General Information

Describe about the Naturopathy for Occasional Chest Tightness.

This is the case study related to a Mr G, who had been facing occasional chest tightness. In the last five months this problems has increased. The reason of the visit of the patient is due to the problem of bilateral chest tightness, which is not painful, yet makes the patient very uncomfortable. Chest tightness is observed in the upper region of the chest, however sensations are not radiated. This problem is also accompanied with dyspnoea, which is also called as shortness of breath. According to the case description and personal statement of the patient tightness of chest and shortness of breath occur in the psychologically stressful situations and do not occur when the patient is physically exhausted. Mr G also has the history of seasonal rhinitis in every spring, which is self managed by Loratadine

Assessment

1. Primary Diagnosis

Chest tightness is considered as one of the symptom of anxiety. Due to anxiety many other physical symptoms can arise. Chest tightness could also occur due to asthma, high blood pressure and chronic pulmonary diseases. In the case of Mt. G chest tightness has occurred without any kind of pain. According to the provided case description that patient suffer with chest tightness when he suffer from any kind of stressful situation or psychological distress, which explains that patient suffers from anxiety chest tightness (Kumar, 2015). This kind of problem occurs when people experience anxiety. Problem of anxiety can also have historical connection. Family history of anxiety can increase the problem in patient.

1. Probable underlying cause(s)

There could be many pre-disposing factors underlying the condition of the patient. Anxiety could occur due to various causes. These causes could be multi faceted and complex. Some of the major causes of anxiety are stress, less coping skills, health issues, unbalance nutrition, environmental factors and hormonal factors (Kumar, 2015). Very little could be done about the genetic factors; however naturopathy can be very helpful in reducing anxiety and anxiety related symptoms.

Some of the excitatory factors can also be associated with occurrence of anxiety. Traumatic events can leave people with vulnerability to various mental disorders. There are many infections, which can also result in anxiety. Mr. G has the history of being suffered with seasonal rhinitis in every spring. The severity of the allergies can induce anxiety. According to the study of Postolache et al (2008), allergic diseases are very prevalent and reach to peak in the season of spring. One of the reasons behind the anxiety chest tightness could be the result of the severity of his rhinitis. Sustaining factors are not found in the case of Mr. G.

1. Differential diagnosis

Assessment

Differential diagnosis is the process of distinguishing the particular disease. According to this diagnosis in patient, diagnose to be suffering with anxiety chest tightness associated with Dyspnoea. It is significant symptom of anxiety. Psychologically stressful situations worsen the patient situation and induce shortness of breath, but physical exertion does not induce dyspnoea, which means that psychological distress is the problem for patient.

1. Treatment Objective

There are various kinds of treatment that comes under naturopathy. Some of the types of treatments included in naturopathy are herbal medication, nutrition, acupuncture, Homeopathy and even massages. The main aim of the naturopathy is to avoid medicines and provide an alternative treatment for various diseases. The objective of the treatment would be to provide comfort to patient and ease his discomfort.  There could be specific or relevant time frame for the treatment, as it depends on the response of patient towards treatment.

1. Treatment – Pharmacological

The pharmacological treatment of the Mr.G with naturopathy will be done in two ways. First will be the herbalism and second will the nutritional products.

Herbal Formulae:

The study of Pratte et al (2014) provides a systematic review of the literature for the herbal medication for anxiety disorder and stress. For Mr G the prescribed herbal medication will include Withania somnifera (WS) (botanical name). This herb is also called as “ashwagandha”. It is a ayurvedic her and it is highly used in the ayurvedic treatment of anxiety. Alramadhan et al (2012) states that “WS is categorized as an anti-inflammatory, antioxidant herbal supplement”. The chronic symptoms of stress such as chest tightening and anxiety are efficiently controlled by WS. Dosage of 600mg will be prescribed to the patient for daily medication (Ernst, 2006).

Another herbal formulae used for the patient would be Piper methysticum L.f (Kava). Various randomized control trials and meta analysis have been carried out to find the effectiveness of Kava (Patel & De Sousa, 2013).The herbal medication is very effective in reducing the symptoms and problems associated with anxiety (Teschke, 2010). The prescribed dose could be 60 to 280 mg daily (Chevallier, 2016). Some of the other herbal medications used for the anxiety are Passiflora incarnata L. (Passion flower), Melissa officinalis L. (Lemon balm), Scutellaria lateriflora L. (Skull cap) and Valeriana spp. (Valerian) (DeGrandpre, 2010).

