Follow the SAME TREATMENT GUIDELINES for IBS as for SPLENIC FLEXURE SYNDROME?
#366571 - 12/21/11 09:29 AM
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Short version question: Should I follow the SAME TREATMENT GUIDELINES for IBS for SPLENIC FLEXURE SYNDROME?
Yes! Splenic Flexure Syndrome has been designated a sub-category of an IBS diagnosis. Use high volatile oil Fennel Tummy Tea to prevent as well as relieve the trapped gas and bloating.
Long Version:
I was an energetic, happy, healthy, vibrant woman training for a half marathon a little over a year ago. I began to have symptoms that I thought were gastritis (diagnosed 6 yrs ago and resolved).
My GI put me on omeprozole for a month. It did nothing and my condition worsened every day. I went back and he told me it was probably stress and muscle related.
The pain:
The pain is ALWAYS there (except when I am sound asleep). It just varies in intensity. It is on my LEFT side ONLY. UPPER Abdomen. ( I know this differes from IBS). It is located where my spleen is and at its worst feels like an organ or muscle is being twisted and strangled. Sometimes, the pain radiates around the side and up toward my left shoulderblade. It gets so severe that I can not stand up straight, and I need to squat or lie down.It can stay like this for days straight. At times, the pain radiates down to my lower abdominal area, but I would call that strong discomfort more than full on pain.
At times, I am short of breath and my chest feels restricted on the left side. It always feel like a gas pocket is blowing up on my left side from waist to heart area. Even if I can manage to pass gas, this does not relieve the pain.
DOCTORS SEEN:
Psyiatrists
Osteopaths
GYN
GI's
Spine Specialist
Nueorologist
Rheumatologist
Endocrinologist
Acupuncturist
Herbalist
Chiropractor
Naturopath
TESTS DONE:
Sonogram
Ultrasound
MRI
CAT SCAN
XRAYs
Nerve conduction Test
Pelvic Exam
Blood tests, including for celiac(negative) and Ovarian cancer (CA 125)
Endoscopy
Colonscopy
MEDICINES and THERAPIES:
("complementary medicine")
Acupuncture (various styles)
Herbs (chinese)
Massage
Reiki
Chiropratic
PT
Homeopathy
Craniosacral
Sound therapy
"western medicine"
Omeprozole (did nothing)
Prevacid (did nothing)
Valium (as a calming treatment and a muscle relaxer- suggested by my first GI- made me sleepy, but did not alter pain.)
Percocet (as prescribed by spine dr. Knocked me out, but irriated my stomach and I did not feel an addictive pain pill was a viable long term solution, especially without a clear diagnosis)
Voltrane (topical, did nothing)
Flexeril (muscle relaxer- made me sleepy, did not change pain)
Mobic (strong anti inflammatory- as SPine dr. said maybe it was costochondritis- did not change pain, and irritated stomach a little)
Xanax (prescribed by first GI- as he suggested, if you can get your nerves under control , you would feel better. did not change pain at all)
Amitiza (for constipation, helped constipation, but did not relieve pain)
Miralax (same as above)
Elavil (a low dose antidepressant for peripheral pain and used in IBS, did not change pain)
HEalth History:
35 yo female. 5'7 125 lbs that fluctuates only slightly 5lbs over or under. My family health history is healthy- slim, active and no major illnesses.
During all these tests, my endocrinoligst found, while my thyroid levels are normal, I do have the anitbodies for Hashimoto's ( which ,means I may develop hypothyroid at some point. ALlthough she says this has nothing to do with the pain I am experiencing.
I have always eaten (what I thought) was pretty healthy. A diet mostly of organic, local cooked veggies, fruits and whole grains. I added greek yogurt for the probiotics ( and its yummy!). I also take a probiotic (powder) for a long time now.
I was a vegetarian from ages 15- 30 and began incorporating animal protein for various reasons around age 30. I would say I ate, again organic, animal protein about once a week or every other week.
My weakness was ice cream ( once or twice a month roughly), chai tea (daily)- which is a black, sweet tea made with skim milk, and butter on bread.
I thought these were the worst offenders, so I have given them up for 1 month now, with no noticeable change.
