Homeopathic treatment of chronic non-steatotic diarrhea after total or partial pancreatectomy. Development and use of a prescription aid algorithm for diarrhea in oncology

Context: Diarrhea is very often encountered in cases of pancreatic cancer, whether episodically after certain chemotherapy treatments or chronically after surgery. It can reduce quality of life, lead to weight loss, and hinder the progress of chemotherapy. Free from significant side effects and adverse drug interactions, homeopathy is the most widely used complementary medicine in integrative oncology in Europe. There is not “one” specific homeopathic medicine for treating diarrhea, but several candidate medicines. How can we determine which one will be the most effective? Methodology: The authors studied the pathophysiology of diarrhea following pancreatectomy, identified the symptoms present in all patients, compiled an electronic inventory, selected candidate medicines, analyzed their materia medica, and put together a decision algorithm. Findings: The symptoms identified were as follows: the pressing need to have a bowel movement, intestinal rumbling, the predominance of diarrhea during the day, its onset after eating or drinking, and weight loss. Croton tiglium, Podophyllum, Aloe socotrina, Natrum sulfuricum, Arsenicum album, and Phosphorus were among the six main medicines. A total of sixteen medicines were analyzed and then integrated into an algorithm to be used as a decision-making aid. Conclusion: There is no “standard” treatment for diarrhea in oncology. Homeopathy, to be effective, must be personalized. It must comply with the usual rules of similarity, individualization, and infinitesimality. By consulting the decision algorithm, prescribers can be quickly directed toward one or more possible medicines. If necessary, the materia medica can help determine the best course of treatment. This algorithm now needs to be tested and validated through practical application and clinical trials.