Various types of leukemia can cause an increase in the size of lymphoid tissues in body areas such as the lungs, bone marrow, lymph nodes — and spleen. Located next to 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. Splenomegaly is an enlargement of the spleen caused by an underlying disease. Not only can the condition adversely impact your appetite, but the foods you eat can improve or worsen the condition.

One MyLeukemiaTeam member described how their enlarged spleen affected their ability to eat. “My spleen was massive. My oncologist said it was lying on top of my stomach. It's supposed to be under the left rib cage. Yes, it did have a lot of associated pain,” they wrote. “I couldn't eat because there was no room in my stomach. If I forced myself to eat, it brought on more pain, much more.”

Understanding splenomegaly and the signs related to this condition are important factors in being able to recognize and manage symptoms — including making changes to your diet — as soon as possible. If you are living with leukemia and are experiencing a loss of appetite or rapid, unintentional weight loss, talk with your health care provider immediately.

What Is Splenomegaly?

Splenomegaly is a rare condition, and it does not necessarily indicate the presence of a disease. Normally, it only affects 2 percent of the total population in the United States. Nonetheless, it is a serious and potentially life-threatening condition, if caused by disease, if it is not detected and treated immediately.

In healthy adults, the spleen is normally the size of a fist and weighs approximately 7 ounces (200 grams). If you experience moderate splenomegaly, the spleen can weigh about 14 ounces (400 grams). In severe cases, massive splenomegaly can occur, with the spleen weighing more than 2 pounds (1 kilogram).

What Causes Splenomegaly in Leukemia?

The cause of splenomegaly depends on the underlying condition. The spleen has the largest collection of lymphoid tissues in the body. In people with leukemia, abnormal cells can enter the spleen and stretch it in size over a period of time. As the spleen grows, it presses against the stomach and sends signals to the brain to tell the body it is satiated, or full. Additionally, splenomegaly can decrease your number of healthy white blood cells, red blood cells, and platelets — which are important to fight against infections.

People diagnosed with leukemia are at a greater risk for developing splenomegaly. Splenomegaly can also occur in children and young adults with mononucleosis, or individuals exposed to malaria and other conditions.

Splenomegaly and Nutrition

Splenomegaly can interfere with an individual’s meals, eating, nutrition, and weight. It is important to be aware of certain foods to avoid or introduce to your diet in order to manage your splenomegaly symptoms and diagnosis. Foods that are high in fat or sugar have been shown to cause inflammation and aggravate splenomegaly, while anti-inflammatory foods have been shown to alleviate symptoms.

Inflammatory foods to avoid in your diet include:

• Refined carbohydrates, such as pastries and white breads
• Fried foods
• Sugary beverages, such as sodas
• Red meat, such as burgers and steak
• Processed meat, such as hot dogs and sausages
• Shortening, lard, and margarine

Anti-inflammatory foods to include in your diet include:

• Green leafy vegetables
• Tomatoes
• Nuts
• Olive oil
• Fatty fish, such as tuna, salmon, and sardines
• Fruits, such as berries and oranges

Additionally, studies have found that combining light exercise with a low-fat, low-sugar, anti-inflammatory diet may reverse the enlargement of the spleen. Light exercise may also help you manage leukemia.

Symptoms of Splenomegaly

People living with splenomegaly often experience difficulty with their overall diet and nutrition. As the spleen grows in size, it presses against the stomach and tricks the body into thinking it is full. One MyLeukemiaTeam member shared their symptoms: “My weight dropped considerably over the last year. I can’t eat the same amount of food as I used to. My stomach will start to hurt even when I eat small portions of food.”

Symptoms of splenomegaly that can affect your relationship with food include:

• Stomach pain or discomfort
• Feeling full
• Swelling of the stomach
• Decreased appetite
• Weight loss

If you have an enlarged spleen and find it difficult to eat enough throughout the day to get enough calories and nutrition, try eating multiple smaller meals

Other symptoms of splenomegaly may include:

• Easy bleeding
• Fatigue (related to anemia symptoms)
• Anemia
• Susceptibility to infections

How Is Splenomegaly Diagnosed?

The spleen can be felt during a physical exam. This is the most common way to detect splenomegaly. However, lab tests and imaging may be required to rule out underlying conditions.

Lab tests and imaging include:

• Blood tests to check the number and shape of red blood cells, white blood cells, and platelets
• Abdominal CT or ultrasound scans to measure the size of the enlarged spleen
• MRI scans to examine the blood flow through the spleen

How Is Splenomegaly Treated?

Treating splenomegaly goes hand in hand with treating the underlying condition. For people living with leukemia, it is best to manage the symptoms of the condition in order to treat splenomegaly effectively.

Avoid Contact Sports

All individuals with splenomegaly are advised to avoid contact sports and other physical activities that could increase their risk of injuries. An enlarged spleen is more prone to rupturing and causing internal bleeding, which can be life-threatening. It is important to prevent these injuries until the spleen is reduced to its normal size.

Some popular contact sports include:

• Soccer
• Hockey
• Rugby
• Football
• Lacrosse
• Water polo

Routine Vaccinations

Individuals with splenomegaly are at a higher risk of developing an infection. It is important to stay up to date with vaccines, including the diphtheria, tetanus, and pertussis (DTaP) booster every 10 years and an annual flu shot.

Surgery

If other treatments and therapies do not improve symptoms, surgical removal of the spleen — called a splenectomy — may be considered. An individual can survive without a spleen, but they are at a greater risk of developing infections and sepsis. Getting vaccinated against certain bacterial infections is highly recommended before and after surgery.

Radiation Therapy

If an individual cannot undergo surgery to remove their spleen, radiation therapy could be an option. Radiation uses beams of high energy to help reduce the size of the spleen, and it can work with a much lower radiation dose and fewer treatments than those used to treat cancer.

Talk With Others Who Understand

MyLeukemiaTeam is the social network for people with leukemia and their loved ones. On MyLeukemiaTeam, more than 8,300 members come together to ask questions, give advice, and share their stories with others who understand life with leukemia.

Are you living with splenomegaly? Share your experience in the comments below, or start a conversation by posting on your Activities page.