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Liver pain is a colloquial pain that is thought to be related to the liver. The liver itself has no pain receptors, so that the pain, for example when the organ is enlarged, is perceived as pressure pain in the surrounding tissue. The cause is usually dysfunction and liver disease, although the complaints are often difficult to localize and are perceived, for example, as diffuse pain in the right upper abdomen. Otherwise, the sentence common among doctors applies: liver pain manifests itself in the form of chronic fatigue. Since the complaints are often the result of a serious illness, a medical clarification should urgently be carried out.
As the central organ of metabolism, the liver takes on tasks such as the production of essential protein substances, the production of bile and the breakdown or excretion of metabolic products, medication and toxins. The liver also regulates the blood's nutrient content. The underlying causes of liver pain are often due to an overworked liver function due to unhealthy nutrition, persistent alcohol abuse or the side effects of medication. The increasing pollution of our environment can also promote liver disease with corresponding liver pain. However, a high-fat and sugar-rich diet and excessive alcohol consumption remain the main triggers of liver problems.
Causes of liver pain
Diseases such as fatty liver, inflammation of the liver, cirrhosis of the liver or liver cancer can be considered as the causes of liver pain. Mostly, liver pain is accompanied by digestive problems, exhaustion and chronic fatigue. These diseases of the liver can be traced back to various causes, ranging from viral infections to years of alcohol abuse and side effects of drugs to hereditary factors. Recent studies have also shown that oxidative stress in tissues plays an important role in the development of liver diseases.
Important: Liver diseases are often asymptomatic for a long time and the first symptoms only appear at a very advanced stage. If liver pain or other noticeable symptoms occur, medical help should be sought immediately!
Lifestyle and diet favor complaints
With a particularly high-fat diet, the liver has to process an excess of fats in a short period of time, whereby the fats consumed are broken down by the production of bile juice, which is released into the small intestine depending on the amount of fat in the small intestine. With excessive intake of fat or cholesterol, the liver may already reach its limits here. If alcoholic drinks or medication are also taken in, the liver's performance is often no longer able to meet the requirements, which is initially manifested in dyspeptic complaints, i.e. indigestion with bloating, bloating, loss of appetite, nausea and vomiting.
If the detoxification and degradation options of the liver are overwhelmed in this way, more and more fats have to be stored in the organ, which can lead to pathological changes in the liver tissue and corresponding liver pain. Over time, the organ swells and loses its ability to function, which has the consequence that the detoxification and degradability of the liver continues to decline and additional fats are stored in the organ. This is how a self-reinforcing process begins, in the course of which a so-called fatty liver and possibly a fatty liver inflammation develop. The organ increasingly loses its functionality and the risk of significant health problems increases.
Death of the liver cells leads to cirrhosis
If those affected do not change their lifestyle and if the liver's pathological stress cannot be switched off, the chronic overworking of the liver may develop into life-threatening cirrhosis. Here, the liver cells mostly died as a result of the persistent overload and the liver begins to shrink. The tissue in the liver scars and the organ can no longer perform its vital tasks.
At this stage, a so-called Shrink liver spoken, which can also cause liver pain. In this case, there is no longer any prospect of a cure and the reduction in the size of the organ also worsens the blood flow to the liver lobes, which causes the blood to backflow into the portal vein (Portal hypertension) can result. This in turn also brings with it significant health risks and possibly pain in the liver.
In the course of portal hypertension (portal hypertension), the congestion of the blood in the portal vein or liver not only causes the liver cells to die, but also bypasses the portal vein circulation, so that the blood from the abdominal organs of the stomach, small intestine, large intestine, pancreas, and spleen and part of the rectum can no longer take its natural route back to the heart via the liver. Another cause of liver pain is congestion liver, in which the blood builds up in the area of the liver due to heart failure (heart failure), which increases the pressure on the liver cells. As a result of the sustained increase in pressure, the liver cells die and the tissue scars - cirrhosis threatens.
Liver failure as a trigger
As a rule, liver pain is based on liver insufficiency (liver weakness), in which the vital organ can no longer perform its metabolic function to the required extent, and pathological, sometimes painful changes in the liver tissue occur. A relatively clear signal for a corresponding liver weakness is, for example, a disturbance in the bilirubin metabolism, which can be recognized quite easily by a yellow discoloration of the skin and eyes.
Bilirubin is a breakdown product of the red blood pigment hemoglobin, which is metabolized with the help of the liver. If the liver can no longer perform its function properly in bilirubin metabolism, bilirubin is increasingly stored in the body tissue, with a yellow discoloration of the skin, mucous membranes and conjunctiva of the eye. The sufferers suffer from the so-called Jaundice (jaundice). This can be an indication of a serious liver disease and should therefore be examined urgently by a doctor. If a dysfunction of the liver is the cause of jaundice, experts speak of a so-called intrahepatic jaundice.