Nutritional Medication:

Natural medications include many natural medicines that do not provide any kind of negative impact on the health. Some of the important nutritional supplements that can be used to treat anxiety are:

Care Plan

Lysine

It is an amino acid, which has been found to influence neurotransmitters which are found to be involved in stress and anxiety(Lakhan, & Vieira, 2010). This supplement can be given from 500 to 1000 mg per day. The expected outcome is to reduce the stress induced chest tightness in patient.

Magnesium

It is considered as the positively charged ion and controls many molecular functions of the human body. It is also beneficial in controlling anxiety related symptoms and disorders. This could be included with the multivitamin treatment that includes calcium and zinc as well. The recommended safe dose for magnesium is 400mg to 1000 mg every day (Lakhan, & Vieira, 2010).

The non-pharmacological treatment of anxiety or any other disease in naturopathy includes improving the diet and lifestyle. The management of this disease requires the treatment that could focus on the prevention of the disease. The daily diet of the patient must include:

For maintaining the level of proteins patient should include fish, soy, nuts, white meats or eggs, or supplement.

The diet should also include fresh fruits and vegetables.

Caffeine, alcohol and caffeinated drinks should be avoided.

Instead of tea and coffee, green tea should be included in diet.

Chamomile tea can also be used for the period of eight weeks to decrease the symptoms of anxiety.

The lifestyle modifications are also required to reduce anxiety and chest tightness.

Regular exercise is very important.

Daily diet should include all healthy food items and food products including fat and cholesterol must be avoided.

Sleep is also very important part to reduce stress and anxiety. To have balanced brain and mood, patient should take long sleep.

Feeling of hopelessness and helplessness should be avoided.

For reducing stress and to cope with psychologically stressful situations, patient should learn relaxation techniques.

Expected Outcomes: The expected outcomes for the patient are to reduce anxiety level, symptoms of anxiety such as, shortness of breath and chest tightness.

Referral Plan: This plan for the patient will include his regular check-up with GP. GP would be able to evaluate the changes in the patient’s condition, and would be able to make changes in treatment plan if required.

Summary

The paper is based on the case study of Mr. G, who has been presented with the problem of chest tightness. He had been facing this problem since last five months. According to the description provided by him, his problem of chest tightness increases during stressful situation, which is also associated with dyspnoea. He does not have such problem during physical exertion. The diagnoses explains that patient suffer from anxiety chest tightness. With the help of this case, I have learnt that personal communication with the patient is very important. Obtaining the subjective data is very important to decide the appropriate treatment plan. Understanding the exact problem can help to develop appropriate strategies and to set appropriate goals.

References

Alramadhan, E., Hanna, M. S., Hanna, M. S., Goldstein, T. G., Avila, S. M., & Weeks, B. S.

(2012). Dietary and botanical anxiolytics. Medical Science Monitor, 18(4), RA40-RA48.

Chevallier, A. (2016). Encyclopedia of herbal medicine. Penguin.

DeGrandpre, M. S. (2010). Botanical Therapeutics: Text Only Version. Lulu. com.

Ernst, E. (2006). Herbal remedies for anxiety–a systematic review of controlled clinical

trials. Phytomedicine, 13(3), 205-208.

Kumar, T. S. (2015). How Anxiety and Depression can affect the Perceptual Process of Human

Life. Exploring Human Values with Nature as a Secure Base and Focussing On Healthy Life with Yoga and Meditation (An Empirical View of Himalayan Region).

Lakhan, S. E., & Vieira, K. F. (2010). Nutritional and herbal supplements for anxiety and

anxiety-related disorders: systematic review. Nutrition Journal,9(1), 1.

Postolache, T. T., Langenberg, P., Zimmerman, S. A., Lapidus, M., Komarow, H., McDonald, J.

S., … & Postolache, B. (2008). Changes in severity of allergy and anxiety symptoms are positively correlated in patients with recurrent mood disorders who are exposed to seasonal peaks of aeroallergens. International journal of child health and human development: IJCHD, 1(3), 313.

Pratte, M. A., Nanavati, K. B., Young, V., & Morley, C. P. (2014). An alternative treatment for

anxiety: a systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). The Journal of Alternative and Complementary Medicine, 20(12), 901-908.

Patel S., De Sousa A (2013). HERBAL MEDICINES FOR DEPRESSION AND ANXIETY: A

COMPREHENSIVE STATE OF THE ART REVIEW, Global J Res. Med. Plants & Indigen. Med., Volume 2(5): 317–336

Teschke R (2010). Kava hepatotoxicity – a clinical review. Ann.Hepatol. 9:251– 265.