You may go your entire life and never even really think about your spleen. Unless it becomes damaged, your spleen will go on filtering your blood and producing white blood cells without a fuss. Tucked up under your rib cage, your spleen is well protected. This does not mean, however, that your spleen can't become damaged, and potentially turn into a big problem. 

Enlarged Spleen (Splenomegaly) Definition and Facts

An enlarged spleen is the result of damage or trauma to the spleen from any of several different medical conditions, diseases, or types of physical trauma. Infections, liver problems, blood cancers, and metabolic disorders can all cause your spleen to become enlarged, a condition called splenomegaly.

When your spleen is enlarged, you are at an increased risk of it rupturing. A ruptured spleen or even a bad splenic laceration could cause massive amounts of internal bleeding, which will need immediate medical attention. 

What is the Spleen? What is its Function?

Your spleen is a small orange-sized organ in the upper left side of your abdominal cavity. Tucked behind the ninth, tenth, and eleventh ribs just under your left lung, your spleen is an organ that has a role to play in not just one, but two major systems of the body. 

The spleen is made of two distinct types of tissue, each with its own job. The first role of the spleen is to filter your blood. One kind of tissue in your spleen, known as the red pulp, helps remove damaged blood cells and other cellular waste materials from your blood supply. Your spleen is also responsible for holding platelets in reserve to aid in clotting when you are injured. The spleen also helps to maintain a healthy number of red blood cells in your blood to allow your blood to carry oxygen efficiently.

As a part of your lymphatic system, the second major function of the spleen is to help keep your immune system functioning properly. The second kind of tissue in your spleen, the white pulp, is responsible for helping to store lymphocytes. Also known as white blood cells, these cells are the main defense your body has against infections. When you are sick, the spleen releases these white blood cells into your bloodstream to attack any invaders, such as bacteria or viruses, in an attempt to destroy them and keep you healthy.

What Type of Pain Does an Enlarged Spleen Cause?

You would think any organ being enlarged would cause pain, but surprisingly, an enlarged spleen may not give you many signals that something is wrong. 

Unlike many other illnesses, problems with your spleen don't often exhibit a lot of symptoms on their own. It takes a serious case of splenomegaly for you to begin feeling pain from your spleen. If your spleen becomes significantly enlarged, it is possible to experience pain in your upper abdomen and even into your left shoulder. 

The pressure an enlarged spleen can put on surrounding organs can sometimes be felt if the swelling has become severe enough. If you experience sharp pain in the upper left part of your abdomen when taking a deep breath, it may be time to talk to your doctor to see if you are suffering from splenomegaly. 

Causes of an Enlarged Spleen

With its role in cleaning and maintaining your blood supply, the spleen can be susceptible to many different conditions that affect your blood. This can include hereditary diseases and blood cancers like Hodgkin’s disease (a form of lymphoma) and leukemia. Your dietary habits and lifestyle could cause your spleen to become enlarged. Liver disease, such as cirrhosis caused by chronic alcoholism, can affect the spleen. Some forms of heart disease, which can be affected by diet and exercise, can also disrupt the blood supply to your spleen.

Blood disorders are a significant source of splenic problems. Since your spleen spends its day filtering and cleaning your blood supply, things that go wrong with your blood, particularly when they affect your red blood cells, can be a challenge for your spleen. Several of the blood disorders that are common causes of splenomegaly involve the spleen working too hard to remove damaged blood cells. These conditions include hemolytic anemia, sickle cell disease, thalassemia, and spherocytosis. 

The blood disorders mentioned above are not the only reason your spleen may be working overtime trying to target and filter damaged cells from your blood. Cancers such as leukemia and Hodgkin’s disease can both cause damage to blood cells and result in abnormal amounts of filtration by the spleen. It is also possible that other types of cancer can metastasize into splenic tissue. 

