Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Author: Richard Weil, M.Ed., CDE Medical Editor: Jay W. Marks, MD
Viewer Question: Can you suggest some safe core exercises for someone with an enlarged spleen?
Expert's Answer: Check with your doctor before you do any of these exercises. An enlarged spleen can be serious, and your doctor should give you the okay before you start any exercise program.
"Core" exercises have been the buzzword for some time. Although humans have been using their core muscles since the beginning of time, exercise scientists, physical therapists, fitness trainers, and others have recently been pushing the virtues of exercising the core. What is the core? The core is loosely defined as the spine, abdomen, pelvis, and hips, and the muscles that support these structures for posture and movement.
The spleen is an organ located in the upper left quadrant of the abdomen just
below the diaphragm and protected under the lower left ribs.
The spleen has a couple of important functions involving blood cells within
the body.
It filters blood and removes old and damaged red blood cells,
bacteria, and other particles as they pass through the maze of blood vessels
within the spleen.
It produces lymphocytes, a type of white
blood cell that produces antibodies and assists immune system.
The
filtration system is part of the red pulp while the white pulp of the spleen
contains the immune functioning cells
Normally, the spleen is a small organ about the size of a small fist or
orange. Splenomegaly describes the situation where the spleen enlarges in size
(spleen+megaly=enlargement).
What are the causes of an enlarged spleen?
The spleen enlarges if it is asked to do excessive work in filtering or
manufacturing blood cells, if there is abnormal blood flow to it, or if it is
invaded with abnormal cells or deposits.
Abnormal red blood cells: Since the spleen filters abnormal blood cells and removes them from the
circulatory system, diseases that result in abnormal red cells will cause the
spleen to enlarge. Sickle cell disease,
thalassemia, and
spherocytosis are examples of
diseases that form unusually shaped cells that cannot easily maneuver through
the small blood vessels and capillaries of the body. If they are not removed by
the spleen, these abnormal cells can cause
blood clots and decrease circulation.
However, removing them causes the spleen to swell and enlarge.
Viral and bacterial infection: The spleen is involved in making cells
that fight infection and part of that response is to enlarge. This is commonly
seen in viral infections such as
infectious mononucleosis (caused by the Epstein Barr virus),
AIDS and
viral
hepatitis. Examples of bacterial infections associated with splenomegaly include
tuberculosis, malaria, and
anaplasmosis (formerly known as ehrlichiosis).
Splenic vein pressure/blockage: Blood enters the spleen through the splenic artery and leaves through the
splenic vein. If the pressure within the vein increases or if the splenic vein
becomes blocked, blood cannot leave the spleen and it may swell. Because of the
relationship to liver blood flow, cirrhosis and portal vein obstruction can
cause complications with venous blood flow from the spleen. Congestive heart failure
may cause both the liver and spleen to swell because of increased venous
pressure.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Infectious mononucleosis is a virus infection in which there is an increase of white blood cells
that are mononuclear (with a single nucleus) "Mono" and "kissing
disease" are popular terms for this very common illness caused by the
Epstein-Barr virus (EBV).
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased. Symptoms of anemia may include fatigue, malaise, hair loss, palpitations, and more. Treatment for anemia includes treating the underlying cause for the condition. Iron supplements, vitamin B12 injections, and certain medications may also be necessary.
Blood clots can occur in the venous and arterial vascular system. Blood clots can form in the heart, legs, arteries, veins, bladder, urinary tract and uterus. Risk factors for blood clots include high blood pressure and cholesterol, diabetes, smoking, and family history. Symptoms of a blood clot depend on the location of the clot. Some blood clots are a medical emergency. Blood clots are treated depending upon the cause of the clot. Blood clots can be prevented by lowering the risk factors for developing blood clots.
Leukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should refer only to cancer of the white blood cells (the leukocytes) but in practice it can apply to malignancy of any cellular element in the blood or bone marrow, as in red cell leukemia (erythroleukemia).
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis bacteria. Symptoms include weakness, fever, weight loss, night sweats and in worse cases, chest pain, shortness of breath, and coughing up blood. A person with an active infection (a positive TB skin test, abnormal chest x-ray and TB bacteria in their sputum) requires treatment with izoniazid, rifampin, ethambutol and pyrazinaide.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Melanoma is a type of skin cancer which begins in skin cells called melanocytes and affects more than 53,600 people in the United States each year. These melanocytes can grow together to form benign moles which, after a change in size, shape, or color can be a sign of melanoma. Caused by sun exposure, early detection becomes extremely important to avoid a spread to other areas of the body. Diagnosis is confirmed through a biopsy of the abnormal skin and treatment depends on the extent and characteristics of the patient.
Internal bleeding occurs when an artery or vein is damaged and blood to escapes the circulatory system and collects inside the body. Internal bleeding can be caused by a variety of situations such as blunt trauma, deceleration trauma, medications, fractures, and spontaneous bleeding. Treatment of internal bleeding depends on the cause of the bleeding.
