Splenomegaly: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Splenomegaly?
A primary care doctor usually starts the evaluation, and a hematologist (a doctor who treats blood diseases) often helps find and treat the cause. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is splenomegaly?
Splenomegaly means a spleen that is larger than normal. The spleen is an organ in the upper left part of the belly. It sits above the stomach and under the ribs on the left side.
The spleen is part of the lymph system, the body's network that helps fight germs and keeps body fluids in balance. The spleen filters the blood and helps keep red blood cells, white blood cells, and platelets healthy. It also plays a role in immune function, which is how the body fights infection.
Certain diseases might cause the spleen to swell. A doctor can find a mildly enlarged spleen on a scan, and this is increasingly found by chance when a scan is done for another reason.
Symptoms
There are usually no symptoms from an enlarged spleen. When symptoms do happen, they can include:
- Pain in the upper left side of the belly.
- Not being able to eat a large meal.
- Hiccups.
Causes and who gets it
Splenomegaly can be caused by infections, liver diseases, blood diseases, and cancer.
A clinician guide from NHS Borders in Scotland lists infections such as malaria and infective endocarditis (an infection inside the heart), chronic liver disease, and autoimmune disorders such as rheumatoid arthritis and lupus. It also lists Gaucher's disease and sarcoidosis. Blood-related causes include hereditary spherocytosis, leukemias, and lymphomas, which are cancers of the blood and lymph system.
How doctors diagnose it
Your provider will ask about your symptoms and medical history. Then comes a physical exam. The provider will feel and tap along the upper left part of your belly, especially just under the rib cage.
Tests that may be done include an ultrasound or a CT scan of the belly, which are pictures of the inside of the body. Blood tests, such as a complete blood count (CBC) and tests of liver function, may also be done. Doctors may also test the blood for viruses, such as Epstein-Barr virus, HIV, and hepatitis viruses.
Treatment
The treatment depends on the cause of splenomegaly. Your provider will tell you what else you need to do to take care of yourself and any medical condition.
In rare cases, an injury can rupture the spleen. If you have splenomegaly, your provider may advise you to avoid contact sports.
A spleen that is badly damaged may need to be removed with surgery. You can live without a spleen, but your body loses some of its ability to fight infections.
When to see a doctor
Seek medical help right away if pain in your belly is severe or gets worse when you take a deep breath.
Call 911 or go to the emergency room if you faint, have trouble breathing, or have bleeding that will not stop.
Because there are usually no symptoms, an enlarged spleen can be found by chance on a scan done for another reason. Talk with a provider about pain in the upper left side of your belly or trouble eating a large meal.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can start the evaluation, order blood tests and scans, and refer you to a blood or liver specialist. They can also help with follow-up while the cause is treated.
Common questions
What causes splenomegaly?
Infections, liver diseases, blood diseases, and cancer can all cause splenomegaly. Some autoimmune disorders, in which the immune system attacks the body, can cause it too.
Does splenomegaly cause symptoms?
Usually not. There are usually no symptoms from an enlarged spleen, but some people have pain in the upper left side of the belly, hiccups, or trouble eating a large meal.
Can an enlarged spleen rupture?
Yes, but this is rare. An injury can rupture the spleen, and the risk is higher when the spleen is already swollen. Your provider may advise you to avoid contact sports.
Can you live without a spleen?
Yes, you can live without a spleen. Other organs, such as the liver, take over some of its work, but your body loses some of its ability to fight infections.
Sources
- MedlinePlus - Splenomegaly
- MedlinePlus - Spleen Diseases
- NHS Borders (Right Decisions) - Splenomegaly
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
