Chronic Pain

Unraveling the Mysteries of Splenic Flexure Syndrome

splenic flexure syndrome

INTRODUCTION

All of us have occasionally suffered from abdominal pain involving trapped gas in the intestinal tract.

As miserable as we feel when this happens, we look for a cause and believe relief will not be far away.

What happens, though, when the usual treatments do not work and the pain and discomfort worsen? Most likely, we consult our physician for testing and diagnosis of our ongoing illness.

WHAT IS SPLENIC FLEXURE SYNDROME? 

When gas symptoms such as pain and bloating linger too long, we turn to our doctor for help. Our doctor may diagnose splenic flexure syndrome.

This condition is caused by gas becoming trapped in the flexures (curves) of the intestinal tract.

Splenic flexure syndrome is named for its close proximity to the spleen, located in the upper left abdominal quadrant.

The spleen is partially protected by the lower rib cage and sits below the diaphragm near the tip of the pancreas and behind the stomach.

According to the University of Michigan – Comprehensive Cancer Center, The splenic flexure is located at the junction of the transverse and descending colon.

Experts in the field of medicine have studied for years trying to comprehend the multi-faceted condition of splenic flexure syndrome.

It is believed by many health care providers that many patients postpone seeking treatment for the condition too long.

According to HealthForm, it is stated that splenic flexure syndrome might be defined as a sense of having “a large bubble” in the middle of one’s body that is refusing to go away.

Anatomical features surrounding the splenic flexure and a discussion of splenic flexure syndrome can be found on this YouTube.

The video will help you to visualize the position, shape, and placement of the splenic flexure.

WHAT ARE THE SYMPTOMS OF SPLENIC FLEXURE SYNDROME?

Pain

One symptom of splenic flexure syndrome is continuing abdominal pain. Early on, it may be interpreted as a simple, transient gas attack. The pain will persist and be located in the upper, left side of the abdomen.

The location of the pain, under the left rib cage, often accompanied by shooting pains in the shoulder, has led people to believe they are experiencing a heart attack.

The pain is severe, may last for several minutes, and recur often for weeks or even months.

Spasmodic contractions of the colon cause pain that can be referred to the back as well, and like the abdominal pain, can be severe to debilitating at times.

Gas-filled intestines can make relaxation difficult, which can exacerbate the back pain.

Distended Abdomen

Abdominal distention (bloating) in the upper-left abdomen is another identifying symptom of splenic flexure syndrome. Along with this distention, there may be excessive sensitivity to touch.

The symptom of bloating is tied to a motility disorder of the intestines. This means the intestinal muscles do not move or contract normally to help digest food and keep it moving through the intestinal tract.

Other conditions that result from this motility disorder are peptic ulcer disease, gastritis, GERD and irritable bowel syndrome.

Because of the poor muscle contractibility, people may feel bloated at times when they are not.

Other conditions that can mimic or cause splenic flexure syndrome are colon cancer, Crohn’s disease, adhesions (scar tissue) from surgery, and internal hernias.

An overgrowth of bacteria in the small intestine can also cause bloating symptoms.

A hollow sound may be elicited if the stomach is tapped, similar to the sound of tapping a ripe watermelon.

As stated in an article by HealthResource4u, ingesting too many fatty foods may worsen the distention.

Bowel Irregularity

Irregularities of the bowel caused by splenic flexure syndrome (SFS) may manifest as diarrhea or as constipation.

Accompanying these anomalies, there may be fever, bloating, abdominal cramping or spasms of the colon.

Similar symptoms caused by ordinary gas attacks are relieved by passing gas by mouth or by rectum. With splenic flexure syndrome, passing gas is more difficult but can be achieved.

Proper diet is important in controlling constipation in SFS patients. Unfortunately, many of the foods that help regulate the bowels are on the ‘do not eat’ list and must be avoided or strictly limited. Fluid and high-fiber intake can help balance this out.

Anxiety

It is commonly accepted that anxiety can cause GI upset by stimulating the secretion of more acid in the intestinal tract. This leads to increased gas production with subsequent bloating and cramping.

It is also true that gastrointestinal pain and discomfort can trigger anxiety and/or depression.

According to WebMD, “medical illness sometimes brings with it anxiety disorders”.

The elusive nature of GI pain makes it hard to diagnose, and the fear of unexplained physical symptoms can create high levels of stress, leading to anxiety.

Studies show that undiagnosed ailments including a headache, fatigue, dizziness, palpitations, constipation, nausea, stomach upset and musculoskeletal pain are common complaints of anxiety/depression patients.