There are a number of metabolic and genetic disorders that can affect the spleen. These conditions are less focused on damage to the blood itself, but the damage to other tissues in the body can still cause there to be extra work for the spleen to do. The more common causes of this type of damage to the spleen include the following:

  • Amyloidosis: the buildup of abnormal protein deposits in the spleen and other areas of the body
  • Gaucher disease: a genetic enzyme deficiency disorder leading to damaged white blood cells
  • Hurler Syndrome: a genetic condition preventing the proper digestion of sugar that affects many different organs, including the spleen 
  • Niemann-Pick Disease: an enzyme deficiency allowing lipids to build up in several kinds of tissue throughout the body
  • Sarcoidosis: a condition of the lymphatic system that causes inflammatory cells to build up in the spleen

Infections of various types are also possible causes of splenomegaly. This can include viral, bacterial, and even parasitic infections. These infections span the spectrum of serious, life-threatening infections from HIV/AIDS and malaria to tuberculosis and viral hepatitis. Other, lesser-known infections such as anaplasmosis and cytomegalovirus, can also cause damage to the immune system, including the spleen.

What are Other Signs and Symptoms of an Enlarged Spleen?

Most organs in the body have their way of telling you something is wrong. Chronic coughing and nasal drainage can indicate something has gone wrong in your respiratory system. Blood in your stool is a clear sign you should go talk to your doctor, as something might be very wrong in your digestive tract. Problems with your spleen, on the other hand, have few such telltale signs. 

If you find yourself pushing back from the table feeling full before you have eaten a full meal, a problem with your spleen is probably not the first thing that will come to mind. In fact, an unexplained sensation of fullness is sometimes an indication that your spleen has become enlarged and is pressing against your stomach. 

Other symptoms of splenomegaly are more closely related to whatever underlying ailments has damaged your spleen in the first place. These can run the gamut from the symptoms of infections like HIV/AIDS to liver disorders and malaria. A few common symptoms that are closely linked to splenic problems are listed below:

  • Anemia
  • Easy bleeding
  • Fatigue
  • Frequent infections
  • Jaundice
  • Pain in the upper left abdomen
  • Weight loss

Treatments for Splenomegaly (or Enlarged Spleen)

It is unlikely you will ever go to the doctor just to investigate an enlarged spleen. Typically, the symptoms of the underlying cause of your splenomegaly will be the reason you seek medical attention. 

Diagnosing your condition will likely start with a physical exam and blood tests to see what is going on. If your doctor believes your spleen may be enlarged, he or she may recommend further imaging such as X-rays or a CT scan to get a better look at the condition of your spleen. 

From here, your course of treatment is going to depend on what causes of splenomegaly may have been identified. For some common causes it is possible that treatment through medication or lifestyle and diet changes can begin to bring about relief. For some other genetic conditions, cancers, or if your spleen has simply been too badly damaged, it may be necessary to remove your spleen altogether. 

The good news is, there is no reason to be concerned about having your spleen removed. There are many organs that you cannot live without, but the spleen is different. You can live a very full, normal life without a spleen, though there will be some negative effects. Due to the important role the spleen plays in maintaining your body’s reserve of white blood cells, having your spleen removed will make you more susceptible to infection for the rest of your life. 

Regardless of the reason for your splenomegaly, you should exercise caution if your spleen has become enlarged. The risk of splenic laceration or rupture is very real, especially if your spleen is enlarged. This is especially true of contact sports or outdoor action sports like skiing or mountain biking. 

Normally, your ribcage protects your spleen, but when it is damaged or irritated it is possible for your spleen to enlarge beyond the ribcage, making it easier to damage in an impact. This is why, as strange as it may seem, avoiding contact sports for a period of time after you have had certain illnesses like infectious mononucleosis is likely going to be something your doctor recommends. 

Whenever there is pain or discomfort in your abdomen for more than a few days, it may be time to talk to your doctor. This is particularly true if you are experiencing more worrying symptoms like unexplained bleeding or sharp pains when you breathe. If you are concerned you may be experiencing the symptoms of splenomegaly, or one of the serious conditions that can cause it, request an appointment at Cary Gastroenterology Associates today. We can help you sort through the symptoms and understand the risks and treatments available for an enlarged spleen.