What Would an Enlarged Spleen Feel Like?

September 30, 2025 •

4 min read

An estimated 2% of the population experiences an enlarged spleen, or splenomegaly, in their lifetime. However, it often doesn't cause any symptoms and is discovered during a routine physical exam. Knowing what would an enlarged spleen feel like when symptoms do arise is crucial for understanding potential health issues.

Quick Summary

An enlarged spleen is often asymptomatic but can manifest as pain or fullness in the upper-left abdomen that may radiate to the left shoulder. It can also cause a feeling of fullness after eating only a small amount, along with fatigue, frequent infections, or easy bleeding related to impaired function.

Key Points

Upper-Left Abdominal Discomfort: Pain or a sense of fullness under the left rib cage is the most common symptom of an enlarged spleen.
Pain Radiation: The pain may sometimes spread to the left shoulder, which can occur if the enlarged spleen irritates the diaphragm.
Early Fullness: Pressure from the enlarged spleen on the stomach can cause a person to feel full after eating only a small amount of food.
Symptoms of Impaired Function: An enlarged spleen can lead to secondary symptoms like fatigue, frequent infections, and easy bruising due to over-filtering of blood cells.
Watchful Awaiting: Many cases of enlarged spleen are asymptomatic and discovered incidentally; depending on the cause, doctors may recommend a period of watchful waiting.
Risk of Rupture: A severely enlarged spleen is more prone to rupture from trauma to the abdomen, which is a life-threatening medical emergency.
Importance of Diagnosis: Splenomegaly is a symptom of an underlying condition, such as infection or liver disease, and a medical professional must investigate the cause.

The Typical Sensation of an Enlarged Spleen

The spleen is an organ located under the left rib cage, but in most healthy adults, it is not palpable, or detectable by touch, during a physical exam. When it becomes enlarged, it can push against other organs, leading to a variety of sensations. The most common feeling is discomfort, pain, or a sense of fullness in the upper-left part of the abdomen. This pain can range from a dull ache to a sharper, more noticeable discomfort.

The pain associated with an enlarged spleen can manifest in several ways:

Left-sided fullness: A primary symptom is a feeling of fullness or pressure just under the left ribs, where the spleen is situated.
Pain that spreads: The discomfort may sometimes spread to the left shoulder or back. This can happen if the enlarged spleen irritates the diaphragm, a muscle under the lungs that shares nerve pathways with the left shoulder.
Increased pain with breathing: The pain may worsen when taking a deep breath, as the diaphragm and surrounding organs are put under pressure.

How an Enlarged Spleen Affects Digestion

Another telling sensation is a feeling of early fullness, or satiety, during a meal. As the spleen grows, it can press on the stomach, which is located nearby. This pressure can cause you to feel full after eating only a small amount of food, even if you have a normal appetite. This can lead to a loss of appetite and, over time, unintentional weight loss.

Systemic Symptoms Caused by an Overactive Spleen

An enlarged spleen can sometimes become overactive, a condition called hypersplenism. When this happens, it begins removing healthy blood cells from circulation too aggressively. This can lead to a host of systemic symptoms that affect your overall health and well-being. These symptoms are a key part of understanding what would an enlarged spleen feel like beyond just the localized pain.

Fatigue and Weakness: A reduced number of red blood cells (anemia) can lead to a persistent feeling of tiredness and weakness.
Frequent Infections: If the spleen removes too many white blood cells, it can weaken your immune system, making you more susceptible to colds, flu, and other infections.
Easy Bleeding or Bruising: A low platelet count can result in easier bleeding and bruising than normal.

Potential Complications of an Enlarged Spleen

One of the most serious risks of an enlarged spleen is the potential for rupture. The spleen is already a fragile organ, and an enlarged spleen is even more vulnerable. A ruptured spleen is a medical emergency that can cause severe internal bleeding. This can be caused by an impact to the abdomen (like in a car accident or contact sport) or, in rare cases, occur spontaneously. It’s important to avoid contact sports and be mindful of potential abdominal trauma if you know you have an enlarged spleen.

