Table of ContentsView AllTable of ContentsSymptomsChronic CausesAcute CausesRisk FactorsDiagnosisTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Symptoms
Chronic Causes
Acute Causes
Risk Factors
Diagnosis
Treatment
Prevention
Liver pain is typically felt in the upper right abdomen just below the rib cage. Your liver might hurt for many reasons, includingacute(sudden) conditions like a liver abscess or liver injury, orchronic(persistent) conditions like cirrhosis (extensive liver scarring), fatty liver disease, or liver cancer.
Some conditions, like viral hepatitis and Fitz-Hugh-Curtis syndrome, can cause acute and chronic pain.
Liver pain is often dull and generalized but can be sharp and specific depending on its underlying cause. Blood tests, abdominal imaging, and liver biopsy may be necessary to diagnose the cause and prescribe the appropriate treatment.
This article describes the symptoms and causes of liver pain, including how it is diagnosed and treated. It also explains what you can do to avoid liver pain and when it may be a sign of a medical emergency.
m-gucci / Getty Images
Pain Locator: Where Is My Liver?
Theliveris an organ about the size of a football located in the upper right portion of your abdomen just beneath the rib cage anddiaphragm(the thin muscle separating your chest and abdominal cavities).
Theliver serves over a hundred vital functionsin the body, including:
Describing Liver Pain
Although the liver is the largest internal organ in the body, liver pain is often hard to pinpoint and easy to confuse with other types of upper abdominal pain, including stomach or gallbladder pain.
Because the liver doesn’t have any pain receptors (nociceptors), any pain felt is usually the result of pressure placed on the membrane surrounding the liver—called the Glisson’s capsule—which is rich with nociceptors.
If the liver is injured or infected in any way, the swelling of the organ will activate these receptors, causing a dull, aching, generalized pain that is difficult to locate.This is especially true with chronic conditions like cirrhosis.
Even so, the pain can vary significantly based on the underlying cause. With certain acute conditions, the pain can be sharp and stabbing or cause throbbing waves of pain that come and go. The pain may also sometimes be felt in the center of the abdomen, the lower back, or the right shoulder.
If the pain is due to liver disease, you may also experience signs ofhepatitis(liver inflammation), including:
Signs and Symptoms of Hepatitis
Chronic Conditions Associated With Liver Pain
Chronic liver conditions tend to cause dull, generalized upper abdominal pain. The pain is often the result ofcirrhosis, a condition in which the buildup of scar tissues reduces the overall function of the liver.
Although cirrhosis is usuallyasymptomatic(without symptoms), it can cause pain as the condition progresses and the liver starts to fail. This is the end stage of liver disease, known as decompensated cirrhosis.
Among the chronic conditions associated with liver pain are viral hepatitis, alcoholic hepatitis, fatty liver disease, portal hypertension, Budd-Chiari syndrome, and liver cancer.
Viral Hepatitis
Viral hepatitisis the most common cause of hepatitis. In the United States, thehepatitis A,hepatitis B, andhepatitis Cviruses are the primary sources of infection.
In the acute stages of infection, hepatitis A, B, and C can cause pain in the upper right abdomen along with jaundice and other classic signs of hepatitis.
In the majority of cases, the body’simmune systemis able to clear the virus, often in the absence of any symptoms. But with hepatitis B and C, the infection can sometimes become chronic, causing low-level inflammation and pain that can contribute to the onset of cirrhosis if left untreated.
Does the Liver Regenerate (and When Doesn’t It)?
Alcoholic Hepatitis
Alcoholic hepatitis is the point at which ALD becomes symptomatic due to the progression of cirrhosis. People who develop alcoholic hepatitis typically drink heavily and have been consuming large amounts of alcohol daily for at least 20 years.
Fatty Liver Disease
Fatty liver disease develops over many years, generally affecting adults over 50, Between 20% and 30% of these adults will experiencemetabolic dysfunction-associated steatohepatitis (MASH). the stage at which fatty liver disease turns symptomatic due to the onset of cirrhosis.
