Splenic Flexure Syndrome: What You Need to Know

Medically reviewed by Robert Burakoff, MD

Splenic flexure syndrome is a non-life-threatening digestive system disorder associated with upper left abdominal pain and a sensation of fullness and swelling in the belly.

Considered by some to be a variant of irritable bowel syndrome (IBS), this disorder is caused by gas accumulation and subsequent swelling of the splenic flexure—the highest-reaching point of the colon (large intestine), located near the spleen (an organ under the left rib cage that filters blood).

This article will discuss splenic flexure syndrome, including its symptoms, possible causes, diagnosis, and treatment. It will also highlight self-care strategies to optimize your care and how you feel.

What Does Splenic Flexure Pain Feel Like?

A person with splenic flexure syndrome may feel pain that is a sharp or cramping pain. It can be mild to severe. It is felt in the upper left abdomen.

Splenic Flexure Syndrome Symptoms

The splenic flexure is the bend or curve inside the body where the transverse colon, which runs across the abdomen from right to left, joins the descending colon, which runs down the left side of the stomach.

Splenic flexure symptoms are attributed to distension of the splenic flexure as excess gas becomes trapped within the transverse colon.

Possible symptoms include:

• Left upper abdominal cramping or sharp pain that ranges from mild to severe

• Bloating (a feeling of abdominal swelling and fullness)

• Flatulence

• Constipation

• Nausea and vomiting

The above symptoms may improve or go away after passing gas or having a bowel movement.

Learn More: What Does Colon Pain Feel Like?

What Causes Splenic Flexure Syndrome?

It's not clear what exactly causes splenic flexure syndrome. Some experts speculate that anatomical variations of the colon influence the development of this disorder.

Specifically, an excessively elevated splenic curvature, a transverse colon that's longer than typical, and a narrower-than-typical angle where the transverse colon meets the descending colon might contribute to gas accumulation.

Some experts also consider splenic flexure to be a type of irritable bowel syndrome (IBS).

Irritable Bowel Syndrome

IBS affects between 5% and 10% of healthy individuals at some point in their lifetime. Symptoms include crampy abdominal pain and a change in stool frequency, including constipation, diarrhea, or an alteration between the two.

Certain causes of IBS may similarly trigger the development of splenic flexure syndrome. Some of these potential causes include:

• History of a severe gastrointestinal (GI) infection—for example, from the bacteria Salmonella

• Antibiotic use early in life

• Physical or emotional trauma in childhood

• Food sensitivity or allergy

• Genetic predisposition (a person's genes may make them more vulnerable to IBS/splenic flexure syndrome)

Diagnosing Splenic Flexure Syndrome

Healthcare providers establish the presence of splenic flexure syndrome by considering a person's symptoms, the findings from a physical examination, and the results from one or more diagnostic tests.

Medical History and Physical Exam

When evaluating abdominal pain, a healthcare provider will inquire about a person's symptoms, including location, severity, and triggering or alleviating factors. They will also ask about past and current health conditions.

During the physical exam, a healthcare provider will take your vitals (temperature, heart rate, blood pressure, breathing rate) and gently press on and tap your abdomen. Vitals should be normal in a person with splenic flexure syndrome, other than their heart rate perhaps being elevated due to acute pain.

With splenic flexure syndrome, tenderness and a high-pitched drumlike sound (when tapping) may be evident in the upper left side of the belly due to gas buildup.

Blood Tests

Blood tests can help a healthcare provider rule out other causes of abdominal pain. For example, a complete blood count (CBC) can provide clues about infection or anemia (possibly from blood loss or chronic inflammation).

Imaging Tests

Imaging tests help providers confirm a diagnosis of splenic flexure syndrome and rule out alternative abdominal or spleen-related diagnoses like tumors, polyps (growths), or inflammation.

The two imaging tests often used to help diagnose splenic flexure syndrome are:

• An abdominal computed tomography (CT) scan uses X-ray technology to create three-dimensional (3D) images of the inside of the body.

• A barium enema involves instilling a contrast material (barium) through a lubricated tube into a person's rectum. The barium coats the inside of the intestine. After administration, a series of X-rays are taken, allowing providers to visualize the inside of the colon.

