Introduction:
The liver is the largest internal organ in our body. It is present in the right upper region above the stomach below the rib cage. The liver pain is generalized, dull, throbbing, and nonspecific. The liver does not have nerves to receive pain signals. The pain can be due to an inflamed liver or inflammation or swelling of the structures around it. The liver pain is difficult to find, as the pain is generalized and not specific. Liver pain can be due to underlying liver disease or condition. The diagnosis is made depending on the other symptoms of the disease. Treatment of liver pain depends on treating the underlying disease or condition.
What Are the Functions of a Liver?
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The liver breaks down the food that we intake into simpler forms for the body to absorb.
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It metabolizes the medications into easily absorbable form and removes the toxic wastes.
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It produces bile that helps in transferring waste products during digestion out of the body.
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It produces a protein that helps in blood clotting and regulates blood clotting.
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It metabolizes alcohol and removes the toxic waste from circulation.
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It produces proteins needed for blood plasma.
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It produces cholesterol and proteins to carry all over the body.
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It stores blood sugar in glycogen form for later use when the body needs energy.
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It regulates amino acid levels in the blood. Amino acids are building blocks of proteins.
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It removes bilirubin, a byproduct during the breakdown of red blood cells.
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It plays an important role in making immunity regulating factors and removes bacteria from the circulation.
What Is Liver Pain?
Pain in the liver is generalized, and it is not in a particular spot. It can be dull or throbbing pain in nature. Since there are no pain receptors in the liver, the pain is generally due to inflammation of the liver due to an underlying disease or condition. Severe liver pain is experienced in patients with cirrhosis (scarring of liver tissues). Liver disease can cause pain in other parts of the area like the shoulders and back. So liver pain is mostly missed in some cases due to misleading pain sites.
What Causes Liver Pain?
When there is an underlying disease or condition, the liver fails to function properly. The functional damage causes toxins and other liver enzymes to elevate in the circulation. This causes damage to the liver cells and results in liver disease. Liver pain can be caused due to certain liver diseases or conditions.
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Hepatitis: Hepatitis is inflammation of liver cells due to damage to the liver cells by the toxins in the liver. It can also be due to viral hepatitis A, B, and C.
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Non-Alcoholic Fatty Liver Disease: Non-alcoholic fatty liver is excess fat deposition due to obesity or diabetes mellitus.
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Alcoholic Hepatitis: There is an excess accumulation of toxins due to too much alcohol consumption. The toxins are not excreted by the liver, and this damages the liver cells. This causes inflammation of the liver.
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Drug-Induced Hepatitis: It is the inflammation of the liver due to taking medications frequently that contain Acetaminophen. Taking certain medications prescribed by the doctor beyond the prescribed time.
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Cirrhosis: Cirrhosis is the replacement of healthy liver tissue with scar tissues. This is a serious condition that hardens the liver.
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Reye’s Syndrome: It is a rare and serious condition that causes swelling of the liver and the brain. It causes damage to the liver.
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Hemochromatosis: It is an acquired condition that results in storing too much iron in the liver.
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Liver Cancer: Cancer of the liver.
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Liver Injury: Injury due to external trauma.
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Cholangitis: It is the swelling of the bile duct. The bile duct is a tube that carries bile from the liver and gallbladder to the small intestine.
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Liver Abscess: A liver abscess is a pus-filled sac in the liver.
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Portal Vein Thrombosis: It is the narrowing or block in the blood vessels that carry blood from the intestine to the liver.
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Budd-Chiari Syndrome: It is a syndrome where the hepatic vein (a blood vessel that clears out the liver) is blocked by a blood clot or narrowing of the vein. This results in the backflow of blood into the liver, causing enlarged liver.
How Is Liver Pain Diagnosed?
Liver pain is challenging to diagnose as the pain is generalized and not in a specific spot. A physical examination is done to examine the liver for any enlargements. Additional tests like liver function tests, complete blood count, ultrasound, computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, and liver biopsy are carried out to rule out the cause of liver pain.
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Physical Examination: Physical examination is done by the physician to feel the enlarged liver and to know if there is pain while touching the site.
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Liver Function Tests (LFT): It is a group of tests that involves screening of liver enzymes like alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transference (GGT) to rule out liver disease. Proteins like albumin and globulin, bilirubin, and prothrombin time are also screened. The changes in the levels of any of the parameters reveal liver disease.
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Complete Blood Count: Blood components like red blood cells, white blood cells, platelets, and hemoglobin are screened. The changes in the levels of these components help diagnose liver disease.
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Ultrasound Abdomen: This imaging technique uses a high-frequency sound wave to capture images of the internal structures.
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CT Scan: This imaging technique captures a series of X-ray images at different angles with the help of a computer. This gives a detailed view of the internal structures.
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MRI Scan: This imaging technique uses a combination of high-frequency radio waves in a magnetic field to capture images of internal organs. This gives a more detailed view of the internal organs and tissues.
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Liver Biopsy: A small portion of the liver is removed and viewed for pathological changes at a microscopic level. This is a confirmatory test and is done in severe cases.
How Is Liver Pain Treated?
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Liver pain is treated depending on the underlying disease. The liver has a self-healing property and tends to form new cells over time.
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The triggering factors that cause damage to the liver should be avoided.
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Avoid alcohol intake.
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Maintain a healthy weight by exercising regularly.
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Do not take medications beyond the prescribed time.
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Surgery to remove a part of the damaged liver.
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Liver transplant in severe liver damage cases.
When to See a Doctor for Liver Pain?
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If the pain is unbearable.
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If associated symptoms like jaundice (yellowish discoloration of the skin and the eyes), blood in stools, vomiting blood, lightheadedness, and an enlarged stomach appear.
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If you develop a fever.
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Dark urine.
Who Is at Risk of Developing Liver Pain?
People with underlying liver disease or conditions are at risk:
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Alcoholic Hepatitis: Alcoholic hepatitis is liver damage or disease due to excess alcohol consumption.
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Non-Alcoholic Fatty Liver Disease: Excess accumulation of fat due to an underlying disease or condition, like diabetes mellitus or obesity.
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Liver Cancer: Cancerous lesion or tumor in the liver.
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Liver Abscess: A pus-filled sac in the liver.
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Cirrhosis: It is the scarring of the liver tissues. Scar tissues replace the healthy liver tissues.
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Viral Hepatitis: Viral hepatitis is inflammation of the liver due to viral infections like hepatitis A, B, C, or D.
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Drug-Induced Hepatitis: Drug-induced hepatitis is inflammation of the liver due to the intake of medications like Acetaminophen (medication used as a painkiller and to control fever), and painkiller drugs like NSAIDs (non-steroidal anti-inflammatory drugs), birth control pills, and antibiotics used to treat bacterial infections.
Conclusion:
Liver pain occurs due to liver disease. Liver pain can be severe at times. The severity of the pain depends on the severity of the disease. By detecting the disease early and getting appropriate treatment, the pain and the severity of the disease can be reduced. The liver has a regenerating property, and the disease can be reversed. With lifestyle modifications and a healthy diet, liver disease can be cured.
