- Why the liver and where is it?
- Mechanism of pain syndrome
- What causes pain in the liver?
- Characteristics of pain
- Additional symptoms of pain
- How are the functional causes of pain manifested?
- Pain in hepatitis (acute and chronic)
- Cirrhosis and pain
- Pain with steatosis
- Liver Neoplasms
- Pain in the area under the liver
- Related Videos
Determine what the pain in the right upper quadrant means and whether the liver is hurting, only an expert can. Often patients, assuring themselves that they suffer from liver disease, do not even know where it is located, and when they are examined they detect diseases of neighboring organs. To find out how the liver hurts is useful to everyone, since in the body of a person the work of this organ on irreplaceability and constancy can be compared only with the heart muscle.
Why the liver and where is it?
Liver in humans - an unpaired multifunctional organ, refers to the parenchymal, which means the absence of a cavity inside, complete filling with tissues and cells. It is not for nothing called a "biochemical factory".
It is here that the mass of substances necessary for maintaining health is synthesized (proteins, vitamins, hormones, blood coagulation and anti-coagulation, immune defense). It is an organ that supplies energy for the life of cells, the blood depot. At the same time, he processes slags, relieves the body of toxic substances, and participates in digestion.
The location can be defined as the right upper corner of the abdominal cavity. Front covered with ribs. The highest point is at the level of the fifth edge. The lower edge usually protrudes slightly from the right hypochondrium. The left lobe leaves the epigastric zone and is located above the stomach.
The posterior surface has pits in which the upper pole of the right kidney and the head of the pancreas tightly fit. The lower border is covered by a gallbladder with ducts and a bend of the duodenum.
To know exactly where the liver is hurting, it is necessary to find out from which side the pain begins, where it spreads, its character, the accompanying symptomatology.
Anatomical structures located in the liver region, with their pathology or functional malfunction, give pain in the general zone
Mechanism of pain syndrome
Inside the liver are liver cells (hepatocytes), vessels, bile ducts. The whole structure is divided into segments. They lack nerve endings. And yet, in the question "can the liver ache" the doctors are sure that it can, but the pain is formed not in the parenchyma of the organ, but in the nerve receptors of the glisson capsule surrounding it.
For this, the organ should increase in size (swelling, blood overflow, inflammation, neoplasm) and stretch the capsule. The intensity of pain directly depends on the tension force. Pain in the liver can be associated with external pressure on the capsule and peritoneum from the side of enlarged "neighbors".
Another option is the transition of the inflammatory reaction to the adjacent peritoneal sheets (perihepatitis), which is very rich in nerve endings. Causes of pain in the liver can be associated with the pathology of the organ itself or others, distinguish between functional and organic.
What causes pain in the liver?
The causes of pain in the liver of a functional nature, unlike organic ones, are removed after the termination of the irritating factor, rest, normalization of nutrition or soothing procedures. These include:
- alcohol intoxication with a single intake of alcohol-containing beverages;
- physical overstrain;
- stressful state;
- overeating of fatty, meat foods;
- uncontrolled reception of medicines.
For organic reasons, we can include all diseases of the hepatic parenchyma. They disrupt the structure of hepatocytes, cause necrosis and replace non-functioning connective tissue. Why does the liver hurt a particular person, you can find out only after a thorough examination. More details and the course of diseases we will consider below.
Characteristics of pain
Pain in the liver region has a different "color", its patients describe with an emotional touch, which emphasizes the duration of human suffering.
Aching and drawing pains
If the patient indicates that "noeth in the hypochondrium on the right", it should be understood that the process has a chronic course, often started. Functional pains are not aching. Usually, at the same time, the feeling of heaviness is disturbed after eating and exercise or without a reason.
Drawing dull pains spread to the top and back (in the neck, shoulder blades, shoulder). Reinforce with excitement, slopes. Accompanied by nausea, bloating, belching, unstable stool. The appearance of icteric sclera and skin suggests the transition of the disease to the acute stage, possibly without a sufficiently pronounced intensity of pain. The patients develop weakness, itching of the skin.
Blood supply of the liver is completely dependent on the state of the total blood flow, the cells suffer from hypoxia, venous stasis
Pain of blunt character is most similar to the pathology of the hepatobiliary system. The fibrous capsule stretches over the entire surface, so the pain does not have a bright localization. Differentiation of the disease is possible with the help of a survey.
Simultaneously, other symptoms should be considered. For example, with neoplasms, dull pain accompanies weight loss, signs of liver failure, is expressed already in the late stage of the disease.
The definition of "strong" and "acute pain" speaks of the high intensity of the pain syndrome. Strengthening pain after a period of "pain" is associated with a growing tumor, cyst, liver abscess. It is necessary to pay attention to the nature of the temperature (rapid rise with chill and a sharp decline in abscessing), loss of appetite, stool disorders, mild icteric sclera.
Hepatitis does not cause severe pain. It is associated with an attack of cholelithiasis. Occurs suddenly, localized in the middle of the right hypochondrium, accompanied by vomiting. It radiates into the interlapar area, the right collarbone, the shoulder, the lower abdomen. Lasts up to a day, it subsides gradually.
Wave-shaped pulsation corresponds to the heart rate. This can be understood by placing one hand on the area of the hypochondrium, and the other on the pulse. It is possible for heart defects (insufficiency of tricuspid or aortic valves). With an increase in the liver, it can be seen from the oscillation of the muscles.
A rare pathology - an aneurysm of the hepatic artery is also accompanied by a throbbing pain. Stagnation in the absence of blood circulation is caused by adhesive pericarditis, mitral stenosis.
Blood overflow of central veins leads to increased pressure in the portal system and oxygen hunger of hepatocytes. The liver increases significantly, necrosis occurs in the center of the lobules, a replacement for connective tissue (cardiac cirrhosis). Patients complain of severe severity, nausea. It combines icterus and cyanosis of the skin.
Sharp pain in the liver is not a sign of damage to the liver tissue. This is inherent in acute cholecystitis. The pain radiates to the right and upwards, into the neck, lower jaw, scapula. Occurs suddenly, accompanied by chills, fever, vomiting. Attack of biliary colic is provoked by shaking, physical activity, violation of diet.
If the movement of the stone occurs along the narrowed duct, acute pain without temperature and vomiting is caused
Additional symptoms of pain
If the liver hurts, then there are always signs that indicate the failure of the parenchyma, digestive disorders, metabolic processes. Most often, pain intensifies after eating fatty foods, alcohol, running, exercise.
An indication of pain in the liver can be:
- irritability, weakness, apathy;
- eructation with a rotten smell;
- yellowing of sclera and skin;
- dark urine;
- gray feces;
- headache and muscle pain (in the back and legs);
- vascular "asterisks" (telangiectasia) on the face, abdomen, shoulders, chest;
- tendency to bleed gums;
- in men, the first place is a complaint of sexual weakness, and in women - infertility.
The main danger of liver disease is a mild symptomatology. Patients consult a doctor in the stage of irreversible changes (fatty degeneration, cirrhosis). In the chronic course of pain in general may be absent.
It is necessary to consider what symptoms are associated with secondary pathology of neighboring organs and on them to establish a diagnosis. This is done by qualified doctors. And patients should be guided when pain in the area of the liver requires a quick call to the "First Aid".
Emergency medical assistance is needed if:
- to remove pain by household means can not;
- there was vomiting with bile;
- pain in the hypochondrium to the right is of a cutting nature, arose suddenly;
- noticeably yellowing of the sclera and skin;
- the temperature has increased significantly.
How are the functional causes of pain manifested?
Violation of the function is possible with aggravating factors, a person may not even guess that the liver is hurting.
Even a single intake of a significant amount of alcohol causes severe intoxication. With pain in the hypochondrium right after the morning after drinking, the liver performs the task of processing ethyl alcohol and suffers itself:
- with the help of the enzyme alcohol dehydrogenase cleaves it to low-toxic substances;
- part of hepatocytes is exposed to toxic effects and is not able to work;
- additional load is caused by an appetizer with abundant fatty meat food, spicy dishes;
- taking medicines for headaches and taking off hangovers is harmful to the body.
In such cases hepatoprotectors are offered for the treatment of liver pain, they contribute to the recovery of cells
Action of increased physical activity
Often when trying to do physical exercises, jogging, long walking, people complain that "they fell ill under the ribs on the right." This is the reason for refusing to attend classes. Prolonged absence of physical activity leads to detenity of the body.
When running in the liver, an increased volume of venous blood accumulates. Especially those who are not accustomed to breathe properly suffer. At them the diaphragm does not promote pumping of blood from a venous bed. The sharp increase in size overstretches the capsule, so the person feels pain.
To overcome the symptoms and continue the session, it is recommended:
- a short rest, then the pain will disappear on its own;
- Think of a gradual increase in load and breathing technique;
- Do not eat 2 hours before training.
In overdose of drugs
Uncontrolled intake of drugs, especially antibiotics (from the group of macrolides, penicillins, cephalosporins), soothing and stimulants of the nervous system, leads to the accumulation of toxic substances in the liver. Decay products are excreted from the body with bile. At the same time they manage to break the viscosity of bile in a more dense side, cause stagnation and disturbance of outflow.
In the elderly, the usual dosages of drugs can become toxic
Toxic effect can cause individual intolerance, the presence of a disease that a person does not know about. There are pains, bloating, jaundice, itching of the skin. Practically, the symptoms can be regarded as acute drug-induced hepatitis. For its formation, a week is enough.
To treat such a condition should be the abolition of all drugs and the use of hepatoprotectors. A positive result appears quickly. Organic liver damage can be inflammatory and of a different nature. We will dwell on some of them.
Pain in hepatitis (acute and chronic)
Inflammation of the liver, lasting up to six months, is considered acute hepatitis. Doctors of infectionists are engaged in the detection and treatment of acute viral hepatitis. Hepatitis A - begins as a respiratory disease with fever, headaches, weakness.
Aching in the liver occurs in 3 weeks. Instead of them, there may be a feeling of heaviness, bloating. Jaundice appears on the 2-4 day. Against her background, the patient's condition improves. All signs gradually disappear, the person recovers.
Hepatitis B - lasts up to two months. The pain syndrome grows gradually from aching to dull feelings of heaviness. Start with fever, general weakness, lethargy. Characteristic of the increase in the liver, signs of jaundice.
With hepatitis D, there are no typical symptoms, it accompanies hepatitis B, it is easier to bear. Hepatitis E - differs, in addition to signs of intoxication, severe pain in the liver and above the navel. Sometimes the disease begins with a pain syndrome. The infectious disease doctor prescribes treatment according to the form.
Viral hepatitis B and C are known for their transition into chronic course. What can be done to prevent unwanted transformation, does not always depend on the desire of the patient and the doctor. Pain in the right hypochondrium is permanent, with some gaining only when the diet is violated and fatty foods are taken.
Localization is inaccurate: patients note pain in epigastrium, then in the navel. Possible nausea and vomiting, flatulence, a feeling of discomfort, all the symptoms of hepatitis. The reason is confirmed by biochemical tests of blood, urine analysis, detection of markers, ultrasound. If necessary, computer tomography is performed.
What to do with pain in the liver and how to treat the disease more can be found in this article.
Cirrhosis and pain
Cirrhosis is a disease that disrupts the structure and function of the hepatic parenchyma. The disease is characterized by an irreversible character: areas of the hepatic tissue are replaced with scars. Progression leads to hepatic renal failure.
Replacement of scar tissue occurs gradually, instead of lobules, dense mounds form
Pain in the liver of a stupid character is constant. There are several types of cirrhosis:
- alcoholic - caused by chronic alcoholism;
- viral - the result of chronic viral hepatitis;
- medicamentous - with toxic effects of drugs;
- primary biliary - causes pathology of hereditary type;
- stagnant - with heart failure.
Against the background of pain, there are other signs: a moderate increase in temperature, severe weakness, weight loss, abdominal enlargement (ascites) when vomiting fluid from the vessels into the abdominal cavity, icterus and itching of the skin, enlargement of superficial peri-ocular veins, cerebral intoxication with mental changes. A biopsy confirms the diagnosis, allows to establish the degree of loss of liver function. The treatment requires hemodialysis, organ transplantation.
Pain with steatosis
The disease is caused by metabolic disorders, as a result of which hepatocytes are filled with fatty inclusions and destroy the normal structure of the tissue. Steatosis is more often observed in chronic alcoholics, obese people, in violation of metabolic processes (diabetes mellitus). Pain in the liver accompany the activation process, have a stupid character. Well removed when the food is normal, refuses alcohol.
In the benign nature of the tumor (adenomas, nodular hyperplasia, hemangiomas, cysts) begin to cause pain in case of significant growth, squeezing the parenchyma and stretching the capsule from the inside. The type is painful, constant. Nausea and vomiting are possible.
Liver cancer is also accompanied with aching pain for a long time, but the patient's fever is increased, there is no appetite, weakness grows, stomach is constantly swollen. The liver is enlarged, palpation increases pain.
If the liver has a pain in a person who has undergone surgery for various malignant tumors, then it is more likely to suspect metastases. Such pains are always caused by the terminal stage of oncological diseases of other organs (stomach, intestine, breast, esophagus, lungs, brain, pancreas).
Most often, metastases to the liver produce cancer of the stomach, large intestine, lungs, esophagus. The pains are constant, weighed down by temperature, weight loss, weakness, nausea, ascites. There is no pain in metastasizing a malignant tumor of the prostate gland, larynx, ovary, uterus, kidney and bladder.
Cancer treatment is only surgical, the volume of surgery is chosen individually for each patient, the complex includes chemotherapy and irradiation of the liver zone
Pain in the area under the liver
Sensations in diseases of the subhepatic organs are very similar to pain in the liver. These include:
- Attack of appendicitis;
- right-sided renal colic;
- ectopic pregnancy and adnexitis in women;
- diseases of the intestine (Crohn, ulcerative colitis, helminthic invasion).
Sometimes it is necessary to differentiate the pain with osteochondrosis. A separate conversation about pain in the liver can be carried out with traumatic organ damage, parasitic diseases, abscesses.
There are many diseases and lesions that different specialists are involved in. You should begin your examination by contacting the therapist. Delaying threatens the loss of opportunity for recovery.