The silent guardian of your health

What is the spleen?

The spleen, also called Splen , is a small organ in the upper left abdomen just beneath the diaphragm. It lies behind the lower ribs at the level of the tenth rib and is well protected by the ribcage, so it is normally not palpable from the outside unless it is markedly enlarged.

The spleen consists of two main parts: the red pulp and the white pulp. The red pulp, which makes up about 80 percent of the organ, filters the blood and removes old or damaged blood cells. The white pulp, which surrounds the spleen's blood vessels, plays an important role for the immune system by storing lymphocytes and fighting pathogens.

The spleen is enclosed by a flexible connective tissue capsule that protects its soft interior. The organ receives a rich blood supply via the splenic artery; each day the entire blood volume is pumped through the spleen about 500 times.

In the unborn child it produces blood cells, a function taken over by the bone marrow after birth. Although the spleen is an important organ, a person can live without it, since other organs such as bone marrow and lymph nodes perform similar functions.

What are the most common spleen disorders?

The most common spleen disorders include both enlargement (splenomegaly) and shrinkage of the organ.

An enlargement can have various causes. These include infections caused by viruses, bacteria or parasites, autoimmune diseases such as systemic lupus erythematosus and rheumatic disorders, as well as blood diseases such as sickle cell disease and thalassaemia. Cancers such as leukaemia or lymphomas, liver cirrhosis and heart failure can also lead to spleen enlargement.

Shrinkage, on the other hand, may be age-related or occur with autoimmune diseases such as Crohn's disease and ulcerative colitis, as well as after chemotherapy or bone marrow transplantation.

Specific spleen conditions include spleen swelling, often caused by infections such as infectious mononucleosis or tuberculosis and which can be painful. A splenic rupture, caused by trauma or a broken rib, can lead to severe blood loss and often requires surgery. Splenic congestion results from circulatory disorders such as liver cirrhosis or heart failure, causing blood to back up in the spleen.

The OPSI syndrome, which occurs in people without a functioning spleen, increases the risk of severe bacterial infections, particularly from pneumococci. Autoimmune diseases can also damage the spleen, and red blood cell abnormalities such as sickle cell disease cause these cells to remain in the spleen and be destroyed there. Finally, benign or malignant tumours can develop in the spleen, and metastases from other cancers are also possible.

What is a splenic infarct?

A splenic infarct occurs when the blood vessels supplying the spleen become blocked, interrupting the supply or outflow of blood. This can affect the splenic artery (arteria lienalis), which brings blood to the spleen, as well as the splenic vein (vena lienalis), which carries it away.

If the arteria lienalis is occluded, the spleen is no longer adequately perfused, leading to oxygen deprivation and tissue damage. If the vena lienalis is blocked, blood pools in the spleen, which likewise leads to oxygen deficiency and tissue death. The damage can be localised or involve the entire organ.

Common symptoms of a splenic infarct include sudden severe pain in the left upper abdomen, which may radiate to the left shoulder. Other signs are a tense, painful abdominal wall, nausea, vomiting, loss of appetite, as well as fever and chills. In severe cases, elevated inflammatory markers and signs of bloodstream infection (sepsis) may be present.

The causes of a splenic infarct are varied. It often occurs secondary to underlying conditions such as bacterial infections of the heart lining, inflammation of the pancreas, or cancers like leukaemia. Anticoagulant medications can also increase the risk, as can malaria, which is the most common cause of splenic infarct worldwide. Cardiac rhythm disorders such as atrial fibrillation, which promote clot formation, can also trigger a splenic infarct.

How else can spleen-energy become depleted?

Depletion of spleen-energy can be caused by various factors. These include weak digestive organs, irregular or inadequate food intake, especially excessive consumption of sweets, as well as psychological overstrain and chronic illnesses. Long-term exposure to persistent dampness can also weaken the spleen. 

Emotional rumination and constant worry further burden the spleen, because in Traditional Chinese Medicine (TCM) the spleen is responsible for emotional balance. A lack of spleen-energy can develop already in childhood and later lead to a deficiency of liver Qi.

The state of spleen-energy is also visible externally, for example on the lips, which appear red and moist when the spleen is in harmony. In TCM the spleen is associated with the Earth element, representing stability and internal warmth.

Can an injury to the spleen become dangerous? 

An injury to the spleen, e.g. a splenic rupture, can be dangerous, as it is often caused by a strong impact to the abdomen, for example in a traffic accident. A splenic rupture causes heavy internal bleeding that can lead to circulatory collapse and severe abdominal pain. 

In chronic diseases that cause marked enlargement of the spleen, symptoms arise because the enlarged spleen displaces the stomach or intestines. In such cases the spleen is palpable and there may be a reduction in red and white blood cells as well as platelets, which can necessitate further diagnostic steps such as bone marrow aspiration.

How to protect and support your spleen: useful tips

• Ensure adequate sleep, especially between 23:00 and 06:00, so the spleen can regenerate.
• Do not eat too late in the evening and favour light, warm meals such as soups that are easy to digest. Take your time when eating and avoid distractions to support digestion and the spleen.
• Maintain a balanced diet rich in spleen-friendly herbs like anise, basil and fennel.
• Use homeopathic remedies such as honey, marjoram and pepper to support spleen function.
• It is advisable to exercise regularly, e.g. jogging, cycling or yoga, to strengthen the spleen.
• Reduce stress by viewing it as a challenge and practising relaxation techniques such as meditation or yoga nidra regularly.
• Try the yoga pose “Frog” to strengthen the spleen and relax in the evening before bedtime. Sit on your heels, open the knees wide and slide the arms forward. Keep the abdomen free and turn the head to the side. Hold this position for a few minutes to relax the body.
• Support the spleen with vitamin B12, B6 and iron to promote blood formation and relieve the spleen.
• Use OPC (oligomeric proanthocyanidins) from grape seed extract to reduce oxidative stress in the spleen.
• Regularly include bitter foods such as endive and chicory in your diet to strengthen the spleen.
• Use natural antibiotics like garlic, onions and radishes to promote the spleen's defences and strengthen your immune system.
• Consider splenectomy for severe spleen diseases in order to remove the affected splenic tissue and connective structures. This may be necessary for certain lymphatic diseases.
• After spleen removal, be aware that your circulation may be affected, as the production of erythrocytes and thrombocytes is disturbed. Lymphatic follicles in the lymphatic system will also be affected, since splenic tissue plays an important role.

The spleen plays a central role for the immune system and blood cleansing and is therefore a very vital organ. It is important to care for its health and to consult a doctor if you experience pain or symptoms. A healthy lifestyle helps the spleen to perform its functions optimally.