What is Liver Pain?
Liver pain is not something to be ignored. It could be a sign of a serious health condition. Therefore, it is important to know where it is and what it does in the body. Your liver is located near your abdomen on the right side, actually beneath your ribs and above your diaphragm which separates the chest and the abdomen.
The liver is a gland but it is also the largest solid organ in the body. It often weighs about 3.5 pounds.  It’s not only the largest gland but is also responsible for detoxifying the human body. The various functions of liver include digesting food (including fats and nutrients). The liver converts glucose into glycogen so it can be used by your body. Also, your liver produces urea and amino acids. As a part of this entire process it purifies your blood from harmful substances. The liver also creates bile and secretes it as part of the digestion process.
The liver is a detoxifying organ. It filters wastes and toxins from the human body. Many underlying conditions can cause the liver to function poorly or not at all. This is what usually causes liver pain. In addition, liver pains play a major role in a variety of conditions such as:
- Gilbert’s syndrome
- Wilson’s disease
- Different types of hepatitis A, B and C.
You can have many different forms of liver pain in your life such as:
- Fatty liver pain
- Liver cancer pain
- Other chronic conditions
- Acute diseases of liver
The most common cause of cirrhosis of the liver is alcoholic abuse. The liver becomes inflamed when it cannot filter poisons, drugs, toxins and other foreign substances from your body. In order to recover, your body must flush them out. Additional cases of liver damage include autoimmune deficiency, hepatitis, and even overuse of acetaminophen (Tylenol).
Where is liver pain felt?
Oh, that’s so easy to answer!!! Isn’t it? The obvious answer would be ‘in the liver’. But there is more to it than just ‘in the liver’.
Liver pain location: Liver pain is easily confused with abdominal pain, kidney pain or back pain due to its location. It is felt in the upper-right quadrant beneath your rib cage. Usually felt as a dull ache, liver pains can be sharp and sometimes being experienced along with back pain.
Picture 1: Liver is located in the right upper region (among the nine quadrants of the abdomen)
Picture 2: Location of liver in relation to 9 abdominal quadrants
Image source: instruct.uwo.ca
Causes of Liver Pain
The causes for liver pain are as different as its symptoms. It requires a thorough clinical exam by a trained medical practitioner.
Fatty Liver Pain
Steatosis, also known as fatty liver, causes liver pain. When there is an accumulation of a large amount of fat in the liver, it results in swelling. This condition of swollen liver is known as steatosis. In steatosis, there is no inflammation, only the presence of a large amount of fat is noticed. However, when fatty liver occurs along with inflammation, the liver cells are damaged and this condition is known as steatohepatitis.
Image Source: symbinatur.com
Excessive fats cause the liver to swell and this results in liver pain. Swollen liver pain is caused by the expansion of the liver. As the liver expands, its membrane is stretched and the organ gets heavier. This results in abdominal pain which intensifies slowly if left untreated.
- Obesity, diabetes and over-consumption of alcohol are all major factors for fatty liver pain.
- Hypertension, diabetes type-2 and metabolic syndrome are additional conditions that may trigger pain in liver.
- An enlarged spleen pressing against the liver causes liver pain.
- Liver pain is also observed after drinking alcohol. Abuse of alcohol is a primary cause of liver pain.
People in the last stage of liver cancer have intense liver pain along with other problems like weight reduction, tiredness and lack of energy.
Picture 4: Stages of Liver Damage
Image Source: commons.wikimedia.org
Other Causes of Liver Pain:
- Biliary obstruction
- Bearn-Kunkel syndrome is sometimes referred to as lupoid hepatitis. It is an autoimmune liver condition most commonly found in women. Liver pain is a primary symptom. 
- Cholangitis is an infection in the bile duct which is responsible for carrying bile from the liver to the gall bladder. 
- Congestive cardiac failure
- CMV is a common virus, cytomegalovirus, which rarely shows symptoms except in pregnant women, babies or people with compromised immune systems. 
- EBV is a very common herpes virus known as Epstein Barr Virus. It is most frequently seen in connection with infectious mononucleosis. Most Americans between the ages of 35 – 40 already carry the virus in a dormant form. 
- Dubin-Johnson Syndrome can cause liver tenderness along with jaundice. It is a hereditary condition which affects the production and transport of bilirubin in the liver. All ethnic groups carry the mutation, though it is more frequently seen among Iranian Jews living in Israel (1 out of 3000 people). 