Portal Hypertension
Portal hypertension does not cause pain but can lead to pain as increased pressure causeslymph fluidto leak into the abdomen. As the abdomen starts to swell due to the onset of ascites, there will often be pain and discomfort radiating to the back.
The change in blood pressure can also affect thespleen(an organ near the liver that filters blood), causing a vague but noticeable pain in the upper left abdomen.
Other non-cirrhotic causes of portal hypertension include blood clots, a parasitic infection calledschistosomiasis, and a benign tumor calledfocal nodular hyperplasia.
Budd-Chiari Syndrome
The risk of BCS is highest in people at risk of abnormal blood clotting, including those with pregnancy,myeloproliferative disorders, and clotting disorders likeantiphospholipid syndrome (APS). In around a third of cases, the cause is unknown.
The severity of symptoms is largely based on the location and number of hepatic veins affected.
Liver Cancer
Liver cancer affects around 40,000 people in the United States each year.The most common form,hepatocellular carcinoma(HCC), originates in liver cells called hepatocytes. As the tumor grows, pain may be felt in the upper right abdomen and/or radiate to the right shoulder or shoulder blade.
Another type of liver cancer, calledintrahepatic cholangiocarcinoma (ICC), starts in the cells that line the small ducts (tubes) that carry bile from the liver to thegallbladder. This obstruction of the ducts can cause sharp, shooting pains not only in the upper right abdomen but also occasionally in the lower right abdomen.
Type of Acute and Chronic Liver Disease
Acute Conditions Associated With Liver Pain
Acute causes of liver pain include:
Liver Abscess
Aliver abscessis a pocket of pus that can form in the liver due to bacterial, fungal, or parasitic infection. Liver abscesses are more commonly seen in older adults, people with diabetes, and others withsuppressed immune systems.
Liver Cysts
Liver cysts can occur in isolation or cause multiple cysts to form (known aspolycystic liver disease). Although the cysts are usually harmless and asymptomatic, large ones can cause discomfort and a feeling of fullness in the abdomen.
However, if a large cyst ruptures, you may experience sudden, severe pain in your upper right abdomen radiating to the right shoulder and chest.
Fitz-Hugh-Curtis Syndrome
People with FHCS experience upper right abdominal pain, often with pain that radiates to the right shoulder. Fever, chills, headache, and malaise are also common.
Liver Injury
Depending on the severity of the injury, the pain can range from dull to severe, often with pain that radiates to the right shoulder and shoulder blade.
If the liver is lacerated, the loss of blood can lead tohypovolemic shockin which blood pressure drops to dangerous levels. Symptoms include rapid breathing, rapid heartbeat, clammy skin, confusion, and unconsciousness.The risk of death is high.
How Liver Elastography Test Works
Bile Duct Obstruction
Bile duct obstruction occurs when the ducts that carry bile from the liver to the gallbladder andsmall intestinebecome blocked. This can lead to deep, aching pain in the upper right abdomen.
If the blockage occurs downstream in the gallbladder, the pain can be sharp and stabbing, coming and going in waves that last anywhere from 30 minutes to several hours.
Possible causes of a blocked bile duct include:
How to Tell Gallbladder and Liver Pain Apart
Who Is More Likely to Have Liver Pain?
Liver pain is often a sign of an underlying liver disease. Certain lifestyle, environmental, and genetic factors can predispose you to liver disease and increase your risk of not only cirrhosis but also liver cancer andliver failure.
These risk factors include:
An Overview of Liver Failure
Diagnosing Liver Pain
Liver pain diagnosis starts with a review of your medical history, including the list of any drugs you take, how much alcohol you drink, your family history of liver disease, and other symptoms you may have.
