Introduction
The spleen is located near the stomach in the abdominal cavity, so that the splenic pain is usually felt in the upper abdomen, although it can also radiate into the lower abdomen, as well as into the left shoulder (Kehr sign). Pressure pain on the left side of the neck (Saegesser sign) is also possible. Those affected often suffer from pain-induced gentle breathing, which can also be recognized by the posture from the outside. The splenic pain cannot be differentiated exactly in its localization and occurs only diffusely. In order to be able to assign the pain reliably to the spleen, it is very important to know the accompanying symptoms.
Causes of splenic pain
Pain in the spleen can have various causes. The spleen can become more or less seriously ill in some diseases. We will go into the following diseases in more detail:
- Rheumatoid Arthritis
- Systemic lupus erythematosus (SLE)
- Ruptured spleen
- Splenic congestion
- Sickle cell anaemia
- Thalassemia
- Splenic pain after alcohol
- Splenic pain after eating
- Piping glandular fever
Rheumatoid arthritis describes an inflammation of the body that occurs in phases and mainly affects the joints of the hands and feet.
Characteristic are swollen and especially in the morning stiff finger base joints (metacarpophalangeal joints) and inter-finger joints (proximal interphalangeal joints) on both sides. The disease process of rheumatoid arthritis gradually leads to a destruction of cartilage and bone structure and is difficult to stop with drugs such as cortisone and methotrexate. Nevertheless, the external signs of the disease can be treated like pain.
Systemic lupus erythematosus is an autoimmune disease. This means that the body’s defense system, which is normally supposed to protect against intruders, attacks the body’s own tissue for reasons as yet unknown. Many antibodies (small “pincers” that recognize and mark intruders) are produced, which stick together and are deposited in different parts of the body, where they cause damage.
Typical signs of SLE are: In addition, the adhered antibodies can also cause damage in internal organs. Attempts are being made to treat systemic lupus erythematosus (SLE) with cortisone, painkillers and agents that suppress the immune system (immunosuppressants, for example methotrexate).
- The redness of the facial skin, which has the shape of a butterfly (butterfly erythema)
- Two-dimensional and spotty redness of the skin (Lupus discoides)
- Photosensitivity
- Joint inflammation and joint pain.
- The kidney
- The heart
- The central nervous system and
- The spleen
A rupture of the spleen occurs when a large force is applied to the abdomen, as may be the case in an accident.
In addition, broken ribs with their sharp ends can break through the thin capsule surrounding the spleen, resulting in bleeding into the abdominal cavity due to the strong blood flow to the spleen. There is a risk that the body will therefore go into shock. In the case of minor injuries to the spleen, the injury can be repaired with a certain tissue adhesive.
In most cases, however, the entire spleen has to be removed, because then it is easier to stop the bleeding. Due to a liver disease such as cirrhosis of the liver, for example, pressure is increased in the bloodstream that is connected between the intestine and the liver (portal circulation) and in which the spleen is also involved. This condition is known medically as portal hypertension.
This can lead to blood congestion in the spleen, which is then enlarged. An enlarged spleen breaks down more red blood cells, which can lead to anaemia (haemolytic anaemia). In sickle cell anemia, the structure of the red blood pigment (hemoglobin) is altered due to an inherited genetic trait.
As a result, the red blood cells cannot take their usual shape, comparable to that of a round inflatable boat, and look more sickle-shaped. These sickle cells are not as flexible as normal red blood cells and can therefore clog small vessels (for example in the spleen), which can interrupt the blood supply to important organs. With regard to the severity of the condition, a distinction is made as to whether a person still produces half normal red blood pigment (heterozygous) or whether a person only produces altered pigment (homozygous).The latter case is much more serious.
In thalassemia, the formation of red blood pigment can be disturbed in various ways. Like sickle cell anemia, thalassemia is a hereditary disease. Normal hemoglobin binds oxygen to transport it, whereas altered hemoglobin cannot bind oxygen as well, which can lead to a reduced supply of oxygen to the various tissues.
Signs of anemia appear: Depending on the amount of the affected hemoglobin, a distinction is made between a “small” minor form, a medium-heavy intermedial form and a heavy major form. As therapy, blood transfusions or, in the major form, a bone marrow transplantation are possible.
- Paleness of the mucous membranes
- Tiredness
- Headaches
- Tachycardia.
When drinking alcohol, there is often talk of liver damage, but here the importance of the spleen in detoxification is usually underestimated.
The spleen has a filter function of the blood system and is an important component of the immune system. All the blood in the body passes through the spleen and dead or damaged red blood cells are filtered out here. If this protective function fails, people are more susceptible to infections.
During the breakdown of alcohol in the liver, acetaldehyde is produced, which is very toxic and is responsible for damage caused by alcohol abuse throughout the body. The cell membranes, including those of the red blood cells, are attacked and indirect damage is caused, causing them to be broken down more in the spleen, which in turn leads to enlargement of the spleen. After eating, pain in the spleen is rather untypical.
As a rule, it is a coincidence of times (after eating and the time of the splenic pain). The spleen is an organ that plays an important role, especially in the immune system and in sorting out old blood cells. This has primarily nothing to do with eating and nutrition.
Nevertheless, pain in the area of the spleen can occur after eating. Since the spleen and stomach are directly adjacent, the complaints are usually due to stomach problems. For example, an injury to the mucous membrane of the stomach (ulcer) can lead to pain after eating.
A reflux disease, in which stomach acid flows back into the esophagus, is also associated with pain after eating. Since the highly acidic gastric juice irritates the esophagus, burning pain occurs at the transition between the esophagus and stomach. This can be in the immediate vicinity of the stomach and spleen or radiate to behind the breastbone.
During pregnancy, pain in the spleen can be caused in two different ways. On the one hand, there may be an infection, which, just like the common cold, requires the spleen to work harder to select immune cells. Since special conditions prevail in the body during pregnancy, the immune system can quickly overreact and thus lead to increased swelling of the spleen.
At an advanced stage of pregnancy, however, pain in the spleen can also be due to a displacement mechanism. If the uterus becomes very large, it displaces the other abdominal organs. This can lead to increased pressure on the spleen and thus to pain.
Whistling glandular fever (also called kissing disease) is a disease caused by the Epstein-Barr virus (EBV). Typically, the pathogens are transmitted via saliva (for example, when kissing – hence the name). They are mainly found in the lymphatic system, lymph nodes and the lymphatic organs (spleen and liver).
In most cases, tonsillitis with severe sore throat also occurs. Swelling of the lymph nodes (especially in the neck) is very common, and the liver and spleen are also swollen in up to 50% of cases. The severe swelling of the spleen can lead to pain in the left upper abdomen. A dreaded complication is the rupture of the spleen, which can lead to severe to life-threatening bleeding.