Results from the above tests may reveal a swollen transverse colon that sags or droops downwards and a narrowed splenic curvature (less than 45 degrees).

Ruling Out Alternative Diagnoses

Splenic flexure syndrome is not a serious condition, although potentially life-threatening conditions such as the following can mimic it, and they need to be ruled out to come to a diagnosis:

• Splenic rupture (when the spleen breaks open, often from blunt abdominal trauma)

• Perforated ulcer (when a stomach or small bowel ulcer creates a hole, leaking digestive fluid into the body)

• Acute pancreatitis (sudden inflammation of the pancreas)

• Bowel obstruction (when stool cannot move through the intestines)

• Intestinal ischemia (impaired blood flow to the intestines)

• Pyelonephritis (kidney infection)

• Ruptured abdominal aortic aneurysm (when a weakened area of the body's main blood vessel breaks open)

• Ruptured ectopic pregnancy (a nonviable pregnancy that implants in and breaks through the fallopian tube)

• Heart attack (impaired blood flow to the heart)

Learn More: Common Tests Used to Diagnose Abdominal Pain

Splenic Flexure Syndrome Treatment

Splenic flexure syndrome treatments aim to relieve symptoms. People should also be reassured that while it's uncomfortable, the condition is not dangerous.

There is no cure or best treatment for this disorder, although healthcare providers may recommend making dietary changes aimed at reducing gas. They may suggest avoiding gas-producing foods like beans, Brussels sprouts, cauliflower, onions, apples, and wheat.

Learn More: What to Eat With Gas Pain

They may also recommend:

• Biofeedback, a mind-body technique, to learn how to control digestive system muscles better to improve constipation

• Antispasmodic drugs like Bentyl (dicyclomine) and Levsin (hyoscyamine) to ease abdominal cramping

• A tricyclic antidepressant or selective-serotonin reuptake inhibitor (SSRI) to reduce depression, anxiety, and/or pain perception

Surgery as a treatment for splenic flexure syndrome is only rarely reported in scientific literature. It appears to be reserved for children (who are seldom diagnosed with this disorder) or adults with severe and persistent symptoms who fail other therapies.

Spleen Is a Highly Vascular Organ

Since the spleen carries many blood vessels, any operation on or near the spleen (e.g., to remove a segment of the affected colon nearby) should only be performed by a highly skilled surgeon.

Splenic Flexure Syndrome Complications and Outlook

There are no real complications of splenic flexure syndrome, although, as mentioned above, serious conditions with similar symptoms (e.g., bowel obstruction or ischemia) need to be ruled out.

Undergoing testing with a gastroenterologist (a medical doctor specializing in digestive disorders) to confirm the diagnosis is ideal.

The good news is that people with this digestive disorder tend to do well with the right combination of lifestyle and medical therapies. That said, be mindful that gaining control of symptoms may take time and be trial and error process.

Prevention and Self-Care Strategies for Splenic Flexure Syndrome

Similar to individuals with IBS, living with splenic flexure syndrome can cause mild to significant physical and mental stress.

Under the guidance of a healthcare provider, consider these self-care strategies sometimes used by individuals with IBS to optimize their care:

• Engage in self-abdominal massages

• Adopt an elimination diet, like the low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, polyols) diet

• Try one or more complementary therapies—for example, probiotics, acupuncture, or hypnotherapy.

• Manage stress healthily with daily relaxation techniques, like meditation or progressive muscle relaxation.
  

Summary

Splenic flexure syndrome occurs when gas accumulates in the bend where the transverse colon and descending colon connect in the upper left part of the abdomen. While not a life-threatening condition, symptoms like cramps and pain in the upper left side of the abdomen below the left ribcage and bloating can cause significant physical and emotional distress.

A physical exam, blood tests, and imaging tests like a CT scan or barium enema are used to make a diagnosis of splenic flexure syndrome and rule out alternative diagnoses. Treatment aims to ease symptoms and may include medication and lifestyle changes, like adopting a low-FODMAP diet to reduce gas.

Read the original article on Verywell Health.