Liver Pain: Symptoms, Causes, and Location

Written by Rachel Reiff Ellis, Kristen Fischer
Medically Reviewed by Melinda Ratini, MS, DO on January 31, 2025
9 min read

Your liver is a football-sized organ that sits under your ribs. It filters and cleans your blood, stockpiles energy, helps you fight infections and diseases, and converts food from the small intestine to help you absorb fat. Even though it doesn’t contain pain receptors, you may feel discomfort or pain that seems to come from your liver.

 

Even though it’s the largest organ inside your body, it can be hard to tell if pain is coming from your liver. It’s easy to confuse it with pain from your stomach. Your liver is in the upper right part of your abdomen (belly area), on top of your stomach, intestines, and right kidney.

 

Depending on the cause, you may feel pain in the front center of your belly, in your back, neck, or your shoulders (especially the right one). The pain may feel sharp or dull.

Having liver pain doesn’t always mean you have a serious condition, though liver pain can signal a more critical issue. The following are common causes of liver pain.

Also known as alcohol-induced fatty liver disease, this form of liver disease is caused by drinking too much alcohol over time. There are three stages of the disease: It starts as alcohol-related fatty liver disease, progresses to alcohol-related hepatitis (also called alcoholic hepatitis), and can turn into irreversible alcohol-related cirrhosis (the latter two can occur at the same time). 

Pain is one of the symptoms of alcohol-induced fatty liver disease, among others such as jaundice, tiredness, and abdominal swelling. The pain typically is around the upper right abdomen.

“When people develop liver disease, there are some associated symptoms that may be present,” says Edward Oldfield, MD, a gastroenterologist at Sentara in Virginia. “This liver pain is not actually from the liver, but from reactive inflammation of surrounding organs and tissues or enlargement of the liver stretching its capsule. The type and severity of these symptoms is dependent on the underlying cause.”

Viral hepatitis is an inflammation of your liver, and it’s a form of acute hepatitis. The three most common types are hepatitis A, B, and C. They’re caused by different viruses that infect your liver. 

Hepatitis can cause pain in the upper right side of your belly, where your liver sits. Other signs of hepatitis include dark-colored pee, yellow skin or eyes (known as jaundice), tiredness, nausea, or vomiting. Learn more about the types of viral hepatitis.

“Most of the time, liver disease is silent,” Oldfield says. “However, when there are symptoms, the most common cause of liver pain is acute hepatitis.”

Formerly known as fatty liver disease and nonalcoholic fatty liver disease, MASLD happens when too much fat builds up in your liver. It’s not caused by alcohol use. You may have an increased risk of MASLD if you’re clinically classified with obesity or have type 2 diabetes, though genetics and race are known factors that impact people in some populations to have MASLD more than others. You may be able to slow or reverse MASLD through weight loss and physical activity. 

You may not have symptoms at all if you have MASLD. About 30% of people worldwide have this disease, but many don’t know it. Pain may be a sign that you do, so paying attention to how you feel can be critical. 

Some people with MASLD have reported pain in the area around the liver, or a dull ache or a sense of fullness in the upper right side of the abdomen.

MASH is a type of nonalcoholic liver disease. (It used to be known as nonalcoholic steatohepatitis, or NASH). MASH happens when fat builds up in your liver, but it's not from alcohol use. MASH is an advanced stage of MASLD. Symptoms can include pain in the area of the liver.

If your liver is damaged severely, it can cause permanent scarring that can affect how the organ functions. Alcohol and drug use, viruses, or metabolic factors can cause cirrhosis. The scarring can lead to liver failure. Pain in the area of the liver can be one of the first signs that you have cirrhosis, but pain doesn’t mean that you necessarily have cirrhosis.

Fitz-Hugh-Curtis syndrome is a rare condition that’s also called perihepatitis. It causes sudden, severe pain in the upper right section of your belly that might spread to your arm and shoulder. It happens in women and those assigned female at birth. The bacterial infection inflames the tissues around your liver and can affect the lining of the stomach. If you have it, you’ll also often have fever, chills, headache, and feel ill. Find out more about Fitz-Hugh-Curtis syndrome.

A bacterial, fungal, or parasitic infection in your liver can form an abscess, or a pocket of pus that can lead to pain. The top right side of your abdomen may be tender. Your doctor may be able to feel that your liver is enlarged. Usually, you’ll also have a fever and chills with an abscess.

Cysts are pockets of fluid, but they aren’t usually infected. If they are large, they may make you uncomfortable, mostly because you’ll feel “full” in your abdomen. Cysts sometimes can bleed, which can cause sudden, severe pain in your upper right belly and shoulder. Most cysts may not require treatment, while others may. Learn about polycystic liver disease.

An abscess is a pocket within your liver that’s filled with pus (also called a pyogenic liver abscess). Just like a cyst, it can be painful in the area of your liver. Causes can range from an abdominal infection like diverticulitis to a perforated bowel, blood infection, recent endoscopy, or other trauma. Some people have pain in the area of the liver or neck. The abscess can be drained to provide relief. 

