A non-randomized clinical trial to assess the effectiveness of dysentery co bowel nosode in patients with irritable bowel syndrome by utilizing irritable bowel syndrome symptoms severity score.

5.

INTRODUCTION**:**

|5.1

RATIONALE OF THE STUDY:

|Homeopathy is scientific holistic system of medicine. Homeopathic medicine can be prepared from different sources of medicine, also prepared from nosodes. In homoeopathic pharmacy there is described techniques for preparation of medicine from nosodes, sarcodes etc.- (5)

The Bowel nosodes provides details of the origin, biochemistry of bowel organism and indication for their use in disease. Although dysentery co bowel nosode is used in homeopathy practice, there is limited scientific evidence supporting it’s effectiveness specifically in irritable bowel syndrome. - (6)

Bowel nosodes represent an important yet relatively underutilized group of homeopathic medicines derived from intestinal bacterial cultures. With the growing understanding of the gut-brain axis and the role of intestinal flora in chronic diseases, it becomes essential to explore their clinical significance. Chronic ailments such as irritable bowel syndrome (IBS), skin disorders, rheumatism, and allergic manifestations often show resistance to well-selected remedies until an underlying intestinal dysbiosis is corrected. – (7)

The bowel nosodes, by virtue of their origin and action, help restore intestinal balance and improve the body’s resistance to recurrent infections. Studying these nosodes also bridges the gap between classical homeopathic philosophy and modern microbiological understanding. – (7)

This study aims to evaluating clinical effectiveness of dysentery co in patient with irritable bowel syndrome.

|5.2.

RELEVANT EPIDEMIOLOGICAL DATA:

|One study in the USA using first occurrence of IBS symptoms within the community estimated the incidence of new IBS by conducting two population cohort surveys 1 year apart. Of patients with no IBS symptoms and no diagnosis of IBS in the baseline survey, 9% had developed symptoms over the year, an incidence rate of 67 per 1,000 person-years. Studies that opt for defining cases as first diagnosis by a physician produce more conservative estimates of around two per 1,000 person years.(8)

In most populations, women report more IBS symptoms than men, irrespective of the diagnostic criteria employed. Rates in women are approximately 1.5- to 3-fold higher than those seen in men. Internationally, the overall prevalence of IBS in women is 67% higher than in men. (8)

|6.

REVIEW OF LITERATURE:

|INCLUDES RECENT RESEARCH STUDIES RELEVANT TO THE PRESENT STUDY:

Lajjun Nahar (2019) compared the effectiveness of Dysentery Co with individual homeopathic medicines and found both to have a similar effect.

Chaphekar and Sharma (2025) evaluated Bacillus Morgan bowel nosode in IBS and reported a notable reduction in symptoms and improved quality of life.

Aakash Deep Das et al. (2023) assessed the efficacy of individual homeopathic medicines in IBS using the IBS-SSS scale.

Yoko J. Alten (2018) studied homeopathic bowel nosode remedies for dysbiosis.

PRESENT KNOWLEDGE GAP FOR THE STATED PROBLEM:

Lajjun Nahar (2019) compared the effectiveness of Dysentery Co with individual homeopathic medicines and found both to have a similar effect; however, the study did not utilize a standardized assessment tool such as the IBS Symptom Severity Score (IBS-SSS) to measure improvement.

Chaphekar and Sharma (2025) evaluated Bacillus Morgan bowel nosode in IBS and reported a notable reduction in symptoms and improved quality of life, yet the study did not explore the role of Dysentery Co bowel nosode.

Aakash Deep Das et al. (2023) assessed the efficacy of individual homeopathic medicines in IBS using the IBS-SSS scale, showing subjective relief, but bowel nosodes were not included in the intervention.

Yoko J. Alten (2018) studied homeopathic bowel nosode remedies for dysbiosis, demonstrating improvement without harmful effects, though no specific indication was made for IBS or Dysentery Co nosode.

JUSTIFIES RESERCH QUESTIONS:

• Does dysentery co bowel nosode improve symptoms in patient with irritable bowel syndrome?

Irritable Bowel Syndrome is a chronic functional disorder that causes significant discomfort and affects daily activities. Although Dysentery Co bowel nosode is clinically used by many practitioners in cases of IBS, there is insufficient documented evidence to confirm its therapeutic effectiveness. Therefore, it becomes essential to evaluate whether Dysentery Co actually produces measurable improvement in IBS symptoms using a standardized assessment tool such as IBS-SSS.

• Is there any difference in response of dysentery co. among different IBS types?

IBS presents in different subtypes (IBS-D, IBS-C, IBS-M), and the clinical response may vary in each type. Assessing whether Dysentery Co shows different levels of effectiveness among these subtypes will help in understanding its specific scope and indications more accurately. Thus, these research questions are justified as they will provide evidence-based clarity regarding the role of Dysentery Co in the management of IBS. IRRITABLE BOWEL SYNDROME:

DEFINITION: It is functional bowel disorder characterized by abdominal pain or discomfort and altered bowel habits in the absence of detectable structural abnormality. - (9)

PATHOPHYSIOLOGY : poorly understood , although roles of .-(9)

• Abnormal gut motor and sensory activity.
• Visceral hypersensitivity.
• Central neural dysregulation.
• Abnormal psychological features.
• Postinfectious IBS.
• Immune activation and mucosal inflammation.
• Altered gut flora.
• Abnormal serotonin pathways.

CLINICAL FEATURES: - (9)

Affect all ages

Key symptoms -pain, abdominal discomfort.

• Altered bowel habits
• Gas and flatulence.
• Dyspepsia.
• Heartburn.
• Nausea and vomiting.