I don't smoke, drink alcohol, never have had coffee and can't stand hot food (mild salsa is even too spicy for me)
A typical meal for me is brown rice, veggies (especially my favorite- brocolli, mushrooms and squash), and maybe some beans or salmon. I included tahini and avocados because my nutirionist said my BMI was a low in body fat, and they taste delicious.
I have ALWAYS had constipation- as a kid they tried various treatments to no avail, but I NEVER had pain. Discomfort, yes, but not pain, and not the type of pain I feel for this past year.
I found, as an adult, that milled flax seed, and LOTS of water, helped me go.
I meditate daily and before this pain I exercisised 6 days a week- alternating btwn light weights at the gym for toning and jogging/running with races every few months or so. I did yoga (hatha) once a week.
WHile i LOVE LOVE LOVE excersising, I have to say when I got this pain, it felt worse- even when I tried to adjust it....I actually thought I fractured a rib or had a hernia- thats how the pain felt.
I have an incredible family, love my work, and adore my husband.
If my pain is non existent (prior to one year ago), or somewhat manageable (most recent) , I am happy and energetic. When it escalates, the pain is SEVERE, excruciating and suicidal. My mood plummets and I am beyond depressed and severely worried and stressed. The littlest thing can set me off.
I NEVER have diarrhea- unless induced (for ex: colonoscopy).
MOST RECENT:
I am an acupuncturist myself and very patient-compliant! And I have to say, I have never, ever been so dismayed by the medical profession as this past year. The doctors I encountered along this journey were horribly dismissive and not even very thorough, communicative or informative. Fortunately, my GYN is an incredible doctor and helped me most recently find a GI....So far, I feel he is a great doctor. He listens, is compassionate, answered my questions and gave me a sense of hope. He looked over all my tests thus far and his initial response is "SPLENIC FLEXURE SYNDROME"...which is when gas (made worse by constipation) , gets stuck at the splenic flexure- which is the area- on the LEFT where the transverse colon turns up slightly near the spleen and then turns down toward the descending colon.
I have to say when I read about it- it described my pain to a T.
SOme say that SPlenic FLexure Syndrome is a FORM of IBS.
SO, I am wondering- should I follow the same dietary guidlines as suggested In Heather's books?
Or does anyone else have this same experience or information to share on this topic?
I have been reading her books (which are such valuable resources), drinking fennel tea twice a day (peppermint makes me sneeze like crazy), been doing the IBS hypnotherapy tapes as directed.
I even ate pretty much the SAME food this whole week- just to see and some days were fine and other days-last night and today was SEVERELY WORSE and I can not figure out why! I've kept food journals and mood charts and can find no discernable patterns!
I cut out most of my usual veggies ( because they are gassy) and avocado, tahini b/c of the fat). My doctor prescribed Hycosamine (antispasmatic) for about 2 weeks now, and I will say it doesn't take away the pain, but I feel it keeps it 80% of the time from escalating. I also have to take miralax twice a day just for this week....which is certainly helping me go.The interesting thing is Hycosamine says a possible side effect is constipation, but when I started this (before miralax), I started going every day (small amounts) and my stools were softer, which is RARELY the case! I have an appt. tomorrow. I am wondering- do any of you know anything about this or have suggestions as to whether I should treat it the same as IBS?
Any information is GREATLY APPRECIATED.
Thank you kindly and I hope you feel better as well!
Edited by Heather (09/10/13 03:03 PM)
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Welcome to the board,
As you said splenic flexure syndrome is considered by many physicians to be a subtype of IBS where gas in the splenic flexure cause bowel spasms. Since the 1970 there have very few if any scientific articles published on this syndrome. It might have been subsumed into the IBS literature.
It certainly cannot hurt to follow the Eating for IBS diet as it focuses on minimizing the consumption of foods likely to produce gas or induce bowel spasms.
Also, you might look at the first two article in my signature which focuses on the reduction of FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides And Polyols) which are short chained carbohydrates that can be malabsorbed causing GI distress and gas. I follow a combination of the Eating for IBS diet and the FODMAP approach with reasonably good results.
Have you tried removing whole grain cereal products and reducing other insoluble fiber consumption as well as increasing your soluble fiber intake as discussed here?
It would be helpful if you could list the foods and snacks you have eaten in the past 2-3 days. It might give us some clues for suggestions.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Hello.
