People with the tendency of hyperacidity possibly have some link with psychology either external, internal, or both. The basic nature of the person or his reaction to the external stimuli reflects in the form of hyperacidity in many cases. Studies found that psychosocial stress is associated with the exacerbation of symptoms in several functional disorders of the gastrointestinal (GI) tract.[1],[2] Heartburn and acidity are common symptoms of many gastrointestinal disorders. Gastroesophageal reflux disease (GERD) is one of the most common conditions with heartburn and hyperacidity. There is a multifaceted interaction between GERD, patient-perceived symptoms, and psycho-emotional states. Shreds of evidence exist on the effects of stress on oesophageal and stomach function. GERD may cause anxiety and depressive symptoms.[3] Psychological comorbidity is also very common with these conditions.[4] Homoeopathy has drugs based on the individualistic nature of the mental condition or manifestation. Documentation of mental symptoms had started since the birth of homoeopathy, from proving to philosophy to the repertory. With the help of repertory, these drugs are utilized effectively in clinical practice. Many main rubrics of main symptoms are with specific individualistic sub-rubrics so that more individualization can be achieved. This article focuses on how the cases of hyperacidity can be approached using psychosomatic analysis.
Major components used in eliciting the mental symptoms
During the case taking, importance needs to be given to certain components of the mental nature of the patient after recording the detailed history of presenting complaints, past, personal and family history, and physical generals. This will help to individualize the case in a deeper manner. After that, identifying and selecting prominent rubrics have a significant role in the success of an effective treatment plan. This further leads to repertorization with these rubrics giving the right weightage (intensity). This will throw all the polychrests at the top. However, the secret lies in how you choose the right similimum by avoiding those pseudo top remedies. Most of the time, additional analysis of concepts, families and expert systems (e.g. Vithoulkas Expert System) will throw light on this. Below some of the components to elicit the mental nature of the patient is given.
Figure 1: Process of approach to hyperacidity including mental symptoms
Fears: Discussing with the patients about the fears will be helpful to find any specific phobia they have. This will further lead to questions like who would be their reaction to such a situation, any after effect of getting sudden fears, etc.
Extrovert/introvert: This will give us the clue to choose rubrics like loquacity, introspective, absorbed, etc. It will also help to identify the temperament of the patient. Usually extroverts will fall under choleric and sanguine temperaments.
Concentration: How good the person is in focus on a work, study, etc? This will help to select a rubrics and subrubrics related to concentration. Kent Repertory has 15 rubrics under concentration.
Memory: Cognitive level of the individual can be assessed from this point. Further, leading questions will help us to find is there any specific type of memory issues the person has? For example, some people tend to forget the names and others some words.
Thinker/doer/watcher: This will help us to learn the type of personality and will lead to the essential rubric. Usually thinkers fall under melancholic, doers fall under choleric and watchers fall under phlegmatic temperaments.
Delay/procrastination/laziness: This will help us to find the personality, temperament and to choose rubric. Laziness is a rubric which can be for all these types of habits and personalities.
Perfection quotient: There are drugs specifically for the perfect people like the Arsenicum album. People suffering from obsessive-compulsive disorders have high perfection quotient.
Optimist/pessimist: Choleric and sanguine temperament personalities are optimists. Nervous, melancholic, and phlegmatic temperament people are pessimists.
Likes outing/no: Patients of Calcarea phosphorica, Hippomanes, Iodium and Tuberculinum would more like to go out. Enquiring this will also bring other symptoms like travel sickness and other modalities.
Emotional quotient: How emotional a person is helpful to determine the personality like Pulsatilla. Melancholic temperament people are of more emotional.
Anger quotient: There are many remedies and rubrics on anger, this component will help in selection of remedy.
Remedies for hyperacidity based on the mental nature of the patient
Agaricus muscarius: Mostly indicated to individuals sing, talk, but do not answer. Inclination to make verses & poems and to prophesy. Embraces companions and kisses their hands; alternately with vexation. Hunger, with want of appetite. After a meal, pressure in the stomach and the abdomen, with fullness. Very drowsy after dinner. Eructation, with the taste of the food that has been taken. Frequent empty eructation; or with the taste of apples; or with the taste of rotten eggs. Inclination to vomit immediately after a meal.
