Liver Pain : Location, Causes, Symptoms and Treatment

The Liver: A Quick Overview

Your liver is one of the most crucial organs in your body. It helps to clean the blood of toxins, aids in food digestion, helps with blood clotting and keeps stores of glycogen (sugar) for extra energy when you need it. The liver works in conjunction with the kidney’s to help the body absorb nutrients that it needs and excretes things that it doesn’t need.

Your liver is located just inside the bottom right side of your ribcage. (See Figure 1) It is housed in this protective area, because it is a very fragile organ. The liver processes and contains large amounts of blood. Bleeding from the liver is a very serious issue because tears to the liver cannot often be repaired. Although, the body protects the liver on the outside some damaging circumstances are hard to avoid on the inside. When the liver becomes injured or damaged, you may experience liver pain.

Figure 1: Location of the Liver

Photo Courtesy of:  healthzene.com

Liver pain is usually felt just under the right ribcage area and may sometimes radiate to the back right flank area. Liver pain is not normal and if your liver hurts, you need to be evaluated for possible liver damage or disease. Sometimes, it can be something as simple as a new medication or as complicated as an autoimmune disorder. Let’s take a look at the causes of liver pain.

What Causes Liver Pain?

Liver pain for “non-serious” reasons is not very common. Anything that affects the liver could break down its delicate tissues and cause liver failure. In order from least serious to the most serious, we will list the causes of liver pain:

Viral Infection 

The main viruses that affect the liver are the Hepatitis viruses. These include Hepatitis A, B, and C. It is important to know how the types of Hepatitis are acquired.

• Hepatitis A – This type of hepatitis is acquired via casual exposure through food, feces/hand/mouth contact and is usually a milder form of hepatitis. Most people recover fully and the virus does not last over long periods of time. Liver pain is usually only experienced during the course of the illness; from weeks to months.
• Hepatitis B – This form of hepatitis is passed via blood, body fluids, sexual contact and sharing of personal items. This form of hepatitis can become chronic and last over a person’s lifetime. Because hepatitis B can become chronic, it can also cause liver damage and pain.
• Hepatitis C – Hepatitis C is one of the most potent and debilitating forms of hepatitis. Those who develop chronic hepatitis C usually go on to develop liver cirrhosis or even liver cancer. It is contracted by blood, sharing of needles, blood transfusions, tattoos and unprotected anal intercourse. This type has little data to show that it can be passed via monogamous sexual intercourse.
• Eppstein-Barr Virus – This is a type of herpes virus that is often mistaken for strep-throat. The other name for this illness is mononucleosis. Some studies point to this virus as the cause of autoimmune hepatitis, (Hepatitis where the body attacks the liver without any virus present).

Toxins

Some medication are toxic to the liver and should only be taken in small amounts. When doctors prescribe these drugs, they usually run a liver test to make sure the liver is strong before the patient takes them. Examples of liver toxic drugs are; acetaminophen, anti-fungal medications, cholesterol lowering drugs and some anti-seizure medications. Liver toxicity can also occur due from exposure to; pesticides, cleaning solvents and plastic chemical agents. There are also some herbal remedies that can be liver toxic.

Alcohol Use 

Mild or moderate alcohol use does not normally cause liver damage. Some people who are heavy drinkers may experience liver pain after drinking, or if they mix the above medications with alcohol. This may only be temporary, but can become permanent if alcohol use is heavy or used over long periods of time.

Cirrhosis 

Cirrhosis is scarring of the liver tissue. The parts of the liver that scar are no longer functional and the liver begins to fail. The most common cause is heavy alcohol use. People with hepatitis B and C can develop cirrhosis. It can also be caused by the body’s own immune system. Cirrhosis can be very painful.

Ascites (Fluid Pockets) 

People who have liver disease and failure can develop pockets of fluid in the abdomen. The liver functions as a filter and a drain via the portal circulatory system. When this system fails, fluid backs up and the area near the liver becomes swollen and puts pressure on the liver and other organs nearby. People who suffer from ascites feel extreme pain until the pockets are drained.

Liver Cancer 

Liver cancer is a very painful cancer. Most often liver cancer comes from another part of the body and migrates (metastasizes) to the liver. This type of cancer is very serious and can often be fatal.

Trauma to the Abdomen 

Any kind of abdominal injury near the liver can cause liver pain. These include; blunt force, open wounds, gun shots and other types of forceful action to the right upper abdomen. This needs to be watched very closely for hemorrhaging (bleeding) from the liver.

Anything that affects the area of the liver can cause liver pain and needs to be evaluated. There are some illnesses that can mimic liver pain and be mistaken for a liver issue. This includes gallbladder disease. The gallbladder lies just beneath the liver and delivers the bile that the body produces to the digestive tract. Because the gallbladder works with the liver, gallbladder disease may also show elevated liver enzyme levels. There are a few other things that may be mistaken for liver issues and these are; gastric ulcer, GERD, pancreatitis, respiratory complications in the right lung area and spine/back problems which cause pain on the right side of the back.

 

Figure 2: Causes of Liver Pain

Photo Courtesy of: hopkinsmedicine.org

What Are the Symptoms of Liver Pain?

The symptoms of liver disease not only include pain, but can include anything felt in the upper right quadrant of the abdomen near the lower part of the rib cage and other symptoms:

• Stabbing pain
• Dull aching pain
• Hard Mass felt below the ribs (enlarged liver)
• Chronic Itching
• Yellow skin and eyes
• Nausea
• Extreme Tiredness
• Weight Loss
• Anemia
• Darkened Amber Urine

Liver pain with any of the above symptoms needs to be evaluated as soon as possible for liver disease to prevent complications.

What is the Treatment for Liver Pain?

Treatment is aimed at preventing any further liver damage and improving the function of the liver. Liver pain that is caused by alcohol or medications can be treated by removing the offending substance and placing the patient on a diet to give the liver rest.

Hepatitis can be treated by anti-viral medications and in a lot of cases is successful in reducing the virus effects on the body. Ascites can be drained to relieve pressure and pain, this is known as paracentesis (See Figure 3). Physicians are careful to prescribe pain medications for liver pain because they can be toxic.

 

Figure 3: Draining Fluid Near The Liver (Paracentesis)

Photo Courtesy of: endo-mds.org

The last resort treatment for painful liver disease is a liver transplant, but is only resorted to in severe cases where the liver is no longer functioning.

Conclusion

Mild liver pain that is caused by short-term medication uses or common viruses usually go away on their own. Advanced liver pain due to disease should be treated as early as possible to prevent further damage to the liver. People who do require liver transplants, usually go on to live normal healthy lives.