You have just learned that you have an enlarged spleen, a condition your doctor may have called splenomegaly. This news can feel overwhelming, especially if you are not familiar with what your spleen does or why it might have grown larger. This guide will help you understand what is happening in your body, what might have caused this change, and what steps you and your doctor will take moving forward.
What Your Spleen Does
Your spleen sits in the upper left part of your abdomen, tucked beneath your rib cage. Though you may not have thought much about this organ before, it plays several important roles in keeping you healthy. Your spleen filters your blood, removing old or damaged red blood cells and helping your body recycle their components. It also stores certain blood cells and releases them when your body needs them, particularly during injury or infection. Additionally, your spleen is part of your immune system, producing white blood cells that fight infection and helping your body recognize and respond to harmful bacteria and viruses.
In a healthy adult, the spleen is roughly the size of your fist and weighs about half a pound. When doctors say your spleen is enlarged, they mean it has grown beyond its normal size, sometimes becoming 2 or 3 times its usual size. However, you want more information and need a splenomegaly (enlarged spleen) explained. The following will help.
Why Your Spleen Might Be Enlarged
Many conditions can cause your spleen to enlarge. Understanding the underlying cause is essential because treatment focuses on addressing what triggered the enlargement rather than the enlargement itself.
One common reason for an enlarged spleen is infection. When your body fights certain infections, whether viral, bacterial, or parasitic, your spleen works harder than usual, producing more immune cells and filtering more material from your blood. This increased activity can cause it to swell. Mononucleosis, for example, is well known for causing temporary spleen enlargement.
Blood disorders represent another major category of causes. Conditions that affect how your blood cells function or how long they survive can make your spleen work overtime. When red blood cells break down too quickly or are shaped abnormally, your spleen must filter out more damaged cells than usual, which can lead to enlargement. Similarly, certain types of anemia and conditions affecting blood cell production can trigger this response.
Liver disease can also lead to an enlarged spleen. When your liver does not function properly, blood flow through the vessels connecting your liver and spleen can become blocked or slowed. This creates a backup of blood in your spleen, causing it to swell much like a backed-up drain causes water to pool.
Cancers affecting your blood cells or lymphatic system, such as certain leukemias or lymphomas, can cause your spleen to enlarge as abnormal cells accumulate there. Additionally, metabolic storage diseases, in which certain substances build up in your body because your cells cannot process them properly, can cause enlargement of the spleen as these substances accumulate there.
Symptoms You Might Experience
You may have noticed certain symptoms before your diagnosis, or you might not have felt anything unusual at all. Many people with an enlarged spleen have no symptoms, and the condition is discovered during a routine physical examination or imaging test performed for another reason.
When symptoms do occur, you might feel fullness or discomfort in your upper left abdomen. This sensation can become more noticeable after eating even small amounts of food, as the enlarged spleen presses against your stomach. Some people describe feeling pressure or aching in this area.
You might experience fatigue, especially if the underlying cause of your enlarged spleen affects your blood cells or if you have developed anemia. Easy bruising or bleeding more readily than usual can occur if your spleen is trapping too many platelets, the blood cells responsible for clotting. Some people experience frequent infections if the condition affecting their spleen also compromises their immune function.
How Your Doctor Made This Diagnosis
Your doctor likely discovered your enlarged spleen during a physical examination. By gently pressing on your abdomen, doctors can often feel the edge of a spleen that has grown large enough to extend below your rib cage. Normally, your spleen stays tucked completely under your ribs and cannot be felt.
To confirm the enlargement and determine its extent, your doctor may have ordered imaging tests. An ultrasound, CT scan, or MRI can show the size of your spleen and provide detailed images that help identify possible causes. Blood tests are typically performed to check your blood cell counts, assess liver function, and detect signs of infection or other underlying conditions.
What Happens Next
Your treatment path will depend entirely on what is causing your spleen to enlarge. This is why your doctor will focus on identifying the underlying condition. Once the cause is clear, addressing it often allows your spleen to return to its normal size.
If an infection is responsible, treating that infection, whether with antibiotics, antiviral medications, or simply giving your body time to heal, will be the priority. For blood disorders, your doctor may recommend specific medications, transfusions, or other therapies depending on the particular condition. If liver disease is the cause, managing that disease becomes the focus of treatment.
In some cases, particularly when the enlarged spleen is causing serious complications such as severe anemia, significant reduction in platelet counts, or symptoms that substantially affect your quality of life, your doctor might discuss the possibility of removing your spleen surgically. This procedure is called a splenectomy. While you can live without your spleen, removal is generally considered only when other treatments have not worked or when the risks of keeping your enlarged spleen outweigh the benefits.
Important Precautions
While your spleen is enlarged, you should take certain precautions to protect yourself. An enlarged spleen has a thinner, more stretched outer covering, making it more vulnerable to rupture from injury. Even activities that would not normally be dangerous can pose risks.
You should avoid contact sports and any activities where you might fall or receive a blow to your abdomen. Talk with your doctor about which physical activities are safe for you. If you experience sudden, severe pain in your upper left abdomen, especially after any injury, seek emergency medical care immediately, as this could signal a ruptured spleen, which is a serious medical emergency.
Moving Forward
Learning about your enlarged spleen is just the beginning of your journey toward understanding and managing this condition. The most important thing to remember is that an enlarged spleen is typically a sign of another underlying issue rather than a disease itself. Working closely with your doctor to identify and treat the root cause gives you the best chance of your spleen returning to normal size and function.
Ask your doctor any questions you do not understand, keep all your follow-up appointments, and report any new symptoms promptly. With proper diagnosis, treatment, and monitoring, many people with enlarged spleens can successfully manage their underlying conditions and return to their normal activities. You have taken an important first step by learning about your condition; now, you and your healthcare team can work together to chart the path forward.
