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Homeopathy and postoperative ileus

Homeopathy gets people hot under the collar, whether they are for it or against it. Many will say that it is ridiculous to expect a solution diluted beyond any possibility of an original molecule of the active material being there to have any effect. The principle of homeopathy is the more dilute the remedy, the more potent its action.

Postoperative ileus

In some conditions, migraine, for instance, there may be a number of remedies to hand. For others, like postoperative ileus, there may be few. So a meta-analysis of the use of homeopathy for postoperative ileus which has a positive conclusion [1] is of interest.


Searching was comprehensive. To be included studies had to be randomised, include a placebo control, be in patients who had undergone abdominal or gynaecological surgery, and have data for analysis by weighted mean difference methods. The homeopathic remedies used were opium or Raphenus sativus principally, though some additives were used.


Time to first flatus was the principal outcome that the authors were interested in, although there is data on time to first faeces also.


Seven trials were found (four published and three published only as theses), and information from six of these was suitable for analysis. The seventh study showed no difference in outcome between homeopathy and placebo.

Results are shown in the L'Abbé plots.
Overall there was a significantly reduced time to first flatus by 7.4 hours (95% CI 10.8 to 4 hours), and this was seen also for four (larger) studies of the highest quality.


Despite the fact that different homeopathic remedies were used at different dilutions, in similar patients and with the same outcomes, homeopathy appeared to be effective. One caveat might be that the largest study showed no difference. Another might be that studies with the highest dilution (and therefore more potent by homeopathic wisdom) showed less effect than those with lesser dilution.

Could this be a statistical freak? This is somewhat difficult to say, because full details of the studies included are not given, and as three of them are unpublished, they may be difficult to obtain. On the face of it, there seems to be an effect, which might, just, be clinically as well as statistically significant. But how this might be incorporated into clinical practice is another matter.


  1. J Barnes, K-L Resch, E Ernst. Homeopathy for postoperative ileus? Journal of Clinical Gastroenterology 1997 25:628-33.

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