- Fatty liver of pregnancy
- Fitz-Hugh-Curtis syndrome is seen in about 1/4 of the women with pelvic inflammatory disease. It is an inflammation of the liver which results in sharp pain in the upper right quadrant. 
- Hepatic vein thrombosis
- Hepatitis causes swelling of the liver and results in pain in the right rib (liver pain in right side).
- Hepatic abscess
- Hydatid cyst is the result of a parasitic tapeworm and its endocysts in the liver.  This video illustrates the surgical removal of these cysts.
- Hodgkin’s disease
- Hepatocellular carcinoma
- Liver abscess – tender liver
- Leukemia – tender liver
- Metastatic carcinoma
- Pylephlebitis – tender liver
- Mononucleosis – liver tenderness
- Schistosomiasis japonica shows as a tender liver among other symptoms. It is the result of a parasitic flatworm commonly found in snail infested waters where clean drinking water and adequate disposal of human wastes are not available. 
- Schistosomiasis – liver tenderness 
- Schistosomiasis mansoni – tender liver 
- VLCAD deficiency results in liver pain. It is a rare hereditary condition which inhibits the ability to properly metabolize fats and convert them to energy. 
- Weil Syndrome is a late stage development of an infection by one or more Leptospira bacteria species. Liver tenderness is one of the symptoms. The bacteria are found worldwide in freshwater and are carried by most mammals. High risk occupations include freshwater fish farmers, outdoor adventurers, hunters, etc. It can be fatal if untreated. 
Picture 5: Leptospira bacteria species
Image Source: thelancet.com
Liver Pain Symptoms
The initial symptom of liver pain can be a sharp or dull pain in the upper right abdomen underneath the rib cage accompanied by a skin rash. Liver pain symptoms also include: itching, pain while inhaling or coughing, difficulty in breathing, swollen testes, nausea, vomiting, brownish blemishes and spots over skin, dark circles under the eyes and yellow discoloration of the eyes like in jaundice. Abdominal swelling is also noticed even though there is a weight loss. This swelling suggests an enlarged liver.
Liver Pain Treatment
Treating liver pain is possible only by initiating with elimination of the possible causes of the disease. Careful clinical examination and inquiry of the patient’s recent activities prior to the onset of the pain will help diagnose potential origins. Once a cause is determined a proper course of treatment can be prescribed. For example, an alcohol or drug addict should quit alcohol and drugs completely before starting medications. There are several possible treatments to get relief from pain of the liver. Some of these are personal hygiene or public health and sanitation related.
- Restore sufficient hydration and correct electrolyte imbalances.
- Most people can be treated as outpatients unless they cannot take medication or fluids orally.
- Flagyl is an antibiotic often used for abdominal infections. Also known as Metronidazole. 
- Antiviral agents:
- Interferon alpha II b
Remedies and Alternative Treatments for Liver Pain
People are always seeking a simpler and safer method to relieve liver pain or illness. Some alternatives can help.
- Water is essential for the human body. By removing toxins, water helps your liver get flushed out. Drink a minimum of 8 glasses of water each day to stay properly hydrated.
- Diet also plays a very significant role. Pay attention to what you eat and add some fresh fruits and pure juices, and fresh vegetables. Asparagus, plums, legumes, broccoli, and brown rice are also particularly effective.
- Take supplements along with whole-food. In particular, Vitamin B1 can help decrease glucose levels in your blood.
- Vitamin K is also advantageous. Deficiency of Vitamin A can contribute to liver disease.
- Linseed oil has very helpful essential fatty acids which are required for the proper liver function.
- To flush away the toxins from the body as quickly as possible, herbal detoxification can be a good technique.
- These steps are practiced and recommended by many doctors.
Liver Pain Do’s and Dont’s
Apart from the treatments and medications, there are some other things to be observed and avoided when suffering from liver pain.
Many people with damaged liver function have excessive protein in their body. This can build up excess amounts of ammonia in the body.
Avoid alcohol. Alcoholic abuse is always said to be the one of the worst things for the human body.
Do not take any type of medicines or drugs without the prescriptions of physician. Anything containing acetaminophen is hazardous for the liver patient. Try to avoid it because it can be dangerous for people with liver malfunctions.
Mostly, you can care for your liver health by diet, supplements of whole-food, and by avoiding those things which can cause dysfunction of liver. Some of the conditions are non-reversible like cirrhosis and have a hopeless prognosis. Health is wealth. Take care of your health and treat your liver right starting now.