Wow , thank you so much for responding so quickly. I will print these articles out and read them on my way to the doctor tomorrow.
You asked what I ate the last few days:
I tried to follow what was suggested:
I had oatmeal (organic, instant, plain, no additives)
half of it and then heated it up about half hr. later and added a few organic blueberries.
Snack: plain sourdough bread toasted.
Dinner: brown rice (is this considered whole grain, no-no?) I just bought white basmati tonight.
ate most of the rice first, then ate it with cooked portabello mushrooms, yellow and green squash.
Second day: pretty much the same thing except this time I added bananna instead of blueberries. to my oatmeal.
and added a tiny amount of honey ( made by my bee-kepper neighbor next door!) on sourdough bread b/c I was craving sugar.
Dinner: same as above.
This morning: plain oatmeal. Sourdough toast plain for snack. Dinner white basmati rice, grilled salmon with dill and parsley and a small amount of steamed kale.
I only (which is usual for me) drank plain water, once adding a squeeze of lemon. and 2 cups each day of fennel tea.
I almost ate the SAME thing all week and that's what I don't understand...how come some days it doesn't aggravate me and then others (last night and this morning)it escalated?
One other question as you mentioned about food that don't stimulate bowel movements, as someone with life-long chronic constipation, don't I WANT to stimulate bowel movements?
This is the part I'm most confused with when beginning to familiarize myself with IBS literature for the first time.
Most significantly Ive cut out all dairy for a month and just cut out broccoli ( my favorite food and eaten daily for YEARS now), when my doctor mentioned trapped gas might be my issue. It seems most foods I've eaten for years are big culprits: broccoli, beans, lentils, whole grain breads, butter, avocado, tahini, greek yogurt, cauliflower, brussel sprouts, kale, collard greens. SO, I JUST changed those things (this week) and the dairy for one month....but I don't notice a huge change yet. Maybe it takes a lot longer?
The thing is I've lost nearly 10 pounds because I've been eating so little and slowly ( because of the pain) and partially b/c I'm scared and confused as to what the heck, if any of these foods, are causing my pain.
Thank you so much for you help!
I really appreciate it.
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Your meals look quite good. Only you can judge how much amount of insoluble fiber you can handle.
C can be caused by the bowel going into spasms and instead of moving things along in a orderly rhythmic manner it develops a charlie horse. So you want to remove foods that can precipitate spasms such as coffee, tea, too much insoluble fiber and so one.
Yes - it can take some time for things to stabilize and you need to experiment to find your personal limits.
Sounds like you are starting to make progress 
--------------------
STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Thank you so much for this post/ these posts. I am so sorry to hear you have had a horrible time, but I am so interested to here how you are getting on. Could you let me know?? I have never joined a message forum before and was going out of my mind with anxiety, but this has instantly made me feel better. THANK YOU! Very similar to you actually! All symptoms match. Very healthy, later 30's, slim, never over or underweight, healthy diet - love jogging, being busy, great family. Diagnosed with IBS about 5/6 years ago, but nothing I could not cope with - all mild.Then OUT OF THE BLUE (well over a few days around Christmas) 2014, I was having discomfort in mid left back, and front, and THEN I could not go to the toilet for DAYS (just mucous). I was a) in agony in all the places you guys describe, and b) scared to death. This was so painful I ended up in the emergency room 3x in one week, and was sent away with painkillers. By the Thursday, I was doubled up, still hadn't been to toilet other than thin, curved yellow stools (!!!) and feeling like I'd been shot through left upper stomach/ back. I thought I was going to die (seriously). They admitted me for four days and I had loads of laxatives after an x-ray found a dilated splenic flexure. I get a bit better, and am discharged. Then (the next week) after 'u'shaped wider loose stools (!!!) I had a colonoscopy. All clear (thank God). And the week after, a CT. All clear. Anyway... 5 weeks on and it has all flared up AGAIN. Agony, debilitating - have to keep being sent home from work. Losing weight, scared to eat. ONLY relieved by gas/ stools but they are non existent at mo (but no blockage shown on CT). Pain in back is worst - have a second kidney infection (from straining and straining and generally been run down I think???) - kidney function told is fine otherwise and CT shows no problem? But this is not normal, sudden, extremely frightening and I feel terribly lonely because no-one seems to have a clue what to do with me - including me! I am scared to eat, go out, go the toilet. I am losing weight (and I am slim anyway). This is hell and I am a mum, a teacher, and I just don't know what to do. The biggest fear is - will it not heal and will it get worse/ block??? And will it be like this for the rest of my life? My life is currently on hold as everything is around this pain. Thanks for listening, please let me know!! Tests are finding nothing (bloods). Desperate but nice lady! X
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Happened to see this on Webmd;Don't know if this helps..
