Liver pain


Listed below is an overview of all diseases that can trigger liver pain.

General symptoms

The liver itself is not equipped with pain receptors. At most the liver capsule can perceive pain through stretching or pressure. As a rule, complaints in the liver area are therefore indirectly caused by an enlargement of the organ as part of inflammatory processes or the like. perceived. The enlarged liver (see also: swollen liver) then presses on surrounding structures (nerves, surrounding organs) and triggers a pain stimulus on them. Depending on the position of the liver in the right upper abdomen, liver pain is usually located just below the right costal arch. Sometimes they can also radiate into the right shoulder or back. Further symptoms that can indicate a disease of the liver are jaundice (jaundice; yellowing of the skin and conjunctiva), the lacquer tongue (smooth, shiny tongue), the palmar erythema (reddening of the palms of the hands), the baldness (loss of hair on the Abdomen; especially in men), the spider naevi (enlargement of the small blood vessels in the skin; resembles a small spider web), as well as the caput medusae (visible vascular markings on the abdominal wall as a result of bypass circuits in the vascular system due to increased pressure in the portal vein) . A build-up of water in the abdomen (ascites) can also be a sign of liver disease.

Read more on the topic: Enlarged liver


The pain felt as liver pain rarely actually comes from the liver.
In these rather rare cases, the cause is then usually an increase in the size of the liver. This creates tension on the capsule surrounding the liver, which, unlike the liver, is sensitive to pain. The tension irritates the capsule and causes pain.

Causes of this liver swelling can malignant diseases like Leukemias (Blood cancer) and liver tumors, but also other causes such as Liver abscesses (for example after an operation) and large Cysts. A dysfunction of the heart (Heart failure) can lead to an enlarged liver or to a backlog of blood in the liver. Also at Inflammation of the liver painful enlargement can occur. These include infectious hepatitis diseases, but these are generally rarely associated with severe pain in the liver. Even the inflammation under a Fatty liver disease can cause pain. A fatty liver is primarily caused by unhealthy diet, obesity and or regular alcohol consumption.

As mentioned above, there are also pains that are localized in the liver but actually do not come from the liver. Typical examples are Gallstones. The gallbladder sits on the underside of the liver and is attached there. The gallbladder can be painful for two reasons: it can ignited be or it can be a Gallstone got stuck in one of the bile ducts. Often times, the gallbladder becomes inflamed after a gallstone has prevented the bile from draining.

What to do with liver pain - general information

As mentioned above, what is felt as liver pain, in most cases, is not pain that actually originates directly from the liver.
In order to be able to decide what to do with pain that is localized in the area of ​​the right costal arch, the most important question is what possible causes are in question.
One of the most common causes of pain that is localized in the liver is probably biliary colic when the biliary tract is blocked by a stone, or gallbladder inflammation. If such a disease is suspected, a doctor should be consulted. In general, if there is pain in the liver, a doctor can use an ultrasound scan to detect abnormalities. However, you do not always have to see a doctor if it hurts in the area of ​​the right costal arch.

Read more on the topic: Ultrasound of the abdomen

It often helps to wait a little. You can also try whether warmth (for example in the form of a cherry stone pillow or a hot water bottle) or cold (for example in the form of a cool pack wrapped in a towel) can provide relief. If the pain persists for several hours to days, if it becomes significantly worse or if it comes in waves, i.e. if it is colic-like, it is advisable to consult a doctor for further diagnosis.

The liver is the organ in which the ingested alcohol is broken down. However, it is very unusual for liver pain to occur after consuming alcohol. Even with advanced liver disease due to chronic alcohol consumption, the liver rarely causes pain. In general, however, even if there is no pain, alcohol should definitely be avoided if the liver is already damaged.

Which doctor go to if you have liver pain?

The treating person can always be the first point of contact for pain Family doctor serve. He or she can carry out the initial examinations (medical history, blood draw, physical examination) and then decide whether further treatment, for example with a Specialists in gastrointestinal diseases (Gastroenterologist) is necessary. If an enlargement of the liver is the cause of the symptoms, a malignant disease may also be responsible less often. In this case, the family doctor can also refer you to the cancer specialist (oncologist) for further diagnostics.