TYPES OF IBS: - (9)

1. IBS -D: Diarrhoea predominant.
2. IBS -C: Constipation predominant.
3. IBS -M: Mixed, switch between IBS -D & IBS-C over 1 year.
4. IBS -U: IBS Unclassified.

SPECTRUM OF SEVERITY IN IBS : - (9)

Clinical features

Mild

Moderate

Sever

|Prevalence

70%

25%

5%

|Correlation with gut physiology

+++

++

|Symptoms constant

0

+++

|Psychosocial difficulties

0

+++

|Health care issues

++

+++

|Practice type

Primary

Speciality

Referral

IBS SUBTYPES: (10)

• Type 1: separate hard lumps, like nuts (hard to pass stool).
• Type 2: sausage shaped but lumpy.
• Type 3: like a sausage but with cracked on the surface.
• Type 4: like a sausage or snake, smooth and soft.
• Type 5: soft blobs with clear cut edges.
• Type 6: fluffy pieces with ragged edges, a mushy stool.
• Type 7: watery, no solid pieces, entirely liquid.

DIAGNOSIS: - (10)

No clear diagnostic maker exists for IBS; this diagnosis is based on clinical presentation.

Rome IV criteria for irritable bowel syndrome:

Recurrent abdominal pain or discomfort at least 1 days per week in the last 3 months associated with two or more of the following criteria:

• Related to defecation.
• Associated with change in frequency of stool.
• Associated with change in form (appearance) of stool.

Patient should have do investigation for rule out other pathology.

• Complete blood count.
• Sigmoidoscopic examination.
• Stool specimen examination.
• Contrast barium.
• Colonoscopy.
• Lactose deficiency.
• Esophagogastroduodenoscopy.

BOWEL NOSODES

Medicines prepared from cultures of non lactose fermenting bacterial flora of the intestinal tract are called intestinal Bowel Nosodes. They are not the morbid product of disease, but they are classified under nosodes.(11)

B. coli in the intestinal tract performs normal & useful function when the intestinal mucosa is healthy, but any change in the host that affects the intestinal mucosa will affect the balance, and change the biochemistry of B. coli. It should be noted that the primary change i.e. the disease, originated in the host which compels the bacilli to modify in order to survive.(11)

These nosodes are used in the treatment of chronic diseases associated with intestinal dysbiosis and autointoxication, where conventional remedies show limited response. The preparation of bowel nosodes follows the principles of potentization as per the Homeopathic Pharmacopoeia standards. (11)

INDICATION FOR THE USE OF BOWEL NOSODE.

During case taking, great attention should be given to the past as well as the presenting complaint.(11)

Bowel nosodes are deep acting remedies so the case taking must cover the totality of symptoms. The nosode should be administered in the same manner as any Homoeopathic remedy, they should not be given empirically but only on Homoeopathic principles.(11)

DOSE, POTENCY AND REPITATION.

As usual in Homoeopathy, the more obvious the mental picture, the higher the potency, but lower the potency if marked pathological symptoms are present. But between these two extremes use the 30th potency—when there is a combination of acute and chronic state, for example, in chronic bronchopneumonia –(11)

Proteus acts best in high potency

Gartner will not work in low potency

According to Paterson do not repeat a bowel nosode within three months, instead prescribe the homoeopathically indicated similimum from the group of remedies (previously given) related to the bowel nosode.(11)

HOW IT’S WORK.

After the administration of the suitable nosode, the curative process begins, the non lactose fermenting bacteria begin to mutate to other groups and ultimately disappear, these happenings occur simultaneously with the disappearance of the symptom, reappearance of the old symptoms and the efflorescence of the skin eruptions with ultimate clearing (Hering’s Law). This is associated with a marked increase in the vitality of the patient.(11)

The bacilli change with the patient. This mutation of the non lactose fermenting bacteria back to normal coli has been demonstrated in the laboratory.(11)

DYSENTERY CO BOWEL NOSODE

D - Duodenal ulcer: From tension. (12)

Y - Yielding discharge. - (12)

S - Stranger’s tension (anticipatory tension). – (12)

C - Chorea and congenital pyloric stenosis in children. -(12)

O - Over cardiac area: Anticipatory discomfort. - (12)

Mental Essence (Summary) of Dysenteriae compound: Anticipatory tension, tension and tension! These people are OVERCONSCIENTIOUS - they allow themselves to become over-burdened, which leads to impatience and hurriedness. This tension and anxiety show on their faces.

They lose the power to be able to relax and so are constantly restless and fidgety, going from place to place, wanting to go out and then wanting to come home again soon after. Lacking in self-confidence, they are HYPERSENSITIVE to criticism, being shy and uneasy in the company of strangers. Worrying about incidentals. This tension and anticipation is felt in the stomach and heart areas. Excitement can bring on a headache, and long-term nervous tension can result in a duodenal ulcer, palpitations and functional disturbance of heart. - (12)

Physical Essence:

Digestive System: B. Dysenteriae has been shown to have selective action on the pylorus causing spasm and retention of digested contents; dilation of stomach; wakened at 12 midnight to 1 a.m. with acute pain in stomach, relieved by vomiting of a large quantity of mucous material. - (13)

In some children, diagnosed as suffering from congenital pyloric stenosis considerable success has followed the use of Dysentery. co. (Bach), which would suggest that in these cases the condition had been due to pyloric spasm rather than to congenital malformation of the pylorus. - (13)

Duodenal ulcer often calls for the use of the nosode Dysentery co. (Bach) but there must always preceds the physical symptom and which the patient feels the refers to his "stomach and heart area". This is in contrast to the type of duodenal ulcer found associated with B. Proteus, where the nerve tension is insidious in action, unpreceived by the patient, and the physical condition of the ulcer-tends to come on as a "crisis" without previous warning. - (13)