Splenomegaly is enlargement of the spleen caused by leukemia or another disease. When the spleen becomes larger, it takes up more space in the abdomen and may cause abdominal pain or make you feel full when you’ve barely eaten. Splenomegaly may make it difficult to enjoy mealtimes and get the nutrients you need to fight blood cancer and recover from leukemia treatment.

If splenomegaly is interfering with your ability to eat, undergoing treatment or adjusting your your diet may help. If you’re living with leukemia and experiencing a loss of appetite or rapid, unintentional weight loss, talk with your health care provider immediately.

Why Does the Spleen Become Enlarged?

Located on the left side of the abdomen above the stomach, the spleen is an important organ that helps fight certain infections, filters out and destroys old and damaged blood cells, produces white blood cells called lymphocytes, and stores red blood cells and platelets. In people with chronic lymphocytic leukemia, chronic myeloid leukemia, and other forms of leukemia, cancer cells can pile up in the spleen and stretch it to an unusual size. As the spleen grows, it presses against the stomach and sends signals to the brain to tell the stomach it’s full.

“I couldn’t eat because there was no room in my stomach.”

— A MyLeukemiaTeam member

Your doctor can feel your spleen during a physical exam. This is the most common way to detect splenomegaly.

Other Causes of Splenomegaly

People diagnosed with leukemia are at a greater risk of splenomegaly. An enlarged spleen can also be a symptom of health conditions including:

• Liver disease, such as cirrhosis (advanced, permanent scarring of the liver)
• Lymphoma, another type of blood cancer
• Infections including mononucleosis, malaria, and HIV
• Sarcoidosis and other diseases of the immune system

What Are the Symptoms of Splenomegaly?

Splenomegaly may not cause symptoms at all. If you do notice symptoms, abdominal pain and feeling full with just a few bites of food are among the most common.

On MyLeukemiaTeam, more than 170 members have reported feelings of fullness or discomfort in the abdomen as symptoms of their leukemia. More than 120 have reported experiencing abdominal pain. “My spleen was massive,” wrote one member of MyLeukemiaTeam. “My oncologist said it was lying on top of my stomach. It’s supposed to be under the left rib cage. It had a lot of associated pain.”

Splenomegaly may also cause:

• Pain that radiates to the left shoulder
• Bleeding easily (due to low platelet count)
• Anemia (low red blood cell count), which can cause fatigue
• Frequent infections due to low white blood cell count
• Bloating
• Anorexia (loss of appetite)

If your splenomegaly is due to cancer, you may also have weight loss, weakness, and night sweats.

“My weight dropped considerably over the last year,” shared another member. “I can’t eat the same amount of food as I used to.”

How Does an Enlarged Spleen Affect Eating?

Splenomegaly can interfere with your meals, making eating a painful and frustrating chore. Members of MyLeukemiaTeam have discussed how an enlarged spleen affects their eating. “My stomach will start to hurt even when I eat small portions of food,” said one member of MyLeukemiaTeam.

“My stomach will start to hurt even when I eat small portions of food.”

— A MyLeukemiaTeam Member

“I couldn’t eat because there was no room in my stomach,” wrote another. “If I forced myself to eat, it brought on more pain — much more.”

Tips for Eating Well Despite Splenomegaly

You can try a few approaches to help you take in more nutritious food and work around the symptoms of an enlarged spleen. One member described how they changed their diet: “I’ve been working hard on getting more protein in my diet. It’s difficult with my spleen and stomach problems — can’t digest meat easily, so I’m going to protein powder, smoothies, salads, etc.”

You can also try strategies such as these:

• Eat smaller, more frequent meals. Try eating multiple smaller meals throughout the day.
• Take time and savor your food. Eat slowly, giving your digestive system time to move food along and make space.
• Make every meal count. Choose nutritious foods with healthy fats such as fish and nuts. An anti-inflammatory diet may help you feel your best.
• Pass on packaged foods. Avoid fast foods and heavily processed foods, which may make inflammation worse.
• Keep food and drinks separate. Take in only solid food at meals, and have something to drink at another time. Liquids may fill you up quickly and make it harder to eat.

How Is Splenomegaly Treated?

Treating splenomegaly means treating the underlying condition. If you’re living with chronic lymphocytic, myeloid leukemia, or another type of leukemia, your doctor may recommend medications or radiation therapy to shrink the spleen. They may also suggest a splenectomy, or surgical removal of the spleen, as a treatment option. This procedure may help with abdominal pain and anemia. You can live normally without a spleen, but you’ll have a higher risk of serious infections.

“If I forced myself to eat, it brought on more pain — much more.”

— A MyLeukemiaTeam member

Anyone with an enlarged spleen should avoid contact sports and any other activities that might result in trauma to the abdomen. People with splenomegaly have a high risk of their spleen rupturing, which is a life-threatening medical emergency.

Your health care provider can help you find the way to treat your enlarged spleen, as well as offer medical advice on how to help improve your eating and ease other symptoms of splenomegaly with leukemia.

Talk With Others Who Understand

MyLeukemiaTeam is the social network for people with leukemia and their loved ones. On MyLeukemiaTeam, more than 19,000 members come together to ask questions, give advice, and share their stories with others who understand life with leukemia.

Have symptoms of splenomegaly made it difficult for you to eat? What approaches have helped you manage your enlarged spleen and have better experiences at mealtimes? Share your experience in the comments below, or start a conversation by posting on your Activities page.