Is Liver Pain Dangerous?

Since liver pain only occurs when liver swelling occurs, it should be always be taken seriously. Liver swelling can be caused by serious illnesses such as liver or blood cancer. Enlargement of the liver as part of a fatty liver disease can also cause pain in rather rare cases. Overall, the occurrence of recurring liver pain requires clarification and a doctor should be consulted.
Much more often, gallbladder disorders lead to supposed liver pain, and in this case too, sooner or later a doctor should be consulted. The disease itself is common in most cases not acutely dangerous, but needs recurring symptoms of a treatment.

Localization of liver pain

Pain in the liver is usually localized in the right upper abdomen in the area of ​​the right costal arch. The pain is often perceived as diffuse and not clearly limited to one area. For this reason, they are often confused with other causes. Liver pain can be wrongly interpreted as kidney or bowel problems. Liver pain can also lead to flank or back pain, depending on its extent, which is why it is often misjudged as a problem in the spinal column. Liver pain can also radiate into the right shoulder. The same goes for the gallbladder. In contrast, pain in the spleen or pancreas is more likely to project into the left shoulder. If there is liver pain, it can usually be exacerbated by applying pressure under the right costal arch. This is also known as tenderness to pressure. In the differential diagnosis, however, an inflamed gall bladder (cholecystitis) must also be considered, which is also associated with tenderness under the right costal arch. there may also be flank pain on the right.

Read more on the topic: Ultrasound of the abdomen

Liver pain up in the back

Liver pain can extend to the back and therefore also to Middle back pain to lead. That's because a enlarged liver can press on surrounding structures and nerves. These run in the chest area between the ribs and in this way can carry the pain impulses into the spinal column area.
Therefore it can rarely happen that pain that is actually generated by the liver than Herniated disc of the thoracic spine, blocked vertebrae or muscular problem are misinterpreted and not recognized as actual liver pain for a long time.
More often than liver pain, however, the colic-like pain radiates in one Relocation of the bile duct by Gallstones in the back. The bile duct is blocked by a gallstone, which is why the gallbladder and bile duct cramp in the form of waves, which are supposed to drive the stone out. This is very painful for those affected. Typically, however, the pain radiating from biliary problems is the left shoulder.
Inflammation in the area of ​​the pancreas can in some cases also cause pain near the liver, which is relatively typical for acute inflammation of the pancreas Belt-like pain in the upper abdomen, often radiating to the back. A doctor should be consulted as soon as possible. An acute one Inflammation of the pancreas can be very dangerous and usually requires inpatient hospital treatment.

Possible triggers of liver pain


As mentioned above, are Gallstones are a common cause of painwhich are located in the liver area because the gallbladder is located on the lower edge of the liver. If a gallstone obstructs one of the bile ducts, it will develop Pain that increases and decreases in waves, one then speaks of biliary colic. In the case of biliary colic, a doctor should be consulted quickly, both for adequate pain therapy and for further diagnosis, since in most patients the gallbladder should be removed if it causes symptoms.

Liver pain and diet

Liver pain caused by food is very rare. However, there are foods that do Liver failure can trigger. These include, for example Poison mushrooms. However, such liver failure goes rarely with pain in the area of ​​the liver. So overall, diet is not related to liver pain.

Liver pain after eating

Liver pain that occurs immediately after eating has theirs The cause is mostly in the gallbladder. The complaints then especially emerge very fatty meals on. The cause are usually gallstones, which interfere with the outflow of bile into the intestine. The Bile fluid is used there to digest fat. It comes to cramp-like pain in the right upper abdomenthat start either spontaneously or immediately during / after food intake. The liver itself is usually not the cause of the discomfort if the pain occurs in connection with eating.

Liver pain from fatty food

In some cases, eating fatty foods can cause those affected to complain of liver pain. While this pain caused by fatty food can be interpreted as liver pain, it is primarily associated with a problem in the neighboring one Gallbladder or the Biliary tract to bring in connection. The gall plays one Main role in the digestion of fats.
Eating fatty foods stimulates the release of bile from the gallbladder into the intestines. If you experience liver pain here, you are suspected Gallstone Near. This blocks the duct and causes pain. Also one inflamed gallbladder is additionally irritated by fatty food. For example, if you have liver pain from fatty food, you should be seen by a gastroenterologist who can investigate the matter.

