Liver pain is felt in the upper right abdomen, and can be a sign of an infection, obesity, high cholesterol or cancer. Liver pain can also be felt if the liver is exposed to toxic substances like alcohol, detergents or even some medication.
Treatment for liver pain depends on what is causing it and the symptoms it presents with. However, liver pain can be prevented with up-to-date vaccination, a healthy diet, regular exercise or by avoiding risky behavior like sharing needles or unprotected sex.
If you notice liver pain, it is important to consult your family doctor or a liver specialist for assessment. The doctor may order tests to identify the underlying cause of the liver pain, and indicate the most appropriate treatment as needed.
Why do I have liver pain?
The most common causes of liver pain include:
1. Infection
The liver can affected by a viral, bacterial or fungal infections, leading to inflammation and changes to functioning. The most common types of liver infections are hepatitis A, B and C, which are viruses that can cause liver pain, joint pain, headache, light sensitivity, light-colored stools, dark urine and yellow skin or eyes.
How to treat: Treatment should be guided by a liver specialist or family doctor. It will vary depending on the type of infection and may involve the use of antivirals, antibiotics or antiparasitics. You may also be advised to eat light, easy-to-digest meals that are low in fat to help prevent further inflammation. Learn more about the treatment of acute hepatitis.
2. Auto-immune disease
Auto-immune diseases are characterized by the body's own antibodies attacking their organs. The liver can be affected by autoimmune diseases, which is the case with autoimmune hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis.
Autoimmune hepatitis is a rare disease, in which the body attacks the liver cells. This leads to liver swelling and symptoms like abdominal pain, yellow skin and nausea. With primary biliary cirrhosis, the biliary ducts undergo a gradual destruction by the body's antibodies, while primary sclerosing cholangitis is characterized by narrowing of the biliary ducts. These conditions can lead to fatigue, itching, scarring and liver failure.
How to treat: Autoimmune hepatitis is curable with a liver transplant, which is done in severe cases. The disease can otherwise be managed with corticosteroid medication (like prednisone), or immunosuppressents (like azathioprine). Patients should maintain a balanced diet and avoid alcohol and fatty foods.
The treatment of primary biliary cirrhosis and sclerosing cholangitis usually involves the use of ursodiol. If treatment of these conditions is initiated early on at the onset of symptoms, then it is possible to significantly reduce the progression of disease and prevent scarring. In terminal phases of these conditions, the only treatment available to cure these conditions is a liver transplant.
3. Genetic diseases
Pain in the liver area can also be caused by genetic diseases that lead to the accumulation of toxic substances in the liver, like hereditary hemochromatosis (which is associated with increased iron in the liver), hyperoxaluria (which is associated with increased oxalic acid) or Wilson’s disease (which is associated with increased copper).
How to treat: Hemochromatosis can be treated by avoiding foods that are high in iron, like red meat, spinach or green beans. It is important to follow a diet as recommended by a registered dietitian. With hyperoxaluria, you should reduce your intake of foods with oxalate, like spinach and walnuts. More serious cases will require dialysis or a liver and kidney transplant. Wilson’s disease can be treated by reducing your intake of food that are rich in copper, like mussels, or by taking medications that link to copper (like zinc acetate or penicillamine), which will help to eliminate it through the urine.
4. Excess alcohol
Excessive and regular intake of alcohol can increase your risk for developing alcoholic hepatitis. It is associated with strong abdominal pain, nausea, vomiting and loss of appetite. It can cause liver damage if left untreated.
How to treat: Treatment consists of suspending alcohol intake and using medications like ursodiol or phosphatedilcholine, which reduce liver inflammation and relieve symptoms. More serious cases require a liver treatment.
5. Medication abuse
Medication-related hepatitis is caused by exposure to toxic substances, excessive medication use, or even allergic reactions to medications, all which can cause damage in the liver at a cellular level.
How to treat: Treatment consists of discontinuing the medication or substance immediately. In more serious cases, corticosteroids may be needed until liver function returns to its baseline.
6. Cancer
Liver cancer can affect hepatocytes, biliary ducts and blood vessels. It is generally very aggressive and can cause abdominal pain, nausea, loss of appetite and yellow eyes. Read more about the common signs and symptoms of cancer.
How to treat: Surgery is usually necessary to remove the affected part of of the liver. Some patients will need chemotherapy or radiation therapy prior to surgery to reduce the size of the cancer.
7. Reye's syndrome
Reye's syndrome is a rare disease that occurs more frequently in children. It is characterized by liver pain that is felt due to the accumulation of fat in this organ, as well as brain inflammation. Patients with this condition presents with symptoms like a headache, vomiting, drowsiness and irritability.
The causes of Reye's syndrome are not completely understood, but it is believed to be related to some viruses, like the flu virus or chickenpox. It may also be linked to excessive use of medications, such as aspirin and paracetamol.
How to treat: Treatment for Reye's syndrome varies depending on the possible cause. Liver pain and symptoms that are triggered by medications, for example, may resolve after suspending the medication. However, patients should be monitored and treated in a hospital setting, as some patients may require IV electrolytes and glucose, as well as vitamin K to prevent bleeding.
Reye's syndrome should be diagnosed and treated as soon as possible to prevent complications.
8. Fatty liver
Fatty liver is common in people who are obese or who have high cholesterol or diabetes. This condition can be asymptomatic, or it can cause symptoms like right-sided abdominal pain, swollen belly, nausea and vomiting.
How to treat: Treatment for fatty liver consists of regular exercise and a balanced diet made-up of lean meat and vegetables. Understand which foods to eat and avoid for a fatty liver diet. To control cholesterol levels, the doctor may prescribe cholesterol medication.
Liver symptoms checker
Report your symptoms below to assess your risk for a liver problem or for another related condition:
How to prevent liver pain
Pain in the liver area can be prevented with the following measures:
- Drink alcohol in moderation
- Avoid risky behaviors, like unprotected sex, using drugs or sharing needles
- Ensure you are up-to-date on vaccines that protect you against hepatitis A and B
- Use medications moderately, to ensure unintended interactions
- Use a mask and protect your skin when using toxic products like paint and detergents
It is also very important to be physically active on a regular basis and to eat a balanced diet with foods that help to detox the liver, like lemon or artichokes.
When to go to the doctor
You should go to the doctor when the abdominal pain become intense or persistent, or if it is accompanied by other symptoms, like yellowed skin or eyes, leg swelling, generalized itching throughout the body, dark urine, light-colored stools, weight loss, fatigue, nausea, vomiting or loss of appetite. Learn more about symptoms of liver disease you should not ignore.
During your appointment, the doctor will perform a physical exam to understand where your pain is coming from. He or she may ask about other symptoms and your dietary habits, and may additionally order testing like an ultrasound, MRI, CT, bloodwork or a liver biopsy.