Why Does Your Liver Hurt?
milan2099 / Getty Images
Medically reviewed by Jay N. Yepuri, MD
The liver is one of your body's largest and most vital organs, which performs hundreds of essential functions, including removing waste products from the blood, filtering chemicals from medications, alcohol, and food, and storing nutrients.
Liver pain can be hard to pinpoint because the liver does not have pain receptors. But, if you're experiencing liver pain, you may be feeling aches around your abdomen and back. When the liver becomes inflamed, injured, or affected by liver disease, it presses on the protective surrounding tissue (known as Glisson's capsule). This tissue is packed with pain-sensitive nerves, which signal to your brain that something may be amiss with your liver.
What Does Liver Pain Feel Like?
The liver is located in the upper right portion of your abdomen, tucked behind the lower ribs and below the diaphragm. You'll often feel liver pain in the upper right side of the abdomen near the ribcage. Sometimes, problems with the liver cause pain in other body areas, such as the shoulders, back, and stomach.
How liver pain feels can vary from person to person, depending on the cause. However, most people often develop one or more of the following symptoms:
Dull, persistent aches in the upper abdomen
A feeling of fullness or bloating
Sharp, stabbing pains that come and go
Tenderness when the upper abdomen is touched
If your liver pain is a result of an underlying liver disease, you may experience other symptoms that accompany pain. Symptoms of liver disease can include:
Yellowing of the skin and eyes (known as jaundice)
Dry mouth
Loss of appetite
Unintentional weight loss
The Differences Between Gallbladder and Liver Pain
Your gallbladder is a pear-shaped organ that sits below the liver. Because the gallbladder and liver are both located in the upper right abdomen, knowing which organ is causing your pain can be difficult to decipher.
While liver pain often feels like a persistent dull ache or throbbing sensation, gallbladder pain tends to be more sharp and severe. Gallbladder pain also tends to come on suddenly—usually after eating a heavy meal or when lying down at night—and comes in waves, lasting anywhere from 30 minutes to a few hours.
If gallbladder problems, such as gallstones, are causing your pain, you may experience additional symptoms, such as:
Vomiting
Liver and gallbladder problems have overlapping symptoms, so it's essential to see your healthcare provider for a comprehensive medical evaluation to learn the source of your pain.
Causes of Liver Pain
Several conditions can cause liver pain. Each of the following conditions may also come with its own unique set of symptoms that you might experience in addition to abdominal or back aches.
Hepatitis
Hepatitis occurs when your liver becomes inflamed. Viral infections often cause inflammation, but certain medications and heavy alcohol use can also inflame the liver. Hepatitis-related liver pain usually feels like a dull ache or discomfort in the upper right abdomen. Other symptoms may include:
Jaundice
Fatigue
Nausea and vomiting
Cirrhosis
Cirrhosis is a chronic, progressive condition that causes scarring and permanent liver damage. Long-term alcohol use or other liver diseases (e.g., hepatitis) can lead to cirrhosis. Unfortunately, people with cirrhosis often have no symptoms until the liver is severely damaged. When symptoms develop, they may include:
Fatigue
Itchy skin
Unintentional weight loss
Muscle cramps and weakness
Loss of appetite
Fatty Liver Disease
Fatty liver disease occurs when there is an accumulation (or, build-up) of extra fat in liver cells. Though the liver contains small amounts of fat, if more than 5% to 10% of its weight is fat, you may have fatty liver disease. This condition causes liver swelling and damage. About one-third of people with fatty liver disease report liver pain that feels like a mild ache or feeling of fullness in the upper right abdomen. Some report steady, sharp pains in the area that disrupt their sleep.