Therapeutically, there is a for gallstones Breaking the stones or the Removal of the gallbladder to disposal. An inflamed gallbladder must also be surgically removed. In some cases, it is enough to avoid fatty foods for a while until the situation has calmed down. Rarely are the causes of liver pain caused by fatty foods actually to be found in the liver.

Further information can be found on our website Gallstones and Inflammation of the gallbladder.

Liver pain and coffee

Coffee usually causes no liver pain. Coffee is more likely to be the cause of stomach pain, especially in patients with very sensitive stomachs. Coffee should be avoided, especially if the stomach is already irritated.

Liver pain after alcohol

The liver is an organ that does not have any pain receptors and so liver pain occurs late when the liver capsule becomes tight. She is the main organ for that Metabolism of alcohol. To longstanding excessive consumption of alcohol damage and enlargement of the liver and thus liver pain can occur due to tension in the liver capsule. Liver pain after alcohol is therefore an expression of an already advanced liver damage. You express yourself through a painful feeling of pressure in the right upper abdomen below the costal arch.
Alcoholic liver damage progresses in stages. First there is one Obesity of the liver. This so-called steatosis hepatis is a preliminary stage of Cirrhosis of the liver and in some cases it can lead to liver pain after alcohol.

Often, however, liver pain after alcohol is an expression of a more serious illness, such as cirrhosis of the liver. This leads to an irreversible fibrotic remodeling of the liver. She gets so big that she's the Liver capsule tense, causing liver pain that is more severe after alcohol.
Also associated with it Diseases of the biliary tract or Gallbladder such as. Inflammation or constriction can appear as liver pain after alcohol because of the close anatomical relationships. They occur after alcohol as it is a stimulus for the Production and release of bile is. In any case, liver pain after alcohol should be clarified by a doctor and alcohol consumption should be stopped immediately.

Liver pain in alcohol withdrawal?

Like alcohol consumption, alcohol withdrawal usually does no liver pain. Although alcohol is metabolized by the liver, too much or too little (in alcohol-dependent patients) alcohol is usually not painful.

Liver pain and medication

There are numerous drugs that can be harmful to the liver. A typical and frequently used representative is, for example, the pain reliever paracetamol. Taken in high doses, paracetamol can lead to liver failure and thus death. But countless other drugs, for example those from the group of epilepsy drugs (anticonvulsants), antibiotics, psychotropic drugs and non-steroidal anti-inflammatory drugs (painkillers), can damage the liver. However, pain rarely occurs when the liver is damaged by drugs.

Please read the following article: Pain relievers for liver diseases

Liver pain after chemo

That liver pain occurs again as part of chemotherapy is rather unusual. However, there are diseases with liver pain as a symptom that must be treated with chemotherapy. These include, for example, cancer in the liver (hepatocellular carcinoma) or leukemia, i.e. blood cancer.

Liver pain and stress

Stress can also usually occur no liver pain cause. Quite often, however, stress can lead to pain in the middle upper abdomen (Epigastrium) are localized. In some cases the cause can be a chronic inflammation of the stomach his or in the worst case one Gastric ulcerwhose growth has been promoted by persistent stress.

Psychosomatic liver pain

Psychological complaints that manifest themselves in the form of physical symptoms are referred to as psychosomatic. In principle, psychosomatic complaints can express themselves in a wide variety of ways. Often, for example, in the form of back pain or pain in very different parts of the body. It is not uncommon for pain to exist even before a psychological stress situation develops. In a vicious circle, pain and psyche then reinforce each other. Liver pain is not a typical symptom of a psychosomatic disorder. However, since this is so diverse, it can occur in the context of such.

Liver pain at night

Liver pain can also occur at night. On the one hand, of course, all of the problems that have already been dealt with in this article can be behind this. Sometimes liver jerks are also noticed more at night because you can calm down and concentrate more on your body. In addition, the lying position cause or worsen liver pain at night.
That is because of the lying down increased blood flow the liver, which increases the pressure in the liver capsule and causes liver pain.

