Many times, we get help when things hurt. But when it comes to the liver, it can be difficult to pinpoint a source of pain and know when to see a doctor.
Liver pain is usually generalized and not focused on a specific area. This article will explore what liver pain can feel like, what types of problems cause liver pain, and what you should do if you suspect there’s a problem with your liver.
Your liver is located near the bottom of your rib cage and is tilted slightly to take up more space on the right side of your abdomen than your left. Your live lies just above your stomach on the left side of your abdomen and the small intestine on the right side.
Liver pain can be difficult to diagnose because it can take many forms. Also, your liver doesn’t actually contain any nerves that sense pain, so discomfort is usually the result of inflammation or damage to surrounding tissues.
Liver disease can be a source of referred pain, in which discomfort is noticed in an area other than where the actual problem is. The shoulders and neck are common sites of pain referred from the liver.
Liver disease can also cause inflammation throughout the body, leading to a general feeling of discomfort. Ascites, or a buildup of fluid in the abdomen caused by liver disease, can lead to sharp pain, or even pain when breathing.
What does the liver do?
The liver is the largest solid organ in your body, weighing in at about 3 pounds. It’s a major filter for your body, removing harmful substances or toxins and balancing your metabolism. The liver makes bile, a digestive fluid, and also produces and stores proteins like albumin — a critical protein that regulates blood volume and fluid balance in your body.
In addition, your liver also stores and manages:
- proteins that help clotting (platelets)
- proteins and substances that help with immune function
- fat-soluble vitamins
- extra blood sugar that’s transformed into long-term glycogen
Without a properly functioning liver, you’ll experience problems like the buildup of toxins, uncontrolled bleeding from poor blood clotting, and increased infections.
Liver pain can signal problems in the liver itself or in other parts of the body. Conditions that directly affect the liver and can lead to pain include:
- excessive alcohol consumption
- hepatitis, or liver inflammation
- nonalcoholic fatty liver disease
- Reye’s syndrome, which causes liver and brain swelling
- hemochromatosis, the buildup of too much iron
- liver cancer
- Budd-Chiari syndrome, in which veins from the liver are blocked
- Wilson’s disease, which casus the buildup of too much copper
- portal vein thrombosis, in which the vein to the liver is blocked or narrowed
- a liver abscess, or pocket of infection
- liver cysts, or sac-like growths
- liver trauma or injury
How common is liver disease?
Sometimes, liver damage generates pain in other parts of the body. Since the liver has no pain receptors, surrounding tissues and other areas of the body like the neck and shoulders may hurt.
Many people have a difficult time pinpointing the location of pain associated with liver disease since it often strikes the peritoneum. This is a membrane that lines the abdominal wall and the organs within it.
Fitz Hugh Curtis syndrome is one example of a complicated disease that can affect the liver and cause generalized abdominal pain.
This rare condition occurs mostly in women and can be a complication of pelvic inflammatory disease. It affects the peritoneum and the tissues around the liver. People with this condition usually report sudden, severe pain in the upper right portion of the abdomen, shoulder, and right arm.
Pain isn’t the only symptom you might experience with liver disease. Since your liver produces and stores vital nutrients and filters out toxins, you’ll notice all kinds of problems if this vital organ isn’t doing its job.
Some non-pain-related symptoms that are common with liver disease include:
Alcohol use is one of the main risk factors associated with liver disease. The liver filters all kinds of harmful substances that run through your body. This includes things like byproducts of the foods you eat, medications, and alcohol.
You can lower your risk of developing liver disease by doing things like:
- avoiding taking too many medications
- drinking alcohol conservatively
- avoiding harmful chemicals and pesticides
- avoiding sharing needles
- using caution when getting tattoos or piercings and making sure single-use tools are used
- eating a balanced diet
- exercising regularly
There are also a number of diseases that can cause liver damage, so it’s a good idea to make sure you’re vaccinated, when possible, against things like hepatitis A virus and hepatitis B virus. You should also get screened for hepatitis C, liver cancer, and diabetes.
It can be difficult to spot the early signs of liver disease. Fatigue is the most common early symptom, and this symptom can be linked to many conditions and lifestyle factors.
Often, liver disease isn’t suspected until you develop later symptoms of the disease like easy bruising, jaundice, itching, or abdominal pain. If you experience the following symptoms, you could be in acute liver failure, and you should make an appointment with a doctor or find immediate care:
- bleeding that doesn’t stop
- vomiting or coughing up blood
- very yellow eyes or skin
- discomfort or pain on the right side of your abdomen
- a swollen belly from fluid buildup
The most important part of protecting the health of your liver is to be open with your doctor about all medications you take, what you eat, and how much you drink. These can all factor into your risk of developing liver disease.
Talk with a doctor if you’re making choices that could affect your liver health so that you can get help, as well as appropriate vaccinations and screenings.
If you have a family history of liver conditions or are at risk of developing liver disease, your doctor may want to see you regularly for an overall physical examination and blood work. Examinations for liver disease may include things like:
- a visual examination for abdominal swelling or inflammation
- checking the skin and eyes for jaundice
- liver function tests
- CT scans
- liver biopsy
You may require specialized testing and monitoring from a gastroenterologist, a healthcare professional who specializes in liver and digestive system conditions.
Examples of tests that specifically check the liver may include transient elastography, which can measure the stiffness of your liver and check for cirrhotic scarring.
How your liver pain is treated will depend on what’s causing the pain. If your liver pain is the result of short-term problems with your diet or alcohol use, the following home remedies can help:
- drinking more water
- avoiding alcohol
- steering clear of fatty foods
- checking your posture and sitting up straight to take pressure off your liver
- consuming enough protein
- watching your cholesterol
If your symptoms continue for several hours or days, call a doctor. You may need additional treatment. The liver is able to repair itself, so early action and lifestyle changes may allow you to reverse some liver damage.
Avoid taking over-the-counter pain medications like acetaminophen or ibuprofen to treat your liver pain. These medications are processed through your liver and could make your pain — and your overall liver health — even worse.
In most cases, a doctor will prescribe a regimen that includes a balanced diet and exercise, as well as medications for specific liver problems. These medications could include:
- antiviral medications like lamivudine (Epivir) and adefovir (Hepsera), which can be used for treating chronic liver infections, for hepatitis B
- ledipasvir/sofosbuvir (Harvoni) for hepatitis C
- lactulose to lower ammonia levels
- rifaximin to prevent ammonia buildup
In extreme cases of liver disease, liver dialysis (used to purify your blood) or a liver transplant may be required.
Managing liver cancer
If your liver pain is caused by liver cancer, a doctor can advise you on how best to stop the spread of your cancer.
You’ll most likely need a referral to a cancer specialist (oncologist) and speedy treatment, as depending on the type, cancer in the liver could be aggressive and grow quickly.
In some cases, the damage to the liver from hepatitis, acetaminophen, other toxin exposure, cancer, or alcohol will be impossible to reverse. In these cases, a doctor may recommend a liver transplant as your best treatment option.
The liver isn’t one of the most well-understood organs, but it’s one of the most important. From filtering your blood to protecting you from infection, the liver performs a number of vital functions.
While your liver itself doesn’t have pain cells, problems in the liver can cause pain or discomfort in other places — usually throughout the abdomen.
If you have pain in the upper right portion of your abdomen, shoulder pain, or other general abdominal discomforts that don’t go away, make an appointment to see a doctor. You have a good chance of reversing liver disease if you catch it and make changes early.