A physical exam will involvepalpation(light touching) of the upper abdomen to check the size of your liver and for any tenderness or pain. Your healthcare provider may also look for signs of hepatitis, including jaundice, abdominal swelling, and easy bruising,
Based on the initial findings, the following tests and procedures may be ordered to help pinpoint the cause of the pain:
When to Seek Emergency CareLiver pain can sometimes be a sign of a medical emergency. Call 911 if you or someone you know experiences:Sudden, severe pain in the upper right abdomenDifficulty breathingDecreased or no urine outputHigh fever with rigors (uncontrollable shaking)Vomiting bloodPassing bloody or tarry stoolsConfusion or disorientationFainting
When to Seek Emergency Care
Liver pain can sometimes be a sign of a medical emergency. Call 911 if you or someone you know experiences:Sudden, severe pain in the upper right abdomenDifficulty breathingDecreased or no urine outputHigh fever with rigors (uncontrollable shaking)Vomiting bloodPassing bloody or tarry stoolsConfusion or disorientationFainting
Liver pain can sometimes be a sign of a medical emergency. Call 911 if you or someone you know experiences:
Treatment for Liver Pain
The treatment of liver pain largely focuses on treating its underlying cause:
To help ease liver pain itself, there are several at-home and over-the-counter (OTC) options:
If your liver condition is severe and at-home remedies don’t help, speak with your provider about the following prescription drug options:
Can You Detox the Liver?
Liver Health and Prevention
The liver has the remarkable ability to regenerate itself when alcohol and other toxins are removed from the system. Doing so may not completely reverse the damage, but it may help slow and even stop disease progression in some people.
Your healthcare provider may recommend the following lifestyle changes to improve the overall health of your liver:
How to Choose Good Foods for Your Liver
Summary
If you have pain in the upper right abdomen just below the rib cage, it may be a result of a liver disease or liver injury. Common causes include viral hepatitis, cirrhosis, fatty liver disease, bile duct obstruction, liver abscesses or cysts, and liver cancer.
Contact a healthcare provider if you have persistent pain and other liver-related symptoms like jaundice, dark urine, or a swollen abdomen. Your provider can help diagnose and treat their underlying causes and prescribe medications that provide symptomatic relief.
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35 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Viral hepatitis.Jung SW, Joo MS, Choi HC, et al.Epigastric symptoms of gallbladder dyskinesia mistaken for functional dyspepsia: retrospective observational study.Medicine (Baltimore).2017;96(16):e6702. doi:10.1097/MD.0000000000006702Llewellyn 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.2023.100760National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of cirrhosis.Hamilton JP.Pain management in liver disease.Gastroenterol Hepatol (N Y).2023;19(6):355–358.National Institute of Diabetes and Digestive and Kidney Diseases.Hepatitis (viral).Tapper EB, Parikh ND.Diagnosis and management of cirrhosis and its complications: a review.JAMA. 2023;329(18):1589-1602. doi:10.1001/jama.2023.5997Centers for Disease Control and Prevention.Viral hepatitis.Hosseini N, Shor J, Szabo G.Alcoholic hepatitis: a review.Alcohol Alcohol.2019;54(4):408–416. doi:10.1093/alcalc/agz036Yanai H, Adachi H, Hakoshima M, et al.Metabolic-dysfunction-associated steatotic liver disease—its pathophysiology, association with atherosclerosis and