There are also mainly in the Naturopathy Theories that the liver is central to the Development of sleep problems is involved. There are many reports that describe that patients wake up at a certain time in the morning complaining of liver pain. The exact mechanism behind this phenomenon is this not yet clarified, however, liver dysfunction was almost always demonstrated in these individuals. If you experience liver pain at night, you should definitely have one medical evaluation of the liver and biliary system in order to be able to recognize and treat serious illnesses in good time.

Liver pain when lying down

Liver pain can be caused by a lying position evoked or reinforced become. This depends on the Blood circulation and the Location of the organs in the abdomen when lying together. Liver pain is caused by the pressure of the organ against its own capsule. This means that any increase in pressure or a change in body position that leads to pressure on the liver capsule can exacerbate liver pain. This is the case when lying down.
On the one hand, the blood supply plays a role. Most of the blood reaches the liver through the Portal veinin which there is a certain pressure. This varies depending on the body position, when lying down it is mainly direct after change of position higher than when standing. If the liver is damaged by obesity or cirrhosis, this slight increase in pressure when lying down can lead to liver pain.
The pressure in the draining vena cava is also higher when lying down. Put simply, more blood now accumulates in the liver, the capsule is stretched a little more and liver pain occurs when lying down.

The position of the organs in the abdomen is also influenced by gravity. During the transition from standing to lying there is an increased Pressure of the liver against the muscular diaphragm. If the liver is damaged, this mechanism can also be sufficient to cause liver pain when lying down.

Liver pain when coughing

Cough leads to a short-term Increase in pressure in the abdomen (intra-abdominal pressure). This can lead to irritation of already diseased organs in the abdomen. If, for example, the liver is enlarged as part of leukemia, the liver capsule is stretched and therefore irritated. This can lead to pain. If there is irritation due to increased pressure in the abdomen (when coughing), this can intensify the pain.

The pain occurs in the liver area only when coughing it is probably a pain due to a pinched nerve or a muscular strain, the liver itself is then rather unaffected.

Liver pain after biliary surgery

Normally, after the removal of the gallbladder (gall bladder operation), there are no other symptoms, apart from the wound pain that lasts for a few days. The patient should then be symptom-free. In some cases, however, the so-called postcholecystectomy syndrome, a special symptom that can occur after the gallbladder has been removed, occurs. Associated symptoms are, for example, pain under the right costal arch (in the liver area), discomfort after eating large and high-fat meals, abdominal pain, diarrhea, flatulence and fatty stools.
Often these symptoms appear after a biliary surgery only after a few weeks and are not always present in their full extent. In any case, the cause of the complaints must be clarified by a doctor, as there are various possible reasons. On the one hand, the cause can be inadequate bile production, but stones or other constrictions can also lead to an obstruction of the bile ducts and no longer allow the passage of the bile secretions. All of this can cause the symptoms described. In addition, after the gallbladder has been removed, the bile duct often widens and to a certain extent assumes the gallbladder's storage function. The stretching of the duct can also cause pain in the liver area. However, gallstones can form again in the enlarged bile duct, which can trigger colic-like pain in the upper abdomen. Accordingly, a doctor should be consulted in the event of complaints in the upper right abdomen following a biliary operation.

Read more on this topic at: Pain after biliary surgery

Liver pain and diarrhea

Liver pain that can be accompanied by diarrhea various causes to have. One possible disease that can express itself in this way is the so-called Fatty liver. Over time, fat accumulates in the liver tissue until the liver is finally very fatty. Possible causes are a excessive alcohol consumption or diabetes (Diabetes mellitus). Fatty liver often becomes symptomatic through unspecific symptoms, for example Sensation of pressure and pain in the right upper abdomen, nausea and Vomit, Loss of appetite, but also diarrhea. Other signs are fever, Weight loss and Jaundice (Jaundice). As a result of the fatty degeneration of the liver, the organ can no longer adequately fulfill its metabolic function, so that secondary severe impairments of the organism can lead to real symptoms of poisoning. The fatty liver can eventually turn into one Cirrhosis of the liver end up. This is a nodular remodeling of the liver tissue, which loses its function as a result. In the final stage, only a liver transplant will help. Since the most common cause of fatty liver disease is chronic alcohol abuse, alcohol consumption must be avoided as strictly as possible in order to improve the prognosis.