Other symptoms of fatty liver disease may include:
Fatigue
Weakness
Loss of appetite
Jaundice
Fluid build-up in the legs and stomach
Liver Cancer
About 36,000 people in the United States receive a diagnosis for liver cancer yearly. Though the condition doesn't always cause symptoms in its early stages, you might experience discomfort in the upper right abdomen as the disease progresses. Other symptoms may include:
Swollen abdomen
A hard lump on the right side, below the rib cage (where the liver is located)
Shoulder or back pain
Jaundice
Loss of appetite
Bile Duct Obstruction
Bile duct obstruction occurs when tubes (ducts) that carry bile from the liver to the gallbladder and small intestine become blocked. This can lead to liver pain that feels like a deep, aching sensation in the upper right abdomen. Other symptoms of bile duct obstruction may include:
Dark urine
Itching
Nausea and vomiting
Jaundice
Liver Abscess
A liver abscess is a collection of pus within the liver. You might develop an abscess due to a bacterial or parasitic infection or injury to the liver, which can result in severe liver pain or pain throughout the entire abdomen. Additional symptoms of a liver abscess may include:
Fever
Loss of appetite
Weakness
Nausea and vomiting
Right shoulder pain
Liver Cysts
Liver cysts are fluid-filled sacs that can develop within the liver. Most people don't experience symptoms of liver cysts, but if these sacs grow large in size or quantity, you might develop the following symptoms:
Abdominal bloating or swelling (known ascites)
Internal bleeding—although this is rare
Risk Factors for Liver Problems
In some cases, your liver pain may be an underlying sign of a deeper liver problem. Certain genetic, environmental, and lifestyle risk factors can increase your chances of developing liver disease. These factors include:
Chronic and excessive alcohol use
History of viral hepatitis
Family history of liver disease
Injectible drug use
Exposure to toxic substances that can harm the liver (e.g., pesticides)
When To Contact a Healthcare Provider
It's important to see a healthcare provider if you experience persistent or recurrent pain in your upper right abdomen—as this may be a sign of an underlying liver issue. Seek prompt medical attention if you experience liver pain coupled with other symptoms, such as:
Yellowing of the skin and eyes without a clear explanation
Chronic fatigue and weakness
Changes in urine or stool color (e.g., dark urine, pale stools)
Persistent nausea and vomiting
Abdominal swelling or bloating
In some cases, liver pain can be severe and requires emergency medical attention. It's vital to visit the emergency room or or an urgent care if you are experiencing the following symptoms:
Sudden, severe liver pain or pain that radiates to your back or shoulder
Fainting or confusion
Vomiting blood or passing tarry stools
High fever with jaundice
Difficulty breathing
How to Treat Liver Pain
Treatment for liver pain depends on the underlying cause of your aches. Managing conditions like viral hepatitis, fatty liver disease, cirrhosis, or liver cancer may involve taking medications, incorporating lifestyle changes, or trying surgical interventions.
Most liver diseases are chronic and progressive, so treatment focuses on slowing the progression of the disease, preventing further liver damage, and managing symptoms. Your healthcare provider may recommend lifestyle changes to support your liver health, such as:
Eating a balanced diet and limiting intake of foods high in salt, sugar, and fat
Participating in regular physical activity or movement throughout the week
Avoiding alcohol
Your healthcare provider may also recommend over-the-counter (OTC) or prescription medications to manage liver pain. Some medications can harm the liver, so it is important to talk to a healthcare provider before taking medications for liver pain.
If your healthcare provider gives you the OK for medication, Tylenol (acetaminophen) is an OTC pain medication that is safe for people with liver disease when taken in small amounts (no more than 2 grams per day). Non-steroidal anti-inflammatory drugs (NSAIDs), such as Motrin (ibuprofen), can damage the liver, so it's best to avoid these drugs if you have liver disease.
Sometimes, liver pain doesn't improve with OTC remedies. In such cases, your provider may recommend the following prescription medications:
Horizant (gabapentin)
Lyrica (pregabalin)
Oxycontin (oxycodone)
A Quick Review
If you're experiencing pain in the upper right abdomen and just below the rib cage, it might be a result of liver pain. Common causes of liver pain include hepatitis, cirrhosis, fatty liver disease, liver cancer, bile duct obstruction, and liver abscesses or cysts.
Contact a healthcare provider if you have persistent liver pain and other symptoms of liver problems, such as jaundice, chronic fatigue, or unexplained weight loss. Your provider can help you understand the cause of your liver pain and develop a treatment plan that can improve your symptoms and prevent or slow down the progression of liver disease.
For more Health.com news, make sure to sign up for our newsletter!
Read the original article on Health.com.