cardiovascular disease, and treatments.Int J Mol Sci.2023;24(20):15473. doi:10.3390/ijms242015473Bosch J.Portal hypertension and cirrhosis: from evolving concepts to better therapies.Clin Liver Dis. 2020;15(S1). doi:10.1002/cld.844Turco L, Garcia-Tsao G.Portal hypertension: pathogenesis and diagnosis.Clin Liver Dis. 2019;23(4):573-587. doi:10.1016/j.cld.2019.07.007Ahmad AK, Atzori S, Maurice J, et al.Non-invasive splenic parameters of portal hypertension: assessment and utility.World J Hepatol.2020;12(11):1055–1066. doi:10.4254/wjh.v12.i11.1055Genetic and Rare Diseases Infomation and Center.Budd-Chiari syndrome.National Cancer Institute.Cancer stat facts: liver and intrahepatic bile duct cancer.Kawamura R, Harada Y, Shimizu T.Missed diagnosis of cholangiocarcinoma presenting with atypical symptoms.Eur J Case Rep Intern Med.2021;8(1):002207. doi:10.12890/2021_002207MedlinePlus.Pyogenic liver abscess.Ahmed M.Acute cholangitis - an update.World J Gastrointest Pathophysiol. 2018;9(1):1-7. doi:10.4291/wjgp.v9.i1.1Marrero JA, Ahn J, Reddy RK.ACG clinical guideline: the diagnosis and management of focal liver lesions.Am J Gastroenterol.2014;109(9):1328-1347. doi:10.1038/ajg.2014.213Kozielewicz DM, Sikorska K, Stalke P.Liver abscesses — from diagnosis to treatment.Clin Exp Hepatol.2021;7(4):329–336. doi:10.5114/ceh.2021.110998Khine H, Wren SB, Rotenberg O, Goldman DL.Fitz-Hugh-Curtis syndrome in adolescent females: a diagnostic dilemma.Pediatr Emerg Care. 2019;35(7):e121-e123. doi:10.1097/PEC.0000000000001525Centers for Disease Control and Prevention.Pelvic inflammatory disease (PID).Coccolini F, Coimbra R, Ordonez C, et al.Liver trauma: WSES 2020 guidelines.World J Emerg Surg,2020;15:24. doi:10.1186/s13017-020-00302-7MedlinePlus.Hypovolemic shock.MedlinePlus.Bile duct obstruction.Lam R, Zakko A, Petrov JC, et al,Gallbladder disorders: a comprehensive review,Disease a Month. 2021;67(7):101130. doi:10.1016/j.disamonth.2021.101130Majid B, Khan R, Junaid Z, et al.Assessment of knowledge about the risk factors of chronic liver disease in patients admitted in Civil Hospital Karachi.Cureus. 2019 Oct;11(10):e5945. doi:10.7759/cureus.5945Wazir H, Abid M, Essani B, et al.Diagnosis and treatment of liver disease: current trends and future directions.Cureus.2023 Dec;15(12):e49920. doi:10.7759/cureus.49920U.S. Department of Veterans Affairs.When to go to the emergency room: cirrhosis for patients.American Liver Foundation.13 ways to a healthy liver.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.711Mancak M, Altintas D, Balaban Y, Caliskan UK.Evidence-based herbal treatments in liver diseases.Hepatol Forum.2024;5(1):50–60. doi:10.14744/hf.2022.2022.0052National Institute of Diabetes and Digestive and Kidney Diseases.Gabapentin.Soleimanpour H, Safari S, Nia KS, et al.Opioid drugs in patients with liver disease: a systematic review.Hepat Mon. 2016;16(4):e32636. doi:10.5812/hepatmon.32636Tandon P, Berzigotti A.Management of lifestyle factors in individuals with cirrhosis: a pragmatic review.Semin Liver Dis.2020 Feb;40(1):20-28. doi:10.1055/s-0039-1696639
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Viral hepatitis.Jung SW, Joo MS, Choi HC, et al.Epigastric symptoms of gallbladder dyskinesia mistaken for functional dyspepsia: retrospective observational study.Medicine (Baltimore).2017;96(16):e6702. doi:10.1097/MD.0000000000006702Llewellyn 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.2023.100760National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of cirrhosis.Hamilton JP.Pain management in liver disease.Gastroenterol Hepatol (N Y).2023;19(6):355–358.National Institute of Diabetes and Digestive and