Why Does Your Liver Hurt?

Biggs June 05, 2024

An image of a woman suffering from liver pain

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.1

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.2

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.3

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:3

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:456

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.7

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.8

If gallbladder problems, such as gallstones, are causing your pain, you may experience additional symptoms, such as:9

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:10

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:11

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.12 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.13

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:14

  • 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:15

  • Dark urine
  • Fever
  • 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:16

  • 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:17

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:18

  • Chronic and excessive alcohol use
  • History of viral hepatitis 
  • Obesity 
  • Type 2 diabetes
  • Family history of liver disease 
  • Injectible drug use 
  • Exposure to toxic substances that can harm the liver (e.g., pesticides)
  • Cigarette smoking

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:19

  • 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:20

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.21

Sometimes, liver pain doesn't improve with OTC remedies. In such cases, your provider may recommend the following prescription medications:21

  • 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.

Sources:

  1. Centers for Disease Control and Prevention. The liver.
  2. Llewellyn J, Fede C, Loneker AE, et al. Glisson's capsule matrix structure and function is altered in patients with cirrhosis irrespective of aetiology. JHEP Rep. 2023;5(9):100760. doi:10.1016/j.jhepr.2023.100760
  3. Khoonsari M, Mohammad Hosseini Azar M, Ghavam R, et al. Clinical manifestations and diagnosis of nonalcoholic fatty liver disease. Iran J Pathol. 2017;12(2):99-105.
  4. Tapper EB, Parikh ND. Diagnosis and management of cirrhosis and its complications: A review. JAMA. 2023;329(18):1589-1602. doi:10.1001/jama.2023.5997
  5. Kalaitzakis E. Gastrointestinal dysfunction in liver cirrhosis. World J Gastroenterol. 2014;20(40):14686-14695. doi:10.3748/wjg.v20.i40.14686
  6. Hansen L, Leo MC, Chang MF, Zaman A, Naugler W, Schwartz J. Symptom distress in patients with end-stage liver disease toward the end of life. Gastroenterol Nurs. 2015;38(3):201-210. doi:10.1097/SGA.0000000000000108
  7. MedlinePlus. Gallbladder diseases.
  8. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms and causes of gallstones.
  9. American College of Gastroenterology. Gallstones and gallstone disease.
  10. Centers for Disease Control and Prevention. What is viral hepatitis?.
  11. National Institute for Diabetes and Digestive and Kidney Disorders. Symptoms & causes of cirrhosis.
  12. American Liver Foundation. Nonalcoholic fatty liver disease (NAFLD).
  13. Fatty Liver Foundation. Right upper quadrant pain.
  14. Centers for Disease Control and Prevention. Liver cancer.
  15. MedlinePlus. Bile duct obstruction.
  16. MedlinePlus. Pyogenic liver abscess.
  17. National Organization for Rare Disorders. Polycystic liver disease.
  18. Melaram R. Environmental risk factors implicated in liver disease: A mini-review. Front Public Health. 2021;9:683719. doi:10.3389/fpubh.2021.683719
  19. U.S. Department of Veterans Affairs. Viral heptatitis and liver disease: when to go to the emergency room.
  20. American Liver Foundation. 13 ways to a healthy liver.
  21. Rakoski M, Goyal P, Spencer-Safier M, et al. Pain management in patients with cirrhosis. Clin Liver Dis (Hoboken). 2018;11(6):135-140. doi:10.1002/cld.711
Important Notice: This article was also published at www.health.com by Lindsay Curtis where all credits are due. Medically reviewed by Jay N. Yepuri, MD.

Disclaimer

The watching, interacting, and participation of any kind with anything on this page does not constitute or initiate a doctor-patient relationship with Veripeudic.com. None of the statements here have been evaluated by the Food and Drug Administration (FDA). The products of Veripeudic.com are not intended to diagnose, treat, cure, or prevent any disease. The information being provided should only be considered for education and entertainment purposes only. If you feel that anything you see or hear may be of value to you on this page or on any other medium of any kind associated with, showing, or quoting anything relating to Veripeudic.com in any way at any time, you are encouraged to and agree to consult with a licensed healthcare professional in your area to discuss it. If you feel that you’re having a healthcare emergency, seek medical attention immediately. The views expressed here are simply either the views and opinions of Veripeudic.com or others appearing and are protected under the first amendment.

Veripeudic.com promotes evidence-based natural approaches to health, which means integrating her individual scientific and clinical expertise with the best available external clinical evidence from systematic research. By individual clinical expertise, I refer to the proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice.

Veripeudic.com does not make any representation or warranties with respect to the accuracy, applicability, fitness, or completeness of any multimedia content provided. Veripeudic.com does not warrant the performance, effectiveness, or applicability of any sites listed, linked, or referenced to, in, or by any multimedia content.

To be clear, the multimedia content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any website, video, image, or media of any kind. Veripeudic.com hereby disclaims any and all liability to any party for any direct, indirect, implied, punitive, special, incidental, or other consequential damages arising directly or indirectly from any use of the content, which is provided as is, and without warranties.

Tags:
Biggs

Posted by: Biggs