Guide To The Causes Of Liver Pain

August 15, 2023

The liver is an organ with multiple important functions in the body, including cleansing the blood, regulating metabolism, and fighting infections. Sometimes liver pain can manifest as a dull backache, right shoulder pain, and or kidney pain. Liver pain is often accompanied by other symptoms such as fever, pale stools, weight loss, abdominal tenderness, itchy skin, appetite loss, dark urine, nausea and vomiting, yellow skin, leg swelling, and fatigue. The underlying cause of liver pain can be identified through a physical exam, blood liver panel tests, CT scans, MRIs, ultrasounds, and liver biopsy. True liver pain not caused by another unrelated medical problem is typically caused by serious conditions that require treatment.

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Injury To The Liver

The liver is the organ in an individual's abdomen that is most likely to become injured because of its large size. The largest solid internal organ in the human body is the liver. The most common injuries to the liver come from motor vehicle crashes, violence, sports, blunt trauma, bicycle crashes, or a penetrating injury to that causes a cut or tear in an individual's liver. Often, an injury to the liver results in bleeding or hemorrhaging inside the abdomen. This bleeding occurs due to the various large blood vessels that run throughout an individual's liver. The pain that results from a hemorrhage in the liver will be concentrated in the upper right portion of the abdomen and radiate to the right shoulder. The tissues in an affected individual's abdomen may become inflamed from the presence of blood that occurs with a liver injury.

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Hepatitis

Five different hepatitis viruses can cause inflammation to occur in an individual's liver if they become infected. The hepatitis B virus is most likely to cause them to experience liver pain. The hepatitis B virus is known to be directly damaging to the liver cells, and it produces a direct immune assault upon infected hepatocytes. A type of T lymphocyte in an individual's immune system can recognize the core antigen of hepatitis B on the membrane of infected liver cells. The combination of direct damage done to the liver cells by the virus and immune system-mediated inflammatory damage may result in the formation of tissue scarring in the liver. Tissue scarring occurs when the body attempts to repair tissue damage in the affected area. The repair is made with a dense fibrotic tissue different from the original tissues. This fibrosis in the liver begins to accumulate over time and causes compounded inflammation in the organ. Liver inflammation can manifest as intermittent upper quadrant abdominal pain and is known to accompany several other classic hepatitis symptoms.

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Cirrhosis

Cirrhosis of the liver is a condition where a patient's liver cells are progressively replaced by fibrous strands of scar tissue. The scar tissue that replaces normal liver cells does not function in the way the original cells do, and can block blood flow through the liver as a result. Long term damage to the liver tissues is required for cirrhosis to develop in an affected individual. As scar tissue accumulates in the liver and its function becomes compromised, symptoms such as fatigue, nausea, appetite loss, weakness, and pain in the upper abdominal region will appear. In the severe stage, the patient may experience a higher degree of pain in the abdomen that radiates up their right arm. This pain is the result of inflammation and a lack of blood flow to tissues in the liver or hypoxia. This deprivation of oxygen occurs due to the pressure scar tissue places on the blood vessels in the liver.

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Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease is a disease where too much fat builds up in an individual's liver. The liver holds a large responsibility when it comes to the breakdown and synthesis of fats in the body, and when this function is compromised, the excess fats begin to deposit in the liver tissues when they have nowhere else to go. This fatty tissue can produce toxic byproducts that may induce a reaction by the immune system. This immune response causes inflammation and damage to the liver tissues. The body repairs damaged liver tissues with dense, fibrous strands that form scar tissue, and the patient's liver disease can progress to cirrhosis. The symptoms of the early stages of nonalcoholic liver disease present include right upper abdominal pain, enlarged liver, belly swelling, and jaundice. Pain in the liver may also be the result of an enlarged fatty liver pressing on nearby nerves.

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Liver Cancer

Primary liver cancer occurs when cancer originates from a liver cell, where secondary liver cancer occurs when cancer spreads to the liver from another part of the body. Cancer begins when a cell sustains damage to the part of its DNA that dictates its rate of growth, multiplication, and apoptosis. Malignant cells are nonfunctional, grow faster, multiply more frequently, and take longer to die than healthy cells do. These characteristics allow it to invade and destroy healthy tissues around the body. When cancer develops inside the liver, the patient typically does not feel pain in the early stages because there are few nerves inside of the organ. However, more advanced liver cancer causes the liver to become swollen and enlarged. Pain is produced by the enlarged liver that places pressure on nearby structures and nerves. Pain from liver cancer is said to manifest as a dull, deep ache that radiates from an individual's upper abdomen around to their back.

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