Non-Hodgkin's lymphoma is cancer of the lymphatic system, a vital part of the body's immune system. Symptoms include swollen lymph nodes, fever, night sweats, coughing, weakness, chest pain, unexplained weight loss, and abdominal pain. Treatment depends on which type of non-Hodgkin's lymphoma you have, the stage of the cancer, your age, how fast the cancer is growing, and whether you have other health problems.
Thrombocytopenia refers to a decreased number of platelets in the blood. There are many causes of thrombocytopenia such as decreased platelet production (viral infections for example rubella, mumps, chickenpox, hepatitis C, and HIV); increased platelet destruction or consumption (for example sulfonamide antibiotics, heparin, blood transfusions, and lupus); or increased splenic sequestration (enlarged spleen due to conditions for example liver disease, blood cancers, and more). Treatment of thrombocytopenia depends on the cause.
Malaria is an infectious disease transmitted by the bite of an infected Anopheles mosquito. Symptoms of malaria include chills, pain, fever, and sweating. Though mild cases of malaria can be treated with oral medication, severe cases require intravenous drug treatment and fluids.
Pleurisy, an inflammation of the lining around the lungs, is associated with sharp chest pain upon breathing in. Cough, chest tenderness, and shortness of breath are other symptoms associated with pleurisy. Pleurisy pain can be managed with pain medication and by external splinting of the chest wall.
Hepatitis is most often viral, due to infection with one of the hepatitis viruses (A, B, C, D, E, F (not confirmed), and G) or another virus (such as those that cause infectious mononucleosis, cytomegalovirus disease). The main nonviral causes of hepatitis are alcohol and drugs. Many patients infected with hepatitis A, B, and C have few or no symptoms of illness. For those who do develop symptoms of viral hepatitis, the most common are flu- like symptoms including: loss of appetite, nausea, vomiting, fever, weakness, tiredness, and aching in the abdomen. Treatment of viral hepatitis is dependant on the type of hepatitis.
Sickle cell anemia (sickle cell disease), a blood disease which shortens life expectancy, is cause by an inherited abnormal hemoglobin. Symptoms may include bacterial infections, painful swelling of the hands and feet, fever, leg ulcers, fatigue, anemia, eye damage, and lung and heart injury. Treatment for sickle cell anemia aims to manage and prevent the worst manifestations of the disease and focuses on therapies that block red blood cells from stacking together, which can lead to tissue and organ damage and pain.
Beta Thalassemia is the most familiar type of thalassemia. Thalassemia is not just one disease but rather a complex series of genetic (inherited) disorders all of which involve underproduction of hemoglobin.
Brucellosis is an infectious disease caused by the Brucella bacteria. Symptoms and signs include sweating, fever, fatigue, dizziness, headache, cough, chest, joint, and abdominal pain, and enlarged liver and/or spleen. Brucellosis is treated with antibiotics.
Medical shock is a life-threatening medical condition. There are several types of medical shock, septic shock, anaphylactic shock, cardiogenic shock, hypovolemic shock, and neurogenic shock. Causes of shock include heart attack, heart failure, heavy bleeding (internal and external), infection, anaphylaxis, spinal cord injury, severe burns, chronic vomiting or diarrhea. Low blood pressure is the key sign of sock. Treatment is dependant upon the type of shock.
Alpha thalassemia is a disorder in which the alpha globin protein is underproduced. There are two pairs of genes that carry the code for the alpha chains of hemoglobin. When one gene is impaired, that person is in a carrier state and suffers no medical problems. When four genes are impaired, the production of fetal and adult hemoglobin is prevented, resulting in hydrops fetalis and leading to death before birth.
Frontotemporal dementia (FTD) is a syndrome that is associated with shrinking of the frontal and temporal lobes of the brain. Frontotemporal dementia used to be referred to as Pick's disease. Frontotemporal dementia has a strong genetic component. Symptoms of frontotemporal dementia include changes in behavior or problems with language. There is no treatment that slows the progression of frontotemporal dementia. Medication may be prescribed to improve symptoms. The outcome for patient's with frontotemporal dementia is poor.
Gaucher disease is caused by an inherited (genetic) defect in an enzyme glucocerebroside. Signs fo Gaucher disease include enlargement of the spleen, fatique, low red blood cell counts, and a low count of blood clotting elements.
Tularemia (rabbit fever) is an infection caused by the Francisella tularensis bacteria. People can become infected with tularemia by coming into contact with infected animals or via a tick bite. Symptoms and signs include fever, headache and rash. Tularemia is treated with streptomycin or gentamicin.
The complete blood count (CBC) is one of the most commonly ordered blood
tests. The complete blood count is the calculation of the cellular (formed
elements) of blood. These calculations are generally determined by special
machines that analyze the different components of blood in less than a minute.
A major portion of the complete blood count is the measure of the
concentration of white blood cells, red blood cells, and
platelets in the blood.
How is the complete blood count test (CBC) done?
The complete blood count (CBC) test is performed by obtaining a few milliliters (one
to two teaspoons) of
blood sample directly form the patient. It can be done in many settings
including the doctor's office, laboratories, and hospitals. The skin
is wiped clean with an alcohol pad, and then a needle is inserted through the
area of cleansed skin into to patient's vein (one...