In general, liver pain associated with diarrhea can also have other causes. If the symptoms persist or get worse, you should definitely consult a doctor.

Liver pain during pregnancy

Liver pain during pregnancy is usually caused by Pressure of the growing child on the liver and gallbladder evoked. The bigger the child becomes, the less space the internal organs have in the abdomen. Accordingly, pregnant women have to go to the toilet more often and sometimes complain of nausea, especially if the child emerges towards the stomach area. That’s exactly how the Pressure on the liver region increased. This can be noticed by dull, pressing pain in the area of ​​the right costal arch. However, liver pain during pregnancy can potentially have other causes, which is why a visit to a doctor is always advisable if the symptoms persist.
Does the pregnant woman suffer from the so-called HELLP syndrome, liver pain can also be due to this dangerous condition. In HELLP syndrome there is one excessive blood clotting in the placenta, causing the number of blood platelets to decrease rapidly. This can make it quick too internal bleeding occur, for example bruises inside the liver capsule. In HELLP syndrome, the liver is additionally damaged by fibrin deposits. It comes to one increased capsular tension in the liverwhich manifests itself as more or less severe pain in the right upper abdomen. This pain often radiates into the surrounding regions. Since HELLP syndrome is a very dangerous disease in pregnant women, any complaints that might indicate it must be taken seriously.

Liver Pain - What To Do?

If pain in the liver area persists for a longer period of time, a doctor should be consulted so that the cause of the symptoms can be determined. Medication should not be used on your own, as the pain could also be triggered by the gallbladder or other organs.To alleviate acute pain, it can be helpful to lie down in the most comfortable position possible and possibly also place a hot water bottle on the painful area. This can be relaxing. If the pain becomes worse due to the warmth, the hot water bottle should be removed again immediately. As an alternative to using the hot water bottle alone, a liver wrap can also be applied. To do this, a small towel is dipped in hot water, wrung out well and placed on the liver region. A hot water bottle is placed on top and everything is then fixed with a large dry towel. The liver wrap remains for about 30 minutes.

In any case, alcohol and fatty foods should be avoided if the liver has problems. However, getting adequate hydration in the form of water and unsweetened herbal teas is very important as it helps the body flush out toxins quickly. Various tea preparations can have a supportive effect on the liver. These include freshly brewed teas made from milk thistle, artichoke leaves, verbena, goose or liverwort, yarrow and toadflax. A warm bath with the addition of oat seeds can also alleviate the symptoms. Unless otherwise prescribed by a doctor, you should refrain from treating the symptoms with medication, for example painkillers, as these medications put additional strain on the liver. As long as the complaints have not been clarified by a doctor, one should accordingly not undertake self-medication.

Home remedies

Home remedies for treating pain in the liver can be gentle teas such as chamomile, rose hip and peppermint tea, physical rest and completely renouncing alcohol. A hot water bottle that is placed on the painful area or, alternatively, a cold pack wrapped in a towel can provide relief.

Pain relief

The home remedies mentioned above, such as warm teas, physical rest, abstinence from alcohol and a hot water bottle can help against pain in the liver. However, if, for example, inflammation of the gallbladder or gallstones are the cause of the pain close to the liver, a doctor should be consulted. This can initially Pain relief and anticonvulsant medication prescribe. Removal of the gallbladder is indicated for recurrent pain caused by gallbladder inflammation or gallstones.

Diseases that lead to liver pain

Fatty liver hepatitis / fatty liver

One to high amount of alcohol (and other poisons) overwhelmed the detoxification and degradation options of the liver.

It swells as it increases Fats stores and solves Liver pain out. At this stage it already loses some of its functions; but is not yet permanently damaged. One speaks of a fatty liver

If the excessive demands on the liver continue in a chronic manner, one develops Cirrhosis of the liver. The majority of the actual liver cells have already died, which is why the liver begins to shrink and can no longer carry out its tasks. The response is connective tissue scarring of the liver (Shrink liver).
This stage of liver cirrhosis is no longer curable. In addition, the blood flow to the liver lobules deteriorates. This in turn results in a backlog of blood into the portal vein (Portal hypertension), which in turn has other negative effects.

