Possible triggers of liver pain

As mentioned above, gallstones are a common cause of pain that is localized in the liver because the gallbladder is located at the lower edge of the liver. If a gall stone obstructs one of the bile ducts, the pain increases and decreases in waves and is called 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 pain.

Liver pain caused by food is very rare. However, there are foods that can cause liver failure. These include poisonous fungi, for example.

However, such liver failure is rarely accompanied by pain in the liver area. Overall, the diet is therefore not associated with liver pain. Pain in the liver area, which occurs immediately after eating, is usually caused by the gallbladder.

The complaints then occur particularly after very fatty meals. The cause is usually gallstones, which disturb the flow of bile into the intestines. There, the bile serves to digest fat.

Cramp-like pain in the right upper abdomen occurs, which may start spontaneously or immediately during or after eating. The liver itself is usually not the cause of the discomfort when the pain occurs in connection with eating. In some cases, fatty food can cause the affected person to complain of liver pain.

Although this pain caused by fatty food can be interpreted as liver pain, it is primarily associated with a problem in the neighbouring gallbladder or bile ducts. Bile plays a major role in the digestion of fats. Fatty food stimulates the release of bile from the gallbladder into the intestines.If liver pain occurs here, gallstones are suspected.

This blocks the excretory duct and causes pain. An inflamed gall bladder is also irritated by fatty food. Thus, in the case of liver pain caused by fatty food, a gastroenterologist should be seen to investigate the matter.

Therapeutically, in the case of gallstones, the stones can be shattered or the gallbladder removed. An inflamed gallbladder must also be surgically removed. In some cases it is also sufficient 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 located in the liver. Coffee usually does not cause liver pain. Rather, coffee is sometimes considered to cause stomach pain, especially in patients with a very sensitive stomach.

Coffee should be avoided, especially if the stomach is already irritated. The liver is an organ that does not have any pain receptors and thus liver pain only occurs late in life when the liver capsule is tightened. It is the main organ for the metabolism of alcohol.

After many years of excessive consumption of alcohol, damage and enlargement of the liver can occur and thus also liver pain due to tension of the liver capsule. Liver pain after alcohol is thus an expression of already advanced liver damage. It manifests itself by a painful feeling of pressure in the right upper abdomen below the costal arch.

Alcohol-induced liver damage progresses in stages. First, the liver becomes fatty. This so-called steatosis hepatis is a preliminary stage of liver cirrhosis and can in some cases already lead to liver pain after alcohol.

Often, however, liver pain after alcohol is an expression of a more serious disease, such as cirrhosis of the liver. This leads to an irreversible fibrotic transformation of the liver. It becomes so large that it stretches the liver capsule, causing liver pain that becomes worse after alcohol.

Associated diseases of the bile ducts or gallbladder, such as inflammation or constriction, can also impress as liver pain after alcohol because of the close anatomical relationships. They occur after alcohol, as it is a stimulus for the production and secretion of bile. In any case, liver pain after alcohol should be clarified by a doctor and the consumption of alcohol should be stopped immediately.

Like alcohol consumption, alcohol withdrawal does not usually cause liver pain. Although alcohol is metabolized via the liver, too much or too little (in alcohol-dependent patients) of alcohol is usually not painful. There are numerous drugs that can have a harmful effect on the liver.

A typical and frequently used example is the painkiller paracetamol. Taken in high doses, paracetamol can lead to liver failure and thus to 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 also damage the liver.

However, pain rarely occurs when the liver is damaged by medication. It is rather unusual for liver pain to reoccur during chemotherapy. There are, however, diseases with liver pain as a symptom, which must be treated with chemotherapy.

These include, for example, cancer of the liver (hepatocellular carcinoma) or leukemia, i.e. blood cancer. Stress can also usually not cause liver pain. Not infrequently, however, stress can lead to pain that is localized in the area of the middle upper abdomen (epigastrium).

In some cases, the cause may be chronic gastritis or, in the worst case, a stomach ulcer whose growth has been promoted by permanent stress. Psychological complaints that manifest themselves in the form of physical symptoms are called psychosomatic. In principle, psychosomatic complaints can manifest themselves in many different 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 the development of a psychic stress situation. In a vicious circle, pain and psyche then reinforce each other.

Liver pain is not a typical symptom of a psychosomatic disorder. However, since it is so varied, it can occur within the scope of such a disorder. Liver pain can also occur at night.

Behind this can be on the one hand of course all those problems, which were already treated in this article.Sometimes liver jokes are also perceived more often at night, because one comes to rest and concentrates more on the body. In addition, the lying position can cause or intensify liver pain at night. This is due to the increased blood flow to the liver when lying down, which increases the pressure in the liver capsule and causes liver pain.

In addition, there are theories, especially in naturopathy, that the liver is centrally involved in the development of sleep problems. There are many reports describing that patients wake up at night at a certain primeval time and complain of liver pain. The exact mechanism behind this phenomenon is not yet understood, but liver dysfunction has almost always been demonstrated in these individuals.

If liver pain occurs at night, a medical examination of the liver and biliary system should always be performed in order to be able to recognize and treat serious diseases in time. Liver pain can be caused or intensified by a lying position. This is related to the blood circulation and the position of the organs in the abdomen when lying down.

Liver pain is caused by the pressure of the organ against its own capsule. This means that any increase in pressure or change in body position that results in pressure on the liver capsule can increase 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 via the portal vein, in which a certain pressure prevails. This pressure varies depending on the body position; when lying down it is higher than when standing, especially immediately after a change of position.

In the case of a liver damaged by fatty degeneration 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. In simple terms, more blood accumulates in the liver, the capsule becomes somewhat more tense and liver pain occurs when lying down.

The position of the organs in the abdominal cavity is also influenced by gravity. At the transition from standing to lying down, there is increased pressure of the liver against the diaphragm, which is very strong. This mechanism can also be sufficient to cause liver pain when lying down if the liver is damaged.

Coughing leads to a short-term increase in pressure in the abdominal cavity (intra-abdominal pressure). This can lead to irritation of already diseased organs in the abdomen. If, for example, there is an enlargement of the liver as part of leukemia, the liver capsule is stretched and thus irritated.

This can lead to pain. If irritation occurs due to increased pressure in the abdomen (when coughing), this can increase the pain. If the pain in the area of the liver only occurs when coughing, it is probably due to a pinched nerve or muscular strain; the liver itself is then unlikely to be affected.

Normally, there are no further complaints after the removal of the gallbladder (gall bladder surgery), apart from the wound pain that lasts for a few days. After that the patient should be free of complaints. In some cases, however, the patient may develop the so-called post-cholecystectomy syndrome, a special symptom that can occur after the removal of the gallbladder.

Associated symptoms include pain under the right costal arch (in the liver area), discomfort after eating large and fatty meals, abdominal pain, diarrhea, flatulence and fatty stools. Often these symptoms occur after a gall bladder operation only after a few weeks and are not always fully present. In any case, the cause of the symptoms must be clarified by a doctor, as there are several possible reasons.

On the one hand, the cause may be inadequate bile production, but stones or other constrictions can also lead to a dislocation of the bile ducts and prevent the passage of bile secretion. All these factors can cause the symptoms described above. In addition, the bile duct often widens after the removal of the gallbladder and thus to a certain extent takes over the storage function of the gallbladder.

The dilation of the duct can also cause pain in the liver area. However, gallstones can also form again in the dilated bile duct, which can cause colicky pain in the upper abdomen. Accordingly, a physician should be consulted after a bile operation if there are complaints in the right upper abdomen.