A review on Medication from reviewer Styvfar @:
http://www.webmd.com/drugs/drugreview-162895-Linzess+oral.aspx?drugid=162895&drugname=Linzess+oral
Condition: Irritable Bowel Syndrome with Constipation9/29/2014 10:39:14 AM
Reviewer: Styvfar, 45-54 Male on Treatment for 1 to 6 months (Patient)
Effectiveness Current Rating: 5
Ease of Use Current Rating: 5
Satisfaction Current Rating: 5
Comment:
Have had IBS-C for many years now, and OTC medications stopped working. Also have spleenic flexure syndrome which produces left-side pain that never goes away. 145 mg Linzess produces bowel movements every day like clockwork. It relieves the pressure on the spleenic flexure and so I don't live with the constant pain any more. I am glad this has been working so well for me. My doctor prescribed this along with Celexa and an anti-spasmodic. I stopped the anti-spasmodic because of bad side effects (diminished cognitive abilities, lack of sleep). In sum, I am living a normal life! I can travel again.
Me: I wish fennelqwr123 had left an e-mail for you;since their post was a while back.
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Hi Heather, Sorry to hear how bad a time of it you have been having. I found your thread searching Google for help on this condition and so hope I am not to late and have missed you.
Without saying too much I am in very much the same boat as you with the exact same problems. The only difference I have is the pain doesn't ever go as high up as my shoulder. Reading through your post I can tell we have lived the same life for the last few years based on the lengths you have went to no doubt out of desperation to try and find some relief.
I have had this since I was 13 and am now 30. The doctors are happy to just put it down to IBS as in your case and some places you read do seem to say it is classed as that as they cannot treat it any differently. I read somewhere on Google in China they actually recognise it as disorder of it's own and perform surgery on people. I find it hard to ever believe my problems will be solved by any tablet etc.
I have had every test going and funnily enough when I had a camera to check my colon when they filled me with gas even though I was sedated I can still remember the pain and it being the exact pain I have felt so many times before. I saw in the report it was in the exact area where the Splenic flexure is but this was put down to IBS.
Would be nice to hear if you managed to get anywhere with this. I like you have tried so many things to help myself and got nowhere really. I do know of a painkiller that if took when you first feel the pain does tend to do the job co-codamol soluble only as the pain relief is near instant. Tablets that are in tablet form can sometimes react badly for me.
The other thing that helps and I shouldn't admit it but every now and again I have a little bit of marijuana for emergencies. I discovered it by accident years ago and as shameful as it is it really is the closest to a miracle for me. It literally feels like putting a pin in a baloon at times. It again isn't ideal but I am sure as you know the pain is just unbearable and unfortunately the likes of Buscopan and Mebeverine which the doctors give out would only leave me pacing the room clutching my stomach in agony if I relied on them.
Would be nice to hear if you have seen any improvement and what has helped.
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Did you mean fennelqwr123? (that was back in 2011), because Heather (the head of this website) just edited within her post only with an answer.
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Me too! After 5 years, 10+ medical providers, and every abdominal test known to man, I am reading for the first time tonight about Splenic-flexure syndrome. It fits my symptoms exactly. I am in constant pain under my ribcage on the left side only, and I have noticed that a few foods cause a violent and immediate increase in symptoms. Some days I just can't go to work and was even wondering if I should pursue disability benefits, although I love what I do. ( I'm a hypnotist). I'm going to be making an appointment with my PCP this week to discuss treatment options. Please feel free to message me if you're a fellow sufferer - maybe we can share what's worked and what hasn't. Thanks to Heather and to everyone who posted here. Susan
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Hi Mark,
Thanks for your post. See my reply below with subject heading Eureka! Tried to send you a private message but couldn't. Please feel free to contact me. It's nice to finally find someone who "gets it". Susan
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