Your liver is located on the right, upper side of your belly, just underneath your right rib cage. It weighs about three to four pounds and takes up most of the space doctors call the right upper quadrant of the abdomen.
Liver disease is quite common in the United States, affecting about one in four adults. You would think that right upper quadrant pain would be a common symptom of liver disease. In fact, right upper quadrant pain is unlikely to be caused by your liver, because your liver does not have any pain nerves.
Liver pain location
When your liver does cause pain, the location is the thin layer of tissue that surrounds the liver, called the liver capsule. This tissue does sense pain, so if the liver swells or grows, it can stretch the capsule and cause pain. If your liver swells from an infection, or grows from a tumor, you can get liver pain in your right upper quadrant. The medical term for an enlarged liver is hepatomegaly.
Common infections that cause hepatomegaly include hepatitis A, B, and C, viruses and the virus that causes mononucleosis. The word “hepatitis” means liver inflammation. Viral infections cause hepatitis, and so does alcohol and fat, called alcoholic and metabolic dysfunction-associated steatotic (fatty) liver disease (MASLD). Growths in the liver that cause hepatomegaly include cancerous tumors, benign tumors, and fluid-filled cysts.
What does liver pain feel like?
The type of liver pain you feel depends on the cause. A condition that causes sudden inflammation, like a viral infection, causes acute pain. Acute (short-term) pain is pain that starts quickly and can be sharp or stabbing. Liver pain caused by the slower growth of a cyst or tumor is called chronic pain. Chronic liver pain is more of a dull ache, sensation of fulness, or discomfort.
Other liver disease symptoms include these acute liver disease symptoms:
Severe fatigue not relieved by rest
- Yellowing of your skin and eyes, called jaundice
- Dark urine
- Nausea and loss of appetite
The liver is a forgiving organ, meaning that it can recover or compensate for a long time before signs of serious liver disease occur. Once these symptoms occur liver disease is usually advanced:
Tiny blood vessels in the skin, called spider angiomas
- Confusion from toxins not removed by the liver
- Swelling of the belly, called as ascites
- Intense itching
- Easy bruising
Fatty liver disease and cirrhosis
Fatty liver disease occurs when more than five percent of the liver cells have accumulation of fat. The more common causes of fatty liver disease include drinking too much alcohol (alcoholic fatty liver disease) and an unhealthy diet that leads to obesity (MASLD). MASLD has been rapidly increasing in the U.S. and other developed countries, probably due to obesity. Eighty to percent of adults who are obese or who have high cholesterol and diabetes develop MASLD.
Fatty liver disease can lead to advanced scarring of the liver, called cirrhosis. Other common conditions that damage the liver can also lead to cirrhosis, including alcohol abuse, and long-term infections with viral hepatitis. Fortunately, with healthy lifestyle changes, weight loss, and control of cholesterol, few people with MASLD will develop cirrhosis.
Other diseases that cause right upper quadrant pain
Liver location pain is usually caused by other conditions. These include:
- Shingles nerve pain
- A rib or muscle injury
- Inflammation of the lung lining, called pleurisy
- Gall bladder or bile duct disease, called biliary colic
- Inflammation of the pancreas
- Peptic ulcer
- Right-sided kidney disease
How to stop liver pain and keep your liver healthy
Once you have liver pain, it is important to get the right diagnosis and treatment of the cause. There are ways to care of your liver health and prevent progression of liver disease. You may have seen adds for liver cleansing or liver health supplements. Unfortunately, there is little evidence to support their use. In fact, because supplements are not strictly regulated or inspected, they may contain toxins that are unhealthy for the liver, so the risk outweighs the benefits. Here are the best tips for a healthy liver:
- Avoid alcohol, and abstain from alcohol if you have any type of liver disease.
- Maintain a healthy weight with diet and exercise.
- Eat a Mediterranean-style diet featuring lean protein and vegetables, and avoiding sugar and saturated fats.
- Get your hepatitis A and B vaccinations. There is no vaccine for hepatitis C
See your primary care doctor if you have right upper quadrant pain or any of the other symptoms of liver disease. See a gastroenterologist if you are diagnosed with fatty liver or if your routine blood test finds elevated liver enzymes.