How an Enlarged Spleen is Diagnosed and Treated

If a healthcare provider suspects splenomegaly based on your symptoms, they will perform a physical exam and order further tests.

Palpation: The provider will gently press on the upper-left abdomen to try and feel the enlarged spleen. They will be cautious during this process to avoid injury.
Imaging Tests: An abdominal ultrasound or CT scan can be used to accurately measure the size of the spleen and determine the extent of its enlargement.
Blood Tests: A complete blood count can reveal low red blood cell, white blood cell, or platelet counts, which is common with hypersplenism.

Treatment is focused on addressing the underlying cause of the enlargement. This may involve medication for an infection, lifestyle changes for liver disease, or managing an autoimmune condition. In severe cases, where complications are significant, surgical removal (splenectomy) might be recommended.

Comparing Enlarged Spleen Causes and Symptoms

The cause of splenomegaly can greatly influence the specific symptoms and treatment required. Below is a comparison of different types of splenomegaly.


Feature	Infectious Splenomegaly	Blood Disorder/Cancer Splenomegaly	Congestive Splenomegaly
Common Causes	Viral (mononucleosis), Bacterial (endocarditis), Parasitic (malaria)	Leukemia, Lymphoma, Sickle Cell Anemia, Hemolytic Anemia	Liver disease (cirrhosis), portal hypertension, heart failure
Associated Symptoms	Fever, malaise, swollen lymph nodes, sore throat	Weight loss, night sweats, fatigue, easy bruising or bleeding	Jaundice, ascites (fluid in abdomen), signs of liver disease
Duration	Typically temporary; resolves with treatment of the infection	Often chronic and requires ongoing management of the underlying disease	Chronic and persistent, related to the severity of the underlying condition
Treatment Focus	Antibiotics for bacterial infections; supportive care for viral	Chemotherapy, radiation, or other disease-specific therapies	Managing liver or heart condition; controlling portal hypertension

Conclusion: When to Seek Medical Attention

While an enlarged spleen may not always be symptomatic, it is important to be aware of the signs. If you experience persistent pain or fullness in the upper-left abdomen, especially if it radiates to your shoulder or worsens with deep breathing, it's time to see a doctor. Other warning signs include unexplained fatigue, frequent infections, or easy bruising. Early diagnosis and treatment of the underlying condition are key to preventing serious complications, such as a ruptured spleen.

For more detailed information on enlarged spleen causes, symptoms, and treatment options, consider visiting the Cleveland Clinic website.

Frequently Asked Questions

In most cases, a healthy spleen is not palpable. However, if it is significantly enlarged (splenomegaly), a doctor may be able to feel it during a physical examination by gently pressing on the upper-left abdomen. It is important not to press hard on your own, as an enlarged spleen can be fragile.

The pain is caused by the enlarged spleen pushing against nearby organs, such as the stomach or diaphragm. The stretching of the spleen's capsule can also cause discomfort. Pain is typically felt in the upper-left part of the abdomen.

Other signs and symptoms include a feeling of fullness after eating a small amount, fatigue and weakness due to anemia, frequent infections, and easy bleeding or bruising due to low platelet counts.

Yes, an enlarged spleen can press on the stomach, causing you to feel full after eating a small amount. This can lead to a decreased appetite and potential weight loss.

You should see a doctor promptly if you experience pain in the upper-left abdomen, especially if it is severe or worsens with deep breathing. Sudden, sharp pain could indicate a ruptured spleen, which requires immediate medical attention.

Common causes include viral infections like mononucleosis, bacterial infections, liver diseases such as cirrhosis, certain blood cancers like leukemia, and autoimmune conditions.

Diagnosis begins with a physical exam and an evaluation of your symptoms. It is confirmed with imaging tests like an ultrasound or CT scan. Blood tests are also performed to check for low blood cell counts that suggest underlying causes.

Yes, if the underlying cause is a temporary infection, the spleen may return to its normal size once the infection is treated. For chronic conditions, the size may be reduced by managing the root cause, but sometimes the enlargement is permanent.