If liver pain is accompanied by symptoms of jaundice, liver dysfunction is extremely likely and because of the impending health impairment, those affected urgently need medical care.
The pain in the liver area can also be caused by so-called ascites, in which fluid accumulates in the abdominal cavity, since the liver does not provide enough blood protein to regulate the fluid distribution inside and outside the blood vessels. This lack of protein may be due to a low protein content in the diet, but is often due to impaired liver function.
Inflammation of the liver
Liver pain can also be caused by inflammation of the liver (hepatitis) are caused. These include all inflammatory reactions in the liver, such as those that can be triggered by toxins, hepatitis A to E viruses, bacteria (Salmonella, leptospiras), parasites, defects in the genome or a misdirected immune response. Mechanical or physical impairment, for example due to bruises or blood flow disorders, can also cause inflammation of the liver. A distinction must be made between acute and chronic forms of inflammation of the liver.
In the course of hepatitis, the liver cells are damaged or destroyed, which can result in considerable impairment of liver function. Disorders of the hemoglobin and bile acid metabolism threaten with a corresponding increase in the bilirubin concentration, but also a disruption of the energy metabolism, which means that those affected may have to deal with persistent fatigue and chronic weakness.
Due to the disturbed removal of free ammonia from the bloodstream, there is also the risk of encephalopathy (brain dysfunction due to insufficient detoxification function of the liver), which in the worst case can trigger the so-called liver coma. In the end stage, those affected suffer from unconsciousness, a loss of muscle reflexes and muscle stiffness and a loss of muscle tension. If there are signs of inflammation of the liver, medical measures are urgently required that address the causes of the symptoms, whereby a precise diagnosis is of particular importance as the basis for successful therapy.
In addition to known symptoms such as chronic fatigue and jaundice, palpation of the abdomen or the liver region can also provide first indications of existing diseases. Subsequent blood tests to check the liver values usually enable the functional disorders of the vital organ to be determined relatively clearly. Examinations of urine and stool may also provide important information. Depending on requirements, imaging methods such as computer tomography, magnetic resonance imaging, sonography or angiography, but also liver biopsies (taking a tissue sample) are used.
Liver pain treatment
Since liver pain can be a sign of numerous serious illnesses, medical help should be called for immediately in the event of any complaints. Successful treatment must be based on strictly avoiding substances that are harmful to the liver. Alcohol and high-fat food should be avoided as well as foods that contain a lot of sugar.
Taking medication should also be subjected to a critical medical examination. This is all the more true since most drugs are broken down via the liver and their effects are geared towards normal liver function. This means that the recommended doses have already taken into account the liver breakdown, if the breakdown decreases due to a liver disease, there is a risk of health problems due to deviations from the correct dose.
Furthermore, the treatment should always be based on the respective causes, the symptoms and the severity of any liver damage. Some of the causes of liver pain can be successfully treated, but in some cases the affected person can only be helped with surgery or a liver transplant. In the case of liver cancer, however, sometimes a cure is no longer achievable even with surgical interventions.
Naturopathy and holistic medicine
To prevent diseases of the liver, it is not only recommended not to drink alcohol and high-fat food, but also to change your diet to facilitate the breakdown of harmful substances in the liver. There are numerous medicinal plants on the naturopathic level that are supposed to help detoxify the liver. For example, dandelions, artichokes and milk thistles are said to have a positive effect on the detoxification processes of the liver. Fasting cures and so-called Glauber's salts (sodium sulfate used orally as a laxative) are also used in holistic medicine to detoxify the liver. (fp)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters
- Wiegand, Johannes; Berg, Thomas: Etiology, diagnosis and prevention of cirrhosis; in Deutsches Ärzteblatt, Volume 110, Issue 6, page 86-91, 2013, aerzteblatt.de
- Michael P. Manns, Natascha Cieplik, Sabine Schneidewind: Anatomy of the Liver; in practice of hepatology, Springer, 2016, springer.com
- Rowe, I.A .: Lessons from Epidemiology: The Burden of Liver Disease; in: Digestive Diseases; Volume 35, pages 305-309; 2017, karger.com
- German Liver Foundation: Liver Diseases - Multiple Causes (accessed October 1, 2019), deutsche-leberstiftung.de
- Halina Cichoż-Lach, Agata Michalak: Oxidative stress as a crucial factor in liver diseases; in World Journal of Gastroenterology, Volume 20, Issue 25, July 2014, wjgnet.com