Budd-Chiari syndrome is an uncommon disorder resulting from a narrowing of the veins that let blood and fluid drain from your liver. It can be caused by blood clots and swelling in your liver. Often, it’ll make the top right side of your abdomen hurt.

This condition, also called Reye syndrome, can affect all organs but cause swelling in the brain and liver. It can cause pain because fat builds up in the liver. Reye’s syndrome can happen as a person gets over the flu or chickenpox, and it often happens in children. Some people recover completely, while others have long-term complications that can include brain damage. Giving aspirin to anyone younger than 19 increases the risk of Reye's syndrome.

Your portal vein is the vessel that brings blood to your liver from your intestines. But if a blood clot blocks the vein, you may feel sudden pain in the upper right part of your abdomen near your liver. You also may have swelling in your belly and a fever. Learn more about the different types of blood clots.

Thanks to its size, your liver may get injured after accidents, falls, and other trauma. If your liver is bleeding, you’ll usually have pain and tenderness in your abdomen and right shoulder. You may also have signs of shock from blood loss.

You normally won’t have any pain until your liver cancer has advanced to later stages. Once you do start to hurt, you may feel pain anywhere from your abdomen to your shoulder. Your doctor may be able to feel a lump by pressing on the right side of your belly. You may also lose weight, feel itchy, have yellow skin or eyes, have a swollen stomach, and feel sick. Find out more on symptoms of liver cancer.

Your gallbladder is tucked right underneath your liver. So gallstones – digestive juices that harden into nuggets – can cause pain that you might think is coming from your liver. You may have sudden pain that gets worse quickly. Gallstone pain may be in the center or right side of your upper abdomen, between your shoulder blades, or in your right shoulder. See a picture of what the gallbladder looks like.

Your liver area may feel tender or painful for a number of reasons. Not all liver pain means that something serious is going on, but it can.

A few other causes of liver pain can include:

  • Immune conditions such as autoimmune hepatitis, primary biliary cholangitis, or bile duct scarring (primary sclerosing cholangitis)
  • Genetic liver diseases like hemochromatosis, Wilson's disease, or alpha-1 antitrypsin deficiency
  • Bile duct cancer
  • Liver adenoma, a noncancerous tumor
  • Medicine use
  • Herbal mixes
  • Toxic chemical exposure
  • Inflamed liver

See your doctor or other health care professional if you think you’re having liver pain. It’s important to know that the pain is, in fact, from your liver. A professional can give you an accurate diagnosis so you can get the right treatment. 

If your liver pain comes on quickly, hurts too much, doesn’t go away quickly, or keeps you from doing normal activities, get it checked out.

Other signs that you need medical treatment right away include:

  • Jaundice
  • Fever
  • Chills
  • Nausea or vomiting

First, find the source of your liver pain by seeing your doctor. Once you know the cause of your liver pain, your doctor can let you know how to treat it. 

“Most mild cases of liver inflammation can be monitored and managed by a primary care doctor. Sometimes, patients will need to see a liver doctor for more extensive testing and treatment,” Oldfield notes.

Managing your existing liver condition, such as MASH or MASLD, can also ease pain. Most people with liver disease (or who have had liver transplants) can take acetaminophen (as long as it is not at high doses), though they have other options for pain, including some like gabapentin used for nerve pain and selective serotonin reuptake inhibitors (SSRIs). Some over-the-counter medicines can be harmful, so check with your doctor before you take anything.

Liver pain can signal a wide range of health issues, but that doesn’t mean it’s serious. You may have liver pain due to swelling, cysts, or abscesses, to name a few.

See a doctor or other health care professional to confirm that the pain you feel is, in fact, from your liver. They can find the cause of liver pain and let you know how to treat it.

What type of doctor should I see if I have liver pain?

Your primary care doctor can be a good place to start. If you’d like to see a specialist, a gastroenterologist or hepatologist treats the liver, specifically.

Does liver pain mean there’s a serious health problem?

Not always. Some causes of liver pain can be temporary, while others may be a sign of liver disease or another condition. See a doctor for an accurate diagnosis.

What tests might a doctor do to identify the cause of my liver pain?

Your health care professional may start with bloodwork to assess your liver function. Other tests may include imaging scans or a biopsy (taking a sample of tissue from your liver). Your doctor may look at bloodwork results before doing anything more invasive. 

Can fatty liver cause pain?

Yes. One of the possible symptoms of fatty liver diseases, MASLD, and alcohol-induced fatty liver diseases is pain in the liver area.

What foods cause liver pain?

Steer clear of fatty foods, alcohol, processed foods, and sugar. A few good foods for liver function include oatmeal, almonds, blueberries, and other whole foods.

Where is liver pain felt?

You may feel pain in the area of your liver, which is in the upper right abdomen. It may also be in the back, shoulders, or neck.

How can I tell the difference between gallbladder pain and liver pain?

Gallbladder pain can happen in the same area of the liver because the organs are next to each other. Gallbladder pain can feel sharp and won’t go away, while liver pain may feel dull or constant.