If you feel discomfort in your abdomen, you can’t necessarily tell if it’s liver pain or not. Because of its somewhat centralized location, any liver-associated pain can sometimes appear to be coming from another source, such as the lungs or the kidneys. There are even times when a hepatic disorder of some kind may result in backache. There are in fact a number of things that can cause backache when there is nothing wrong with the back at all. Backache is often a referred pain, meaning the cause of the discomfort is located somewhere else, usually deep in the abdomen or in the pelvic region. Once in a while however, you can tell the pain you’re feeling is coming from your liver. This is most likely the case when the pain you’re experiencing seems to be coming from the upper right quadrant of that part of your abdomen beneath your rib cage. Another sign that the source is from your liver is that the pain will usually be felt as a dull ache. There are exceptions, however. Liver pain can also be experienced as a sharp pain in the same general area and is often accompanied by pain in the back or in the shoulder.
Causes of Hepatic Pain Are Many and Varied
There are so many different things that can result in liver pain that it’s a wonder that your liver isn’t hurting most of the time. Even if that were the case, much of the time it might still be difficult to identify the source of the discomfort if it were not for a number of other symptoms that quite often make themselves known if you have a liver problem. Some of the more common symptoms are nausea, loss of appetite, and chronic fatigue. Those three symptoms can, of course, be due to a wide variety of other disorders but, coupled with any discomfort you might be experiencing, could give you a clue that something is amiss with your liver. Even more telling would be if the discomfort is accompanied by abdominal pain and/or swelling, bloody or nearly black stool, very pale stool, and/or dark urine. Hepatic problems can also cause itching in the skin that tends to be persistent. The most common symptom of all is discolored skin, or if the whites of the eyes take on a distinctly yellowish hue.
Before getting more deeply into what can cause liver pain, it would be helpful to briefly review what the purpose of our liver is, since when pain or other symptoms are being experienced, it is usually because one or more hepatic functions have been impaired in some way.
The Functions of the Liver
The liver is a vital organ having many functions. It receives its blood supply from two sources. The hepatic artery provides this organ with highly oxygenated blood, while the hepatic portal vein supplies it with blood rich in nutrients. At any given time, this 3-pound organ will contain about a pint of blood, a little over 10% of the body’s total blood supply.
- It acts as a regulator and is responsible for regulating the levels of most of the chemicals being carried along in the bloodstream. If one or more of these chemicals is out of balance, the body may experience symptoms which may or may not be traceable to a hepatic problem, depending on which chemicals are involved.
- It processes blood that is flowing from the stomach and the intestines. This is the aforementioned nutrient-rich blood supplied by the hepatic portal vein. These nutrients are for use throughout the body and are broken down into forms that are more useable by the rest of the body.
- It produces bile. Bile carries waste away and also helps to break down fats in the digestive system.
- It produces cholesterol and special proteins, converts excess glucose into glycogen for storage, processes hemoglobin for the iron it contains which the liver then stores, and clears the blood of toxic elements, acting as a filter.
- It also plays an important role in regulating blood clotting, removing bacteria from the bloodstream, and producing certain compounds used by the immune system.
When one of these functions is disrupted, pain may or may not result, but more often than not, one or more other symptoms will be experienced, although in many instances, hepatic diseases and disorders are asymptotic, at least in the early stages.
The following video allows you to see exactly what the liver consists of and what its functions are:
The 8 Most Common Causes
When one or more of the aforementioned hepatic functions is disrupted, it could be a result of trauma, but our liver is a relatively well-protected organ and trauma is not one of the more common causes of hepatic discomfort. When something is wrong with this multitasking organ, it is almost always because of disease, disorder, or toxicity, all of which are capable of causing discomfort. Below are a few of the most likely causes of liver pain, along with some of the associated symptoms that you might experience.
- Alcohol Liver Disease or Hepatic Cirrhosis – The bad news is that alcohol liver disease and cirrhosis can be deadly and certainly can disrupt an individual’s lifestyle. The good news is that this disease takes a long time to develop, and many heavy drinkers never develop it at all. It does not appear to be the alcohol itself, but acetaldehyde, a chemical produced in the body from alcohol that is capable of liver damage. More good news is that the organ most likely damaged by the disease is capable of reproducing itself. In addition, it is so efficient in carrying out its chores that having only a quarter of a functioning liver is nearly as good as having a fully functioning one. There are two stages of alcohol liver disease, the second stage being cirrhosis, where liver scarring becomes so bad that the organ cannot effectively repair itself. Pain is not one of the major symptoms of cirrhosis, but it can cause fluid to accumulate in your abdomen, which, if it happens in excess, can be a source of significant discomfort.