WHAT CAUSES SPLENIC FLEXURE SYNDROME

Air Ingestion

According to an article by the University of Rochester Medical Center in New York, it is common for a person to produce 1 to 4 pints of gas daily.

When food is digested in the small intestines by good bacteria, the gas produced is composed of non-odorous fumes like oxygen, nitrogen, carbon dioxide, hydrogen and possibly methane.

Sometimes undigested food passes into the large intestines and is further broken down and digested.

Some of the bacteria in the large intestines emit gases containing sulfur and these fumes do have an offensive smell.

A habit of eating too fast can lead to the intake of air into the digestive tract. When air is ingested repeatedly and accumulates in the splenic flexure, the unrelenting symptoms can lead to splenic flexure syndrome.

Haste in eating may be tempting for someone with a hectic lifestyle, but taking the time to eat slowly can save time later by avoiding excess bathroom trips and time spent in bed with abdominal pain.

Less common causes for aerophagia can be smoking or chewing gum. It can also result from wearing dentures that fit too loosely or by experiencing postnasal drip

Food Intake

Another way that food can lead to SFS is due to the bacteria that break down the food releasing gas into the intestinal tract.

Foods containing substances that the body has difficulty digesting can be extra bothersome, such as additives and preservatives.

Certain carbohydrate-rich foods can also trigger SFS. Intake of foods that a person might be allergic to can also worsen the symptoms of splenic flexure syndrome.

Less common causes for aerophagia can be smoking or chewing gum. It can result from wearing dentures that fit too loosely or by experiencing postnasal drip.

Poisoning

Food poisoning can play mischief with the gastrointestinal system. Bacterial infections caused by Salmonella or E. Coli, along with their immediate agonizing effects, can lead to long-term conditions like splenic flexure syndrome.

Disease

One disease that invades the digestive tract is ulcerative colitis. It commonly begins in the rectum and can spread throughout the entire large intestine.

Fortunately, doctors can identify ulcerative colitis as the source of splenic flexure syndrome.

WHAT IS INVOLVED IN DIAGNOSING SPLENIC FLEXURE SYNDROME?

At the present time, no single diagnostic test exists to definitively diagnose SFS.

However, there are protocols that physicians take to lead them to a diagnosis of this condition.

The first step would be to perform a complete medical history on the patient.

Knowledge gained from the patient’s history, including clinical data previously collected, would help to rule out other conditions affecting the gastrointestinal system.

The doctor would question the patient about dietary routines. To evaluate an intestinal problem, the doctor may inquire about the number of times the patient passes gas each day.

To be specific, the doctor would ask the patient to list the foods eaten during the past 24-hour period.

By gaining an understanding of what foods the patient has eaten, the doctor would better understand the part food plays in the intestinal symptoms.

A complete physical exam would be performed to assess the patient’s current state of health and uncover any abnormalities in lab tests that would explain the patient’s symptoms.

A full set of gastrointestinal tests would be performed to evaluate the condition of the GI tract.

A barium enema would be obtained to uncover any diseases of the lower GI tract, consisting of the colon and rectum.

When doing a barium enema, the contrast material (barium) is introduced through the rectum into the intestines. The presence of the barium makes the inside of the intestine visible for examination.

A final step in the assessment would be imaging studies. Abdominal MRI and CT scans would be invaluable in making an accurate diagnosis.

WHAT TREATMENTS ARE AVAILABLE FOR SPLENIC FLEXURE SYNDROME?

Dietary Advice

The first line of treatment would be dietary adjustments. Culprits to be eliminated or seriously restricted would be high-fat foods and those with high concentrations of starches and/or sugar.

The patient would be advised to discontinue carbonated beverages and extremely spicy foods.

The doctor would admonish the patient to increase fiber intake in the diet, as this would boost the digestive process.

Attention would be given not only to what the patient eats but to how much and how often.

Small meals eaten frequently during the day would be easier on the gastrointestinal tract than three large meals.

Keeping a food diary can be very helpful for someone suffering from splenic flexure syndrome.

Make notes on what symptoms are experienced, how often they occur, how long they last, and any connection that can be made with particular foods.

Clare McCarthy, an SFS patient, gave advice on her blog when she shared an incident where she ate something without looking at the nutritional information on the can.

Make a habit of carefully checking the nutritional information on cans and packages at the grocery store as you shop.

PASSAGE OF GAS AND STOOLS

To maximum patient comfort, it would be important for the patient to avoid constipation.

Proper diet, as discussed, along with drinking lots of water, would help keep the patient’s bowel habits regular and allow for easier passage of gas.

Staying active could help with passing gas and stools, so the doctor might recommend taking walks and engaging in gentle exercise, as tolerated, to keep the intestinal system functioning at optimum capacity.