Kidney Diseases.Hepatitis (viral).Tapper EB, Parikh ND.Diagnosis and management of cirrhosis and its complications: a review.JAMA. 2023;329(18):1589-1602. doi:10.1001/jama.2023.5997Centers for Disease Control and Prevention.Viral hepatitis.Hosseini N, Shor J, Szabo G.Alcoholic hepatitis: a review.Alcohol Alcohol.2019;54(4):408–416. doi:10.1093/alcalc/agz036Yanai H, Adachi H, Hakoshima M, et al.Metabolic-dysfunction-associated steatotic liver disease—its pathophysiology, association with atherosclerosis and cardiovascular disease, and treatments.Int J Mol Sci.2023;24(20):15473. doi:10.3390/ijms242015473Bosch J.Portal hypertension and cirrhosis: from evolving concepts to better therapies.Clin Liver Dis. 2020;15(S1). doi:10.1002/cld.844Turco L, Garcia-Tsao G.Portal hypertension: pathogenesis and diagnosis.Clin Liver Dis. 2019;23(4):573-587. doi:10.1016/j.cld.2019.07.007Ahmad AK, Atzori S, Maurice J, et al.Non-invasive splenic parameters of portal hypertension: assessment and utility.World J Hepatol.2020;12(11):1055–1066. doi:10.4254/wjh.v12.i11.1055Genetic and Rare Diseases Infomation and Center.Budd-Chiari syndrome.National Cancer Institute.Cancer stat facts: liver and intrahepatic bile duct cancer.Kawamura R, Harada Y, Shimizu T.Missed diagnosis of cholangiocarcinoma presenting with atypical symptoms.Eur J Case Rep Intern Med.2021;8(1):002207. doi:10.12890/2021_002207MedlinePlus.Pyogenic liver abscess.Ahmed M.Acute cholangitis - an update.World J Gastrointest Pathophysiol. 2018;9(1):1-7. doi:10.4291/wjgp.v9.i1.1Marrero JA, Ahn J, Reddy RK.ACG clinical guideline: the diagnosis and management of focal liver lesions.Am J Gastroenterol.2014;109(9):1328-1347. doi:10.1038/ajg.2014.213Kozielewicz DM, Sikorska K, Stalke P.Liver abscesses — from diagnosis to treatment.Clin Exp Hepatol.2021;7(4):329–336. doi:10.5114/ceh.2021.110998Khine H, Wren SB, Rotenberg O, Goldman DL.Fitz-Hugh-Curtis syndrome in adolescent females: a diagnostic dilemma.Pediatr Emerg Care. 2019;35(7):e121-e123. doi:10.1097/PEC.0000000000001525Centers for Disease Control and Prevention.Pelvic inflammatory disease (PID).Coccolini F, Coimbra R, Ordonez C, et al.Liver trauma: WSES 2020 guidelines.World J Emerg Surg,2020;15:24. doi:10.1186/s13017-020-00302-7MedlinePlus.Hypovolemic shock.MedlinePlus.Bile duct obstruction.Lam R, Zakko A, Petrov JC, et al,Gallbladder disorders: a comprehensive review,Disease a Month. 2021;67(7):101130. doi:10.1016/j.disamonth.2021.101130Majid B, Khan R, Junaid Z, et al.Assessment of knowledge about the risk factors of chronic liver disease in patients admitted in Civil Hospital Karachi.Cureus. 2019 Oct;11(10):e5945. doi:10.7759/cureus.5945Wazir H, Abid M, Essani B, et al.Diagnosis and treatment of liver disease: current trends and future directions.Cureus.2023 Dec;15(12):e49920. doi:10.7759/cureus.49920U.S. Department of Veterans Affairs.When to go to the emergency room: cirrhosis for patients.American Liver Foundation.13 ways to a healthy liver.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.711Mancak M, Altintas D, Balaban Y, Caliskan UK.Evidence-based herbal treatments in liver diseases.Hepatol Forum.2024;5(1):50–60. doi:10.14744/hf.2022.2022.0052National Institute of Diabetes and Digestive and Kidney Diseases.Gabapentin.Soleimanpour H, Safari S, Nia KS, et al.Opioid drugs in patients with liver disease: a systematic review.Hepat Mon. 2016;16(4):e32636. doi:10.5812/hepatmon.32636Tandon P, Berzigotti A.Management of lifestyle factors in individuals with cirrhosis: a pragmatic review.Semin Liver Dis.2020 Feb;40(1):20-28. doi:10.1055/s-0039-1696639
Centers for Disease Control and Prevention.Viral hepatitis.