- Fatty Liver Disease – A fatty liver condition, also called steatosis, occurs when an excess of fat accumulates in hepatic cells. There are many ways in which this can happen, but eating fatty foods does not appear to be one of them. Fatty liver disease is often asymptotic, but if symptoms are present, one of them is likely to be pain that is felt in the upper right abdomen. If the pain is accompanied by weight loss and/or fatigue, its source is likely from the liver.
- Hepatic Fibrosis – Hepatic fibrosis is sometimes confused with hepatic cirrhosis. Cirrhosis is an advanced form of fibrosis, usually caused by heavy alcoholic consumption. There are a number of other things that can cause hepatic fibrosis, however. Fibrosis causes scarring in the liver, resulting in a percentage of hepatic cells being unable to carry out their intended functions. Hepatic fibrosis, like fatty liver disease, is often asymptotic, but like fatty liver disease, it can cause fluid to accumulate in the abdomen, resulting in pain.
- Hepatitis – Hepatitis is an inflammation of the liver. It is a disease that, in some instances, can be quite mild and in other cases, be quite severe. This inflammation is capable of causing damage to the hepatic cells. There are several types of hepatitis. One type is hepatitis B which can be chronic and can also cause liver infection. When hepatitis does cause pain, the pain is most apt to be experienced as a dull ache, which is sometimes referred pain, meaning it will be felt in other parts of the body. Hepatitis is also a disease that, because it causes hepatic cells to malfunction, can impact other organs in the body.
- Hepatic Cysts – Hepatic cysts can cause pain, but they are generally harmless. In most cases, they do not pose a health risk and are usually only removed for the purpose of relieving any symptoms they might be causing. When hepatic cysts do cause pain, it is usually felt in the upper right side of the abdomen. In rare instances, if hepatic cysts become too large, they could infect the bile duct or cause the organ to become enlarged.
- Hepatic Cancer – Hepatic cancer is one of the hepatic diseases that are most likely to cause pain, although it seldom does so in its early stages. Those who are at the highest risk of developing hepatic cancer are those who have had hepatitis or have hepatic cirrhosis. Hepatic cancer is rarely detectable in its early stages. When pain is experienced, it is usually the result of liver enlargement and it is generally felt in the upper right side of the abdomen. Treatments include chemotherapy, cryotherapy, radiation therapy, and transplants.
- Acetaminophen Toxicity – There are instances where, when you take a certain medicine, your doctor will want to take occasional blood tests to see if there are any adverse effects taking place in your liver. One of the more common medications that can cause liver toxicity is acetaminophen. Acetaminophen is found in numerous over-the-counter and prescribed medications for headaches, sinus congestion, and allergies. While acetaminophen in itself is usually harmless, excessive amounts can be toxic. Making certain the proper dosages are taken for certain medications can therefore be quite important. Acetaminophen toxicity is a known cause of liver pain, together with itchy skin, yellowish skin, and dark urine. The pain is usually experienced in the form of tenderness of the right side of the abdomen.
- Primary Sclerosing Cholangitis (PSC) – PSC is a chronic disease that damages the bile ducts both inside and outside the liver. It is a slowly progressing disease that, over time, can cause bile to accumulate in the organ when the bile ducts become blocked. The accumulation of bile can damage the hepatic cells, leading to cirrhosis and, in some instances, liver failure. The causes of PSC are not known, but may be the result of immune system problems or bacterial or viral infections. PSC strikes mostly men. The usual symptoms of a liver disease, including fatigue and skin discoloration, will eventually make themselves known. Abdominal pain is likely to occur in advanced cases and is due to the bile ducts having been infected. There is no cure or treatment for PSC, which fortunately is a rather uncommon disease, but the symptoms themselves are sometimes treatable.
While the list of potential causes is fairly long, most of the causes not mentioned above are uncommon since they are associated with rare diseases. These causes would include such things as parasitic infections, Wilson’s disease, Gilbert’s syndrome, autoimmune hepatitis, and hepatic adenoma. Pain can also be the result of a disorder in an organ or in a part of the anatomy that lies in near proximity to the liver. As an example, swelling of an organ or nearby tissues can cause liver pain if that swelling puts pressure on the liver.
In summary, when you go down through the list of the more common causes of liver pain, aside from cirrhosis or toxicity caused by certain medications, most of those causes are things that are seldom experienced during a person’s lifetime. If you do have abdominal pains, you should consider seeing a physician as something that is essential, whether you think your problem has something to do with your bile-secreting organ or not. As is the case with many diseases and disorders, it is usually a collection of symptoms that enables a physician to make a correct diagnosis of the problem.