Good posture is also a plus in avoiding air entrapment in the intestines. The doctor may advise the patient to be aware of walking upright, not hunching over or slumping, which could hamper the movement of air through the intestinal tract.

MEDICATIONS

Antacids

Pain and discomfort of intestinal disorders like splenic flexure syndrome may be alleviated by the use of antacids such as Maalox, Tums, and Rolaids.

These medications work by neutralizing acids and decreasing the volume of gas being produced.

Anticholinergic and Anti-Spasmodic Medications

Gastrointestinal cramps caused by splenic flexure syndrome can be relieved by anticholinergic and antispasmodic medications. Cramping is caused by improper contracting and relaxing of the muscles.

According to MedicineNet, pain and discomfort can be alleviated by these medications by acting on neurotransmitters in the brain and thereby decreasing muscular motion in the gut, pain and discomfort can be alleviated by this kind of medications.

Some anticholinergic medications that might be used for gastrointestinal cramps and/or muscle spasms would be atropine, belladonna, Immodium, Bentyl, and Phenergan.

Antispasmodic medications that could be helpful could include dicyclomine (Bentyl) and hyoscyamine (Levsin).

Metoclopramide works in the upper digestive tract to increase contraction of the muscles.

The effect is that the stomach empties into the intestines faster. Acid levels and gas production are better controlled, leading to less pain and bloating.

Surgical Treatment

Colonoscopy is a procedure that can result in decompression, leading to relief of bloating and gas symptoms.

A tube is inserted per rectum into the intestine to decompress the colon and allow the trapped gas to escape.

NATURAL REMEDIES FOR SPLENIC FLEXURE SYNDROME

Herbal Teas and Peppermint

For those who are interested in a more naturopathic approach, a cup of tea would be just the thing – especially if the tea contains peppermint, chamomile, anise, ginger, or fennel.

Try a cup of water to which a drop of peppermint extract has been added. Peppermint contains methanol, an antispasmodic, so it can afford relief similar to what you might get in the prescription meds, without any unwanted side effects.

According to YourHealthRemedy.com, It might be best to try to avoid over-the-counter anti-inflammatory drugs like ibuprofen and aspirin. That way you do not treat the symptoms, but the cause of the pain.

Lower Your Salt Intake

Because salt is approximately 40 percent sodium, a high salt intake will cause your body to retain more fluids, which will lead to more bloating and discomfort.

Your doctor can recommend a daily sodium allowance to maintain a healthy balance.

Stress Relief Can Help

Stress causes hormonal changes which can lead to increased fluid retention and be bloating.

It can also impede digestion, leading to more bloating and gas. A good way to manage stress is by making a mindfulness meditation a part of your daily routine.

Stay Well Hydrated

Remember to drink lots of water and other clear liquids. Water flushes out your gastrointestinal tract and cleanses the body of toxins.

This cleansing can remove the triggers to gas, bloating and abdominal pain.

Try Probiotics

Probiotics are important for their role in boosting the immune system. They also aid in treating digestive conditions, mental health, and neurological disorders.

Studies have shown that probiotics can help relieve all symptoms of irritable bowel syndrome.

WHAT IS THE BEST DIET FOR SPLENIC FLEXURE SYNDROME?

It has been stated by professionals that ‘short-chain carbohydrates’ aggravate the symptoms of splenic flexure syndrome in many patients affected by the condition.

Carbohydrates are present in a wide range of seemingly dissimilar foods, so it can be difficult to zero in on what to avoid.

Grains like rye and wheat, as well as many fruits and vegetables, contain short-chain carbohydrates.

Carbohydrates that are poorly absorbed tend to increase the level of water volume in the intestines, which quickly ferments the digesting food and raises the level of gas present in the intestines.

According to the National Institute of Health, These findings have led to the common usage of lactose-free or fructose-free diets in many patients with the syndrome.

Certain foods have been identified as best to omit from a splenic flexure syndrome diet including prunes, cabbage, broccoli, Brussels sprouts, potatoes, beans, peas, corn, dairy products, apples, bread and processed cereals.

Food choices may be guided by the knowledge that it is best for SFS patients to reduce their sodium intake and increase potassium intake.

It would be wise to seek advice from a doctor or dietitian for the best food choices in this area.

CONCLUSION

It must be acknowledged that splenic flexure syndrome is an unnerving challenge for any individual.

The condition is life-altering and must be faced with courage and dedication to making many undesirable changes.

Armed with knowledge and perseverance, however, lifestyle changes can be incorporated into the daily routine to make living with splenic flexure syndrome a challenge that can be overcome.

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