams.
During last 2 weeks he became more lazy and obstinate and it takes a lot of time for me to convince him to do his homework.
His armpits already become hairy”.
My assessment was that the case had relapsed and another dose of remedy should be given.
I did not try to find acute remedy for bronchitis because it was part of his constitution’s pattern. He had this problem before many times and it was not something new for him. At the same time his mental symptoms also match Hyoscyamus well: he is smart, stubborn, tends to argue and oppose. Sexual precocity is also there.
I repeated the same remedy in the same potency.
He took Hyoscyamus 200C on November 11, 2008.
Follow up – December 15, 2008.
His mother reports:
“He recovered from his bronchitis in 5 days without taking antibiotics and Salbutamol.
He had bowel movement every day and there was no encopresis.
His relations at school become better. He got one friend and he is very eager to play with him.
His sleep is good as well.
He become more disciplined now and can do his homework by himself (but not every time, sometimes I still should remind him).
He does not play his computer game as much as before, no more than one hour.
He continues to taking his ballroom dances classes and he likes it a lot”.
My understanding of follow-up was that remedy was acting well.
His life becomes better in general. He got a friend; there were no more problems with peers at school and he enjoys his ballroom dances.
Now he does not have a problem with his stool at all. His sleep was also completely normal. He became more disciplined.
His bronchitis has gone without allopathic treatment.
No action was taken.
Follow up – January 19, 2009.
His mother reports:
“He is doing great. There was no problem with his health during last month: no cough, no coryza. I am so happy that this problem with encopresis and constipation is resolved. I was ashamed of it and can not say about this problem to anyone. Also I used to be very anxious about this problem. He does not have this encopresis from the moment when we started homeopathic treatment. I can hardly believe that homeopathy can do this!
His behavior now became better; he plays with his friend a lot. He is enjoying his ballroom dances.
He does not have any fear or nightmare now. He sleeps in his own bed.
He still kind of stubborn, not very exited about his homework, but he mostly does it by himself”.
My assessment was that he has continued well over the past two month.
He does not have any physical complains. His mental state is much better now and it is stable.
No remedy was given.
Conclusion:
Before receiving homeopathic treatment this boy had a lot of serious problems: encopresis, constipation and frequent acute respiratory viral infections. He also had nightmares, fears of ghosts, problems with peers and his mother; he was obsessed with computer games. Actually, when they came for first consultation, his mother did not consider homeopathy as an alternative to allopatic treatment in a hospital; she did not think that it is strong enough to treat such problems. After homeopathic treatment she realized how deeply homeopathy can work. His encopresis and constipation gone, he does not have nightmares and fear of ghosts any more, he starts sleeping in his own bed, has found one friend. When he got bronchitis it was effectively treated with constitutional remedy without taking antibiotics.