Ambra grisea: It is mainly indicated to children, especially young girls who are excitable, nervous and weak. Nervous affections of old people, nerves are worn out. Suited to lean, thin, emaciated persons who take cold easily. Eructation, with violent, convulsive cough. Acid eructation, like heartburn. Distention of stomach and abdomen after midnight. Sensation of burning in the stomach and in the precordial region. Heartburn from drinking milk.
Anacardium orientale: It is suitable to individual having hypochondriacal sadness, and melancholy ideas. Anxiety, apprehension, and fear of approaching death. Fear and mistrust of the future, with discouragement and despair. Fixed ideas that he is double; that there is no reality in anything, all appears like a dream; that a stranger is constantly by his side. In the evening, water-brash and vomiting, followed by acidity in the mouth. Pressure in the stomach, chiefly after a meal, as well as when engaged in thought and mental exertion. Eating relieves the Anacardium dyspepsia.
Argentum nitricum: Very impulsive; always in a hurry but accomplishes nothing; in continual motion; he walks fast. Hurries restlessly to fulfil engagements, fears to be late when there is plenty of time. Nightly nervousness, with heat and fullness in the head. Nervous, faintish, and tremulous sensation. Gastralgia, esp. in delicate, nervous women; brought on by any emotion, loss of sleep, or at menstrual period. Most gastric complaints are accompanied by violent belching. Eructation of air accompanied by a mouthful of undigested food. Flatulent dyspepsia with belching after every meal; stomach, as if it would burst with wind; belching difficult, finally air rushes out with great violence.
Arnica montana: It is suited to people with lively expression and very red face. Over-excitement and excessive moral sensibility. Great sensitiveness of the mind with anxiety and restlessness. Frequent eructation, esp. in the morning, empty, bitter, putrid, as from rotten eggs. Rising of a bitter mucus or of salt water. Nausea, with inclination to vomit, chiefly in the morning. Pressure, fullness, contraction, and cramp-like pain in the stomach and in the precordial region. Feeling as if stomach were passing against spine.
Arsencium album: It is well suited to nervous anxious, restless individual. Anxiety, restlessness, and excessive anguish which allows no rest, principally in the evening in bed, or in the morning on waking, and often with trembling, cold sweat, oppression of the chest, difficulty of breathing, and fainting fits. Frequent eructation, particularly after having drunk or eaten, mostly empty, acid, or bitter. Regurgitation of acrid matter, or of bitter greenish mucus. Cannot bear the sight or smell of food. Great thirst; drinks much, but little at a time. Ill effects of vegetable diet, melons, and watery fruits generally.
Aurum metallicum: It is suited toMelancholy, with in quietude and desire to die, ruddy people, with black hair and eyes. Foul breath in girls at puberty. Ailments from fright, anger, contradictions, mortification, vexation, dread, or reserved displeasure. Burning at stomach and hot eructation. Pain in the stomach, as if proceeding from hunger. Sensation of indescribable uneasiness in the epigastrium. Uneasy, hurried, great desire for mental and physical activity; cannot do things fast enough
Belladonna: Persons who are lively and entertaining when well, but violent and often delirious when sick. Women and children with light hair and blue eyes, find complexion, delicate skin. Patient lives in a world of his own, engrossed by spectres and visions and oblivious to surrounding realities. Frequent risings, often bitter, or putrid, or sour and burning. Nausea and inclination to vomit, chiefly on beginning to eat, or in the open air, or after breakfast, sometimes with burning thirst.
Bryonia alba: It is best adapted to persons of gouty or rheumatic diathesis; prone to so- called bilious attacks. Patients are irritable, inclined to be vehement and angry; dark or black hair, dark complexion, firm muscular fibre; dry, nervous, slender people. Regurgitation if the food after every meal. Eructation especially after having eaten, mostly bitter or sour, with a taste of the food. Vomiting in general of what has been eaten, which comes up very soon after eating, of food in mouthfuls at a time. Vomiting of food, with hiccough and retching, or vomiting of bitter water, or of bile, even at night. Inflammation of the stomach.
