Severe pain in the abdomen can be an indication of a serious condition and should be examined by a doctor.
A healthy liver helps the body fight infections, cleans the blood, and plays a role in metabolism. It can also repair itself when damaged.
If the liver is unable to do its job properly, it can be a life-threatening situation.
Liver pain can arise for various reasons. It is important to find out what is causing the pain and to get treatment to prevent irreversible damage.
According to the American Liver Foundation, at least 30 million people, or 1 in 10 Americans, have some form of liver disease.
Liver pain and liver disease
Liver pain can be dull and nonspecific, but it can also be severe. It may result in a backache. Liver pain is sometimes confused with a pain in the right shoulder, or in the abdomen, or the kidney.
Many liver diseases and other organ conditions can cause liver pain. Some of these can lead to liver damage. Without treatment, the liver may eventually stop functioning.
Liver disease refers to any condition that causes liver inflammation or damage, and that may affect liver function. Liver pain is often a sign of liver disease.
Symptoms of liver disease often do not appear until the condition is advanced, so it is important to be aware of liver pain and other symptoms that could signal a liver disorder.
Patients should seek immediate medical treatment if they experience any of the following:
- severe pain, especially in the abdomen
- dark urine
- pale, bloody, or tar-colored stools
- nausea and vomiting
- weight loss
- yellowish skin
- severe tenderness when touching the abdomen
- swelling in the abdomen or in the legs and ankles
- itchy skin
- chronic fatigue
- loss of appetite
Over 100 different types of liver disease can cause liver pain. The following are a few examples:
Cholangitis is inflammation of the bile duct system, usually due to a bacterial infection. The bile duct drains bile from the liver and gallbladder, carrying it to the small intestine.
Cholangitis infection causes pressure to build up in this drainage system. It normally indicates that there is an obstruction or blockage in the system.
This may be due to stones, a tumor, blood clots, or a backflow of bacteria.
Hepatitis means inflammation of the liver. The most common cause is a virus, but other causes include heavy alcohol use, toxins, some medications, and some medical conditions.
There are several different types of hepatitis virus.
- hepatitis A is found in feces of an infected person and is transmitted through consumption of contaminated water or food
- hepatitis B is transmitted through exposure to body fluids, such as blood and semen
- hepatitis C is transmitted through infected blood or sometimes sexual transmission
- hepatitis D is a secondary infection that only affects those who have hepatitis B
- hepatitis E is transmitted through the consumption of contaminated water or food
Hepatitis can be acute, meaning sudden and short term, or chronic, meaning long-term and persistent.
A liver abscess is a pocket of infected fluid, or pus, that forms in the liver. Infection from certain germs, such as bacteria, parasites, or fungus, can cause the abscess.
An abscess can damage nearby tissue, it can lead to bleeding, additional infections, and even death. Treatment may include an antibiotic or antifungal medicine, and the abscess may be drained.
Follow-up imaging tests of the liver are normally conducted to ensure the abscess is gone and that there is no permanent damage.
Cirrhosis is a long-lasting injury that can lead to liver failure.
Cirrhosis is an irreversible scarring of the liver. The liver slowly gets worse and becomes unable to work properly due to long-lasting injury.
Over time, scar tissue replaces healthy liver tissue, and this can begin to block the flow of blood through the liver. A healthy liver can regenerate its damaged cells. If the damage is too severe or long-lasting, the liver cannot completely repair itself, and it creates scar tissue instead.
Cirrhosis happens gradually, but as it gets worse, the liver will begin to fail. This can lead to chronic liver failure or end-stage liver disease where the liver can no longer perform vital functions.
This is a rare liver disease where blood clots block off the blood flow out of the liver.
Blood backs up in the liver, causing it to enlarge. In some cases, the spleen may also enlarge.
The buildup of blood causes an increase in blood pressure in the portal vein. This is the vein responsible for carrying blood to the liver from the intestines. This increase in pressure is known as portal hypertension.
Portal hypertension causes fluid to build up in the abdomen. The blocked veins cause the blood flow from the liver to the heart to slow down or stop.
Scarring of the liver or cirrhosis is also possible.
People whose blood is most likely to clot are also more at risk of Budd-Chiari syndrome. This includes pregnant women and those with a tumor, a chronic inflammatory disease, a clotting disorder, or an infection.
The effect of alcohol
The liver cells can be damaged or destroyed if a person drinks more alcohol than their liver can process.
Normally, the liver breaks down alcohol and removes it from the body. If a person consumes more alcohol than the liver can process, liver cells may be damaged or destroyed.
According to the National Institute of Diabetes and Digestive and Kidney Disease, women can consume two or fewer drinks per day and men three or fewer drinks per day without injury to the liver.
Drinking more than these amounts may lead to a buildup of fat and inflammation in the liver, and this can result in alcoholic cirrhosis.
Cirrhosis due to alcohol cannot be reversed even after stopping drinking, but cutting out alcohol can prevent further damage, and it may help improve symptoms.
Causes and risk factors for liver disease
Liver disease has several different causes, including:
- immune system problems
- genetic factors
- toxic effect of medications
- chronic alcohol abuse
- fat building up in the liver
Factors that increase the risk of developing a liver disease or a related complication include:
- heavy alcohol use
- injecting drugs or sharing needles
- unprotected sex
- exposure to certain chemicals or toxins
Many conditions can cause liver pain, so it is important to find out which one is present.
A doctor will carry out a physical examination and look at the person's health history.
Other testing options may include:
- blood tests to assess liver function or identify specific liver problems or genetic conditions
- imaging tests, such as CT scans, MRIs, and ultrasounds to assess for liver damage
- tissue analysis, which involves taking a tissue sample from the liver for a lab test
Sometimes, liver pain will go away after making some lifestyle changes, such as abstaining from alcohol, losing weight, or following a healthful diet.
Other problems may require medication or surgery. If there is liver failure, a liver transplant may be needed.
Preventing liver disease
To prevent liver disease, it is advisable to:
- drink alcohol in moderation
- avoid risky behavior, such as sharing drug needles and having unprotected sex
- get vaccinated against hepatitis, if appropriate
- get screened for hepatitis, if appropriate
- use medications wisely
- maintain a healthy weight
Even if liver pain occurs, with proper treatment and lifestyle changes, individuals can lead a normal life.