An enlarged spleen – also known as splenomegaly – can lead to spleen pain and anemia. The spleen is part of the lymph system and works with the drainage network in order to prevent illness and keep us healthy. The spleen, although it protects us from illness, can get sick from numerous conditions, such as liver disease and even cancer. When the spleen falls ill from other conditions it becomes enlarged (splenomegaly).
Having an enlarged spleen can be symptomless and can go undetected for quite some time. Often an enlarged spleen isn’t discovered until a patient goes for a regular physical exam. Normally a doctor cannot feel the spleen, but when it becomes enlarged they are able to detect it through touch.
In some cases, an enlarged spleen is not cause for concern and could simply reveal that it has been working overtime to keep you healthy. But if your doctor suspects an underlying cause aside from warding off illness, they may request further testing.
Causes of an enlarged spleen
As mention, a spleen can become enlarged if it is working overtime to fight off an illness, but numerous other conditions can lead to splenomegaly as well, including:
- Viral infections
- Bacterial infections
- Parasitic infections
- Cirrhosis and liver disease
- Types of hemolytic anemia
- Blood cancers
- Metabolic disorders
- Pressure on the veins in the spleen, liver or blood clots
The main functions of the spleen are filtering and destroying damaged blood cells, preventing infection by producing white blood cells, and storing red blood cells and platelets to help blood clot. If your spleen becomes enlarged, these functions can become impaired.
Enlarged spleen symptoms
Generally, an enlarged spleen may pose no symptoms, but if it does you may expect the following:
- Pain or fullness in the upper abdomen, which can spread to the left shoulder
- Feeling full even if you haven’t eaten or have only consumed a small amount
- Frequent infections
- Easy bleeding
If the pain in the abdomen worsens when you breathe, you should seek medical attention immediately.
Possible complications that can arise as a result of splenomegaly include infection due to a reduction of red blood cells and a ruptured spleen.
Diagnosis of enlarged spleen
An enlarged spleen can be detected through a physical examination—your doctor can feel it through your skin while pressing around the area of the spleen. This is most effective in average-sized people. In very slender or larger people, this may be more of a challenge.
To confirm the diagnosis, your doctor will run blood tests and complete an ultrasound or CT scan to get a better visual of the spleen.
Enlarged spleen treatment
The underlying cause of an enlarged spleen will largely affect treatment. For example, antibiotics may be used to treat bacterial infections, or treatment may be given based on liver disease. If an underlying cause cannot be determined, your doctor may wish to monitor you periodically to see if an illness emerges.
If you have been diagnosed with an enlarged spleen, you should avoid activities that can injure the spleen; a ruptured spleen can be life threatening. Your doctor will advise you to avoid sports and even exercise and take it easy until swelling is reduced.
In severe cases, surgery may be required to remove the entire spleen. Here are some tips to prevent infection after spleen removal.
- Get vaccinated for pneumococcal (Pneumovax 23), meningococcal and Haemophilus influenzae type b (Hib).
- Take penicillin and antibiotics.
- See your doctor if you develop a fever.
- Avoid travel, specifically to areas of the world with known diseases, such as malaria.
By working closely with your doctor you can ensure a safe recovery from spleen removal surgery. In order to minimize your risk of splenomegaly, it’s important to take precautions to prevent other conditions, such as liver disease and infections.
Prevention and prognosis of enlarged spleen
Because an enlarged spleen is the result of an underlying medical condition, it’s important to reduce your risk of illness as a means to prevent an enlarged spleen. This means reducing your risk of liver disease, portal hypertension, reducing alcohol intake, reducing your risk of the hepatitis virus, and preventing the risk of tuberculosis, malaria, HIV, and anaplasmosis.
Prognosis for an enlarged spleen depends on the underlying illness causing it. For some patients, once the underlying cause is dealt with, the enlarged spleen will go back to its normal size. In other cases, the spleen may be removed to prevent rupturing. Depending on your condition, your doctor will be better equipped to provide you with a prognosis.