Calcarea carbonica: It is suited to leucophlegmatic, blond hair, light complexion, blue eyes, fair skin; tendency to obesity in youth. Disposed to grow fat, corpulent, unwieldly. Head sweats profusely while sleeping, wetting pillow far around. Acidity of digestive tract; sour eructation, sour vomiting, sour stool; sour odor of the whole body. Aversion to meat, boiled things; craving for indigestible things-chalk, coal, pencils; also for eggs, salt and sweets. Loss of appetite when overworked.
Calcarea phosphorica: Great hunger with thirst flatulence temporarily relieved by sour eructation. Heartburn. Easy vomiting in children. At every attempt to eat, colicky pain in abdomen. After belching, a burning in epigastrium.
Causticum: Melancholy and vexatious thoughts, day and night, with tears. Mirthfulness sometimes, and soon after, ill-humour. Irascibility and passion, with great sensitiveness of disposition. Empty eructation, with a taste of undigested food.Feels as if lime were burned in stomach. Worse after eating fresh meat; smoked meat agrees. Sensation of ball rising in throat. Acid dyspepsia.
Cinchona officinalis: It is stout, swarthy persons; for systems, once robust, which have become debilitated, “broken down” from exhausting discharges. Regurgitation esp. after a meal, mostly bitter, acid, or tasteless. Vomiting of acidulated slimy matter, of water and of food. Sensation of excoriation and pressure on the epigastrium, esp. in the morning. Excessive flatulence of stomach and bowels; fermentation, borborygmus, belching gives no relief and worse after eating fruit.
Gelsemium: It is well suited to nervous person. The anticipation of any unusual ordeal, preparing for church, theatre, or to meet an engagement, brings on diarrhoea; stage fright, nervous dread of appearing in public. Excitable, irritable, sensitive; for the nervous affections of onanists of both sexes. Increased appetite easily satisfied with small quantities of food. Sour eructation. Burning in the stomach extending to the mouth.
Graphites: Suited to women, inclined to obesity, who suffer from habitual constipation; with a history of delayed menstruation. Excessive cautiousness; timid; hesitates; unable to decide about anything. Sour risings, with bitterness in the mouth. Retching, with rising up of mucus. Water-brash, at night. Burning pain in the stomach, which compels eating.
Hyoscyamus: Persons of irritable, nervous, hysterical. Hiccough, eructations empty, bitter vomiting, with convulsions; haematemesis; violent cramps, relieved by vomiting; burning in stomach; epigastrium tender. It is indicated for Toxic gastritis.
Ignitia amara: Taciturn, with continuous sad thoughts; still, serious melancholy, with moaning. Ill effects, from bad news; from vexation with reserved displeasure; from suppressed mental sufferings; of shame and mortification. Sour eructation. All gone feeling in stomach; much flatulence. Cramps in stomach; worse slightest contact. Averse to ordinary diet; longs for great variety of indigestible articles. Craving for acid things. Sinking in stomach, relieved by taking a deep breath.
Lycopodium: Silent, melancholy, and peevish humour; despair of eternal salvation. Sadness when hearing distant music. Anguish, esp. in region of epigastrium, with melancholy and disposition to weep; esp. after a fit of anger, or on the approach of other persons. Fatigue from intellectual exertion, and incapability of devotion to mental labour. Inability to express oneself correctly; misapplication of words and syllables. Dyspepsia due to farinaceous and fermentable food, cabbage, beans, etc. Excessive hunger. Aversion to bread, etc. Desire for sweet things. Everything tastes sour; eructation, heartburn, water brash, sour vomiting.
Magnesium carbonicum: Sad mood with indisposition to talk. Anxious and warm through whole body esp. in head, while eating warm food. Regurgitation of green, watery, frothy, like a frog-pond’s scum. Milk passes undigested in nursing children. Sour, with tenesmus.
Mercurius solubilis: Best adapted for light-haired persons; skin and muscles lax. Great anguish, restlessness, and agitation, with fear of losing the reason, or with excessive internal torment, principally in evening, or in bed at night, as if conscious of having committed some crime. Great indifference to everything. Does not even care to eat.
Natrum muriaticum: Melancholy sadness, which induces a constant recurrence to unpleasant recollections, and much weeping. Indifference, laconic speech, moroseness, and unfitness for labour. Heartburn, with palpitation. Unquenchable thirst. Sweats while eating. Aversion to bread, to anything slimy, like oysters, fats. Acid and acrid risings, sometimes with taste of food. Water brash, with revolving sensation in stomach, sometimes followed by a sour vomiting of food.
Nux vomica: It is chiefly successful with persons of an ardent character; of an irritable, impatient temperament, disposed to anger, spite or deception. Well indicated to persons who are very particular, careful, but inclined to become easily excited or angered; irascible and tenacious. Bad effects of: coffee, tobacco, alcoholic stimulants; highly spiced or seasoned food; over-eating; long continued mental over- exertion; sedentary habits; loss of sleep; aromatic or patent medicines; sitting on cold stones; specially in warm weather. Eructation taste sour, bitter, nausea and vomiting every morning with depression of spirits. Weight and pain in stomach; worse, eating, and sometime after. Epigastrium bloated, with pressure s of a stone, several hours after eating. Loves fats and tolerates them well. Dyspepsia from drinking strong coffee. Difficult belching of gas.
Phosphorus: Adapted to tall slender persons of sanguine temperament, fair skin, delicate eyelashes, find blond, or red hair, quick perceptions, and very sensitive nature. Sour taste and sour eructation after every meal. Belching large quantities of wind, after eating. Throws up ingesta by the mouthfuls. Inflammation of stomach, with burning extending to throat and bowels.
Platina: Sadness, esp. in evening, with strong inclination to weep often. Involuntary inclination to whistle and sing. Thinks she stands alone in the world. Anxieties precordium to an excessive degree, with great fear of death, which is believed to be very near, accompanied by trembling, palpitation of heart, and obstructed respiration. Ineffectual effort to eructate. Serum of a disagreeable sweetish bitterness ascends throat, and puts patient in danger of choking.
Pulsatilla: Adapted to persons of indecisive, slow, phelgmatic temperament; sandy hair, blue eyes, pale face, easily moved to laughter or tears; affectionate, mild, gentle, timid, yielding disposition. Weeps easily almost impossible to detail her ailments without weeping. Averse to fat food, warm food, and drink. Eructation taste of food remains a long time; after ices, fruits, pasty. Bitter taste, diminished taste of all food. Dyspepsia, with great tightness after a meal; must loosen clothing. Thirstlessness, with nearly all complaints.
Sepia: Adapted to persons of dark hair, rigid fibre, but mild and easy disposition. Everything tastes too salty. Acid dyspepsia with bloated abdomen, sour eructation. Liver sore and painful; relieved by lying on right side. Tongue foul, but becomes clear at each menstrual nisus, returns when flow ceases; swelling and cracking of lower lip.
Silicea: It is well suited to yielding, faint-hearted, anxious, nervous and excited individual. Sour eructation after eating. Eructation with taste of food, sometimes after every meal. Water-brash, sometimes with shuddering. Imperfect assimilation and consequent defective nutrition. Ill effects of vaccination.
Final word
Stress-induced acidity, acid reflux, heartburn or dyspepsia can well be managed by homeopathic treatment. Its success rate is high provided that the patient complies with the treatment and other regimens diligently.
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References
[1] Naliboff, Bruce D.; Mayer, Minou; Fass, Ronnie; Fitzgerald, Leah Z.; Chang, Lin; Bolus, Roger; Mayer, Emeran A. (2004). The Effect of Life Stress on Symptoms of Heartburn. Psychosomatic Medicine, 66(3), 426–434. doi:10.1097/01.psy.0000124756.37520.84.
[2] Bennett EJ, Tennant CC, Piesse C, Badcock CA, Kellow JE. Level of chronic life stress predicts clinical outcome in irritable bowel syndrome. Gut 1998;43:256 – 61.
[3] T. Kamolz, V. Velanovich, Psychological and emotional aspects of gastroesophageal reflux disease, Diseases of the Esophagus, Volume 15, Issue 3, 1 November 2002, Pages 199–203, https://doi.org/10.1046/j.1442-2050.2002.00261.x
[4] Mizyed I, Fass SS, Fass R. Review article: gastro-oesophageal reflux disease and psychological comorbidity. Aliment Pharmacol Ther. 2009 Feb 15;29(4):351-8. doi: 10.1111/j.1365-2036.2008.03883.x. Epub 2008 Nov 8. PMID: 19035971.