Gas in the bowels (intestines) move along its course until it can be expelled through the anus as flatus. This gas can build up to cause stretching of the bowel walls which may create a sensation of fullness or bloating. Most of the time this is temporary and the gas moves along quickly to be passed out. However, sometimes the gas may be trapped in one small section of the bowel where it can cause significant stretching, severe fullness sensation and even pain.
What is splenic flexure syndrome?
Splenic flexure syndrome is where gas becomes trapped at the left bend of the colon causing fullness, discomfort and even pain. It is important to known that trapped gas can occur at both bends of the colon and is therefore referred to as either hepatic flexure syndrome at the right bend or splenic flexure syndrome at the left bend.
Splenic flexure syndrome tends to be more common and is possibly due to the sharp bend in this part of the colon. However, splenic flexure syndrome is not always recognized as a separate clinical entity. Sometimes it is simply considered a symptom of conditions like irritable bowel syndrome (IBS) alongside bloating and excessive flatulence.
Causes of Splenic Flexure Syndrome
Most swallowed air is passed out from the upper digestive tract during belching (burping). However, some of this air may reach the lower digestive tract. Along with gas from intestinal bacteria and colonic fermentation, a significant amount of gas accumulates in small and large intestine. In addition, some gas from the bloodstream is passed out into the intestines. Collectively, this gas is expelled as flatus, also commonly referred to as fart.
The contractions of colonic muscles pushes solids, liquids and gases along. It can also cause the gas to form large bubbles which may then become lodged between solid and liquid contents. These large bubbles are more likely to form when there is resistance to any further gas movement like if the lower parts of the colon are filled wth feces. Normally the gas would pass around the feces but can accumulate in areas where the colon narrows.
The splenic flexure lies higher than the hepatic flexure. The acuteness of the angle of the splenic flexure may be one of the reasons why trapped gas may occur more commonly at this flexure. Furthermore the more solid consistency of stool in the descending colon hampers gas movement which is another factor for the frequency of trapped gas in the splenic flexure. Any compression in this region of the colon may also increase the likelihood of trapped gas.
Often people who experience splenic flexure syndrome report being constipated or having less frequent bowel movements a day or two preceding an attack. There may also be reports of emotional stress triggering the symptoms and in these cases cardiac conditions need to be ruled out. Splenic flexure syndrome may also be more common in people with conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease and other colon disorders.
Read more on excessive flatulence.
Signs and Symptoms
Pain in the left upper quadrant of the abdomen, including under the left rib cage, is one of the most common symptoms splenic flexure syndrome. The pain can radiate to the left side of the chest and even to the left shoulder and down the left arm. In these cases it may sometimes be confused with cardiac conditions like angina pectoris or even a heart attack. In some instances there is no abdominal pain but chest pain is present on its own.
The pain is often described as a fullness or pressure and can persist for anywhere from a few minutes to several hours. Changing position does not usually help in alleviating the pain. Passing flatus (“farting”) and having a bowel movement tends to help ease the pain or resolve it entirely. There may also be loud abdominal sounds (borborygmi) and sometimes an urging to pass stool.
Clinical examination may reveal gas during percussion of the area. This can also be evident on an x-ray that may show the gas in the splenic flexure with upward displacement of the diaphragm since this part of the colon is attached to the diaphragm by the phrenocolic ligament. If there are symptoms like shortness of breath, dizziness or excessive sweating then immediate medical attention is necessary as it could be a cardiac condition.
Treatment for Splenic Flexure Syndrome
There is no specific treatment for splenic flexure syndrome. The condition is not serious and usually resolves spontaneously or with passing gas and bowel movements. The following medication may be helpful:
- Simethicone may allow for easier passing of gas and reduce the frequency and severity of splenic flexure syndrome.
- Laxatives to incease water in the intestines or speed movement through the bowels to alleviate constipation which may help reduce episodes.
- Antispasmodic agents may be useful for decreasing intestinal spasms and may provide some relief for the pain in splenic flexure syndrome.
Always speak to a medical professional to confirm the diagnosis of splenic flexure syndrome and to be prescribed the appropriate medication.
Diet for Splenic Flexure Syndrome
There are no specifc dietary or lifestyle factors that may cause splenic flexure syndrome. However, certain dietary and lifestyle changes may assist in reducing the severity of symptoms or reducing the frequency of episodes.
- Avoid gassy foods. These are foods that tend to increase digestive gas when consumed and are usually foods with a high sulfur content such as broccoli.
- Incease physical activity. Not only will mild physical activity after meals help with digestion but may also increase movement through the bowels to prevent gas accumulation.
- Maintain regular bowel movements. A high-fiber diet and increased water consumption can help ease and prevent constipation which may therefore reduce gas build up in the bowels.
- Spot and discontinue problem foods. Keeping a food diary can help identify possible triggers or exacerbating factors of splenic flexure syndrome. An elimination diet may also be helpful.
- Eat slowly. Eating too quickly is one of the main reasons for increased air content within th digestive tract. Rather eat a meal slowly and without distractions.
Read more on excessive gas remedies.