Jaundice / jaundice

The Degradation products of the red blood cells, bilirubin, has a yellowish color in its unbound state (as indirect bilirubin).
If the liver If enough degradation products are not processed, these substances remain in the blood and discolour the patient slightly yellow. This yellow color goes best in the eyes (Sclerenic terus).
One speaks of one Jaundice or medically by one Jaundice.

Read more on this topic at: Jaundice


One generally speaks of hepatitis when there is an inflammatory reaction in the liver.

This can be caused by poisons (Alcohol, medication), Viruses (hepatitis viruses A-E), bacteria (Salmonella, Leptospira), Mushroomsgenetic defects or a malfunctioning immune reaction. A distinction is made between an acute and a chronic form of hepatitis, but rarely has the opportunity to intervene curative. In any case, it is important to strictly avoid other substances that are harmful to the liver (especially abstinence from alcohol).
Further information is available under our topic:

  • Overview topic: Hepatitis
    • Hepatitis A
    • Hepatitis B.
    • Hepatitis C.

Hepatic insufficiency

Liver pain can be caused by liver failure. One speaks of one Hepatic insufficiency (Liver weakness), if the liver functions properly (see: Function of the liver) can no longer perceive sufficiently. This can have a wide range of causes and effects. For the doctor, the function of the liver in breaking down drugs is important. The degradation capacity of the liver is included in the recommended doses of the drugs. If this degradation capacity of the liver now decreases due to liver insufficiency, there are problems in estimating the correct dosage.

Portal hypertension

One speaks of portal hypertension (Portal hypertension), if due to pathological conditions (Cirrhosis of the liver, inflammation of the liver / hepatitis) the blood flow through the liver has deteriorated.
Because the constantly flowing blood cannot flow away, but more blood continues to flow in, it continues to build up back into the supplying vessels and also increases the pressure there.
Further information is available under our topic: Portal hypertension.

Congested liver

If due to a pumping weakness of the heart (Heart failure) a backlog of blood is triggered, the clinical picture of congested liver occurs. The blood builds up into the lobules of the liver, which swell as a result and later perish from the chronically increased pressure.

Hypoxia / lack of oxygen

As in all tissues, a lack of oxygen leads to a lack of energy in the liver. Many energy-intensive metabolic processes take place in the liver, so that a lack of oxygen quickly threatens the survival of the cells.

Alpha-1 antitrypsin deficiency

A special blood protein, alpha-1-antitrypsin, is responsible for inhibiting the activity of other proteins that would lead to tissue destruction as part of an immune reaction.

Learn more about: Alpha-1 antitrypsin

If, due to a genetic defect, this special, protective protein is missing, there is excessive damage primarily to the lung tissue (lungs), but also to the liver, which ultimately leads to irreversible (irreversible), progressive damage to the tissue (chronic obstructive Lung disease (COPD)).
You can find out more about this disease at: Alpha-1 antitrypsin deficiency

Edema, ascites (water in the abdomen)

When the liver is unable to make enough blood proteins, the body can no longer regulate the distribution of fluids inside and outside the blood vessels.
There is excessive leakage of fluid from the blood into the tissues, especially in the lower legs (Edema) or in the abdomen (ascites = water in the abdomen).
The protein deficiency can have several causes: If the liver does not have enough building blocks as a result of malnutrition, it can of course not produce enough protein.
Another, more common reason is the generally poor functioning of the liver (Hepatic insufficiency).
You can also find more information on this topic under our topic: Water in the stomach


The deposits (Concretions) called by crystallized bile components. These gallstones are deposited in either the gallbladder or the bile ducts.

There are 2 main forms of gallstones:

  • stones containing cholesterol (approx. 90%)
  • stones containing bilirubin (approx. 10%)

For more information on gallstones, see our topic: Gallstones

Liver tear

A Liver tear (medicinally as Called liver rupture) is usually through a dull abdominal trauma like a blow in the stomach or an inconvenient fall.
A liver tear often occurs as part of a Accident or one Sports injury on. The rupture of the liver capsule usually leads to very severe pain. The liver tear usually has to be surgically treated immediately.