Jung SW, Joo MS, Choi HC, et al.Epigastric symptoms of gallbladder dyskinesia mistaken for functional dyspepsia: retrospective observational study.Medicine (Baltimore).2017;96(16):e6702. doi:10.1097/MD.0000000000006702
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
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of cirrhosis.
Hamilton JP.Pain management in liver disease.Gastroenterol Hepatol (N Y).2023;19(6):355–358.
National Institute of Diabetes and Digestive and Kidney Diseases.Hepatitis (viral).
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
Hosseini N, Shor J, Szabo G.Alcoholic hepatitis: a review.Alcohol Alcohol.2019;54(4):408–416. doi:10.1093/alcalc/agz036
Yanai H, Adachi H, Hakoshima M, et al.Metabolic-dysfunction-associated steatotic liver disease—its pathophysiology, association with atherosclerosis and cardiovascular disease, and treatments.Int J Mol Sci.2023;24(20):15473. doi:10.3390/ijms242015473
Bosch J.Portal hypertension and cirrhosis: from evolving concepts to better therapies.Clin Liver Dis. 2020;15(S1). doi:10.1002/cld.844
Turco L, Garcia-Tsao G.Portal hypertension: pathogenesis and diagnosis.Clin Liver Dis. 2019;23(4):573-587. doi:10.1016/j.cld.2019.07.007
Ahmad AK, Atzori S, Maurice J, et al.Non-invasive splenic parameters of portal hypertension: assessment and utility.World J Hepatol.2020;12(11):1055–1066. doi:10.4254/wjh.v12.i11.1055
Genetic and Rare Diseases Infomation and Center.Budd-Chiari syndrome.
National Cancer Institute.Cancer stat facts: liver and intrahepatic bile duct cancer.
Kawamura R, Harada Y, Shimizu T.Missed diagnosis of cholangiocarcinoma presenting with atypical symptoms.Eur J Case Rep Intern Med.2021;8(1):002207. doi:10.12890/2021_002207
MedlinePlus.Pyogenic liver abscess.
Ahmed M.Acute cholangitis - an update.World J Gastrointest Pathophysiol. 2018;9(1):1-7. doi:10.4291/wjgp.v9.i1.1
Marrero JA, Ahn J, Reddy RK.ACG clinical guideline: the diagnosis and management of focal liver lesions.Am J Gastroenterol.2014;109(9):1328-1347. doi:10.1038/ajg.2014.213
Kozielewicz DM, Sikorska K, Stalke P.Liver abscesses — from diagnosis to treatment.Clin Exp Hepatol.2021;7(4):329–336. doi:10.5114/ceh.2021.110998
Khine H, Wren SB, Rotenberg O, Goldman DL.Fitz-Hugh-Curtis syndrome in adolescent females: a diagnostic dilemma.Pediatr Emerg Care. 2019;35(7):e121-e123. doi:10.1097/PEC.0000000000001525
Centers for Disease Control and Prevention.Pelvic inflammatory disease (PID).
Coccolini F, Coimbra R, Ordonez C, et al.Liver trauma: WSES 2020 guidelines.World J Emerg Surg,2020;15:24. doi:10.1186/s13017-020-00302-7
MedlinePlus.Hypovolemic shock.
MedlinePlus.Bile duct obstruction.
Lam R, Zakko A, Petrov JC, et al,Gallbladder disorders: a comprehensive review,Disease a Month. 2021;67(7):101130. doi:10.1016/j.disamonth.2021.101130
Majid B, Khan R, Junaid Z, et al.Assessment of knowledge about the risk factors of chronic liver disease in patients admitted in Civil Hospital Karachi.Cureus. 2019 Oct;11(10):e5945. doi:10.7759/cureus.5945
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