AYURVEDA PERSPECTIVE ON ENLARGED SPLEEN

A person with an enlarged spleen may feel pain or fullness in the left upper abdomen. Sometimes this pain may spread to the left shoulder. A sore left shoulder could be due to other causes as well - so don't assume your sore left shoulder means your spleen is enlarged! Splenomegaly often presents no signs or symptoms. Other symptoms include pressure on the stomach from the spleen causing a person to feel full after eating a small amount of food or even without having eaten. An enlarged spleen may also cause hiccuping, frequent infections and fatigue.

From a Western perspective, there are many different causes for an enlarged spleen. The spleen often becomes enlarged when it works extra hard at its normal functions. This condition of a hyperactive spleen is called hypersplenism. It is usually connected to diseases where there are too many abnormal or dead red blood cells that must be filtered by the spleen, or from cleanup of various blood components from white blood cells and platelets to immune system by products. The spleen is overworked from removing these blood components

. People with hemolytic anemias like thalassemia or sickle cell anemia may have an enlarged spleen because their red blood cells die quickly, within 30 days instead of the normal 120 days. This type of splenomegaly would be considered a Pitta type because Pitta governs the blood (Rakta Vaha Srotas). In the case of hemolytic anemias the rough (khara guna) and sharp quality (tikshna guna) is imbalanced which kills the red blood cells in order to protect the body from malaria infection. The main element of red blood cells are fire. The quick breakdown of red blood cells increases fire element in the body and the product of irritating bile.

The spleen may be overworked because of an increased immune response as in systemic viral, bacterial or parasitic infections or diseases of the lymph. This would be a Kapha type of hypersplenism because of the congestion that results. The process of filtering blood borne pathogens can result in abscess formation when disease fighting white blood cells become engorged with materials the body can't digest. These giant toxin filled cells accumulate in the spleen as it purifies the blood. Due to the toxicity, abscess formation will also involve the hot quality of Pitta dosha as well as the fire element.

As recognized by Ayurveda, the spleen and liver have an intimate relationship in ensuring healthy blood. Hypersplenism often occurs with disorders of the liver. It can be related to portal hypertension - high blood pressure in the veins carrying blood from the digestive tract to the liver. The pressure from this can lead to severe bleeding in the GI tract and ultimately anemia. Excessive filtering of platelets causes thrombocytopenia, a deficiency of platelets in the blood which causes bleeding into the tissues, bruising, and slow blood clotting after injury. It is the most common cause of hypersplenism and may contribute to portal hypertension related bleeding. It is common for the spleen to become enlarged with liver disease. Liver disease causes abnormalities in blood coagulation and this can cause a person to bleed easily after only a minor injury.

Splenomegaly could also occur when there's a condition causing overproduction of blood cells to grow in the bone marrow. This is a Kapha type condition of excess. The gross and dense qualities are imbalanced as is the earth element. The bone marrow involves both Ranjaka Pitta (in its blood making capacity), Rakta Vaha Srotas (which governs red blood cells) and Majja Vaha Srotas (which governs the nerves and the bone marrow in Ayurveda).

Congestive splenomegaly develops when blood coagulates in the splenic vein, hepatic portal vein which goes from the GI tract to the liver, or in the veins around the heart as in congestive heart failure. This is a Kapha type of splenomegaly due to stagnation. The heavy, slow, gross and cloudy qualities of Kapha are out of balance as are the water and earth elements. This is excess Kapha in Avalambaka Kapha and Vyana Vayu (circulation).

Trauma - as in the case of a sports injury or car accident - can cause spleen enlargement. Trauma always involves Vata dosha via the cold, light and mobile qualities which cause sudden change and ungrounding. Cancer, and other medical conditions can also cause splenomegaly.

Splenomegaly is a serious condition and should be checked by a medical doctor. Splenomegaly is usually caused by an underlying condition. Because splenomegaly mainly involves Pitta and Kapha via their hot, dense, gross and static qualities, favor cooling and cleansing dietary and herbal protocols. Bitter taste is going to be very useful here as it pacifies both doshas. Bitter reduces congestion in the spleen, as bitter taste reduces stagnation and cleanses the liver, directly reducing pressure in the spleen / liver system. Bitter also thins the blood by reducing sugar levels in the blood. Bitter lightens and dries things out to placate enlargement. Aloe, neem, turmeric and pomegranate are all bitter as are bitter greens like dandelion and arugula. Diuretic herbs may be useful where Kapha is congested. A client who has splenomegaly may be anemic or have other blood deficiencies. These should be address with tonics and doshically appropriate food.

Images of Enlarged Spleen