Fatty Liver and Pain Under the Right Rib

Today we’re going to talk about that pain under your right rib that you felt before being diagnosed with a fatty liver (and probably afterwards). That pain that all doctors tell you it doesn’t exist.

Yes, when I told my hepatologist that I had pain under the right rib, just before being diagnosed with NAFLD, she told me that it’s not related to the liver. She said that the liver doesn’t hurt. It can’t be happening.

Yet, it was there and I know that there are many people like me, feeling that pain under the right rib. And probably being told that it has nothing to do with their condition. So I decided to write about this and set things straight once and for all.

Feeling pain – throbbing pain, dull pain, stabbing pain or, actually, any type of pain – is definitely not nice and pretty scary. Especially if it doesn’t go away fast, as it is the case with this pain associated with fatty liver.

Most people who are diagnosed experience it sooner or later (usually the former).

But what causes the pain under the right rib when you have a fatty liver? Is it normal or proof that things are getting really bad? Is it as scary as it seems? And, most important – what to do to get rid of the pain under the right rib when you have fatty liver?

These are questions that I will try to answer in today’s article and I am basing my answers not only on research on the matter and personal experience, but also on countless discussions we’ve had on our free to join Fatty Liver Support Group on Facebook.

Is pain under the right rib normal with Fatty Liver?

This is the question that most people ask me and I can’t really say that it’s normal. We should never feel pain anywhere, but unfortunately most people diagnosed with a fatty liver experience this.

So although not “normal,” the pain under the right rib, associated with NAFLD is very common. It’s actually one of the main symptoms of this condition.

However, if you are to ask your doctor, he or she will probably say that it’s impossible.

“The liver doesn’t hurt” – this is what most of them say, and this is what mine said (she also said that fatty liver can’t be reversed and switching to another doctor was probably one of the best things I did since I actually reversed mine!).

Still, with the liver unable to “feel” pain, why is this pain under the right rib one of the most common symptoms of a fatty liver?

There is an explanation to that and it makes a lot of sense once you hear it: when you have a fatty liver, this means that additional fat starts being stored in your organ.

As a result, this leads to an increased liver size – the liver can grow more or less depending on how much fat it’s actually stored there.

As a result, the enlarged liver will start pressing on other organs in the area or spots it shouldn’t press on – and this is what causes pain.

So although it’s not the liver itself that hurts, it is the fatty liver that’s causing the pain under the right rib due to the liver being enlarged. For some reason, though, it seems to be felt more often during the evening or the night.

There’s also a potential explanation for that as well: not only that in the evening we’re after an entire day of eating, but we also have a more relaxed time, allowing us to focus on the pain itself and feel it more intensely.

Also, the fact that we’re feeling it during the night or before we fall asleep might be related to our position: when we lie on our back, we have the liver press more on areas that hurt more.

So these all could be potential answers to why it usually hurts more in the evening.

The truth is that I simply believe there’s not enough research made on this matter.

I am sure that sooner rather than later, scientists will have more answers to this and doctors will no longer tell us that we’re crazy for feeling this pain if we have NAFLD.

Of course, this could mean that other problems are present – including gallbladder related ones. This is why it’s best to talk to your doctor, no matter what, if you experience this kind of pain, even if you have fatty liver. and this pain is usually associated with it.

How to get rid of the pain under the right rib?

This is the second biggest question that people ask and unfortunately, the answer to it is not as pleasant or simple as the one above.

Most people think about painkillers when it comes to getting rid of that pain – which can be dull or very intense. Unfortunately, taking painkillers usually won’t help.

Many people who have tried it, didn’t really manage to get rid of the pain. And painkillers are very bad for your liver, so you should only take them scarcely, when your doctor recommends it.

The best way to get rid of the pain is to reverse your fatty liver. Start working on your diet and make sure that you stick to it, as difficult as it will get.

Your pain will get better as your liver heals and it usually happens as soon as two weeks after starting to eat healthy.

Of course, it depends on the severity of your fatty liver and how well your body responds to the diet, but it usually starts getting better sooner rather than later.

You don’t have to fully reverse your fatty liver before your pain completely goes away – and these will also be good signs for you that you’re really on the right track.

In my case, things started to improve after a couple of weeks and six months after starting my quest to reverse my condition, I only felt this pain on very rare occasions.

However, sometimes, sticking to the best diet for fatty liver and enduring all that pain is not fun at all.

Therefore, until the liver starts healing and making things bearable, you can try some other potential remedies that might have a smaller or larger degree of success:

try changing positions: sometimes, simply straightening your back if you’re sitting or standing up can help, just as it will usually help if you change positions if you’re laying in bed: switch to one side or another or try to rotate a bit. Find what feels good for you in that particular situation.

try applying some warm compress or pad on the area: the pad shouldn’t be too hot, though and some people can’t take it at all. If it starts feeling uncomfortable, remove it and try something else.

You can also try to apply it on your shirt or a piece of cloth and not directly on the skin. This helps you feel better and the warmth will have a soothing effect.

see if any foods make it worse: in my case, whenever I cheated and ate something particularly greasy or sweet, after a while the pain started to get worse.

So there might be foods that make it worse for you – even in the “healthy foods” department.

Try to experiment a little bit and see if there are any foods causing the pain and simply stop eating them until you get better – most likely you will be able to bring back those foods in your diet if it’s really a must, as long as they are generally considered healthy.

I know that it’s not really a lot of help that I can offer in terms of getting rid of the pain as fast as possible, but hopefully knowing that you will get there eventually as your liver gets better offers you enough motivation to stick to your diet and make things right again.

NOTE: Even though most people diagnosed with NAFLD experience this pain under their right rib, it doesn’t automatically mean that it’s caused by an enlarged and fatty liver.

Although this is the most likely cause, it would be best for you to mention it to your doctor and let them decide if further investigations need to be made since it could be something else causing this pain, like gallbladder problems or even an irritable bowel syndrome.

Also, if the pain is extremely severe, you should also seek medical assistance, as the pain associated with NAFLD is usually dull or at least not extreme.

Even if the pain is not extreme, you should still seek medical attention as no home-diagnosis can beat one made by a trained professional! So visit your doctor ASAP if you haven’t done so already.

If you have other questions or things to add, please comment below!

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26 thoughts on “Fatty Liver and Pain Under the Right Rib”

    • Thank you for sharing this. It really helped me understand the reason of the pain I’m experiencing. I was diagnosed with fatty/ enlarged liver many years ago. I was tested on the upper right quadrant. My gallbladder, pancreas and kidney were normal. Because of the dull, achey pain I experienced the doctor prescribed Actigall which lead me to believe it was possibly related to bile function. One doctor who was a very large man related to my complaint of the dull pain. He called it “slush” and agreed that Actigall might help.

      From your article, which was very enlightening, I wonder if this pain is totally related to the fatty liver. If so then why would the doctors seem to feel it is related to bile function? Could you shed some light on this? I have always felt that the doctors I’ve seen do not seem to know why I experience this pain. When I changed to another M.D. he just continued the Actigall. He has never said anything about it possibly relating to the liver. The tests always show fatty/enlarged liver.

      I wonder is the fat in the liver the reason it is enlarged? Which is the reason the liver is taking up more space and causing discomfort when pushing into the other organs around it. I hope I’m understanding this correctly. It sure makes alot of sense to me. And bewilders me as to why the doctors have never explained this to me. It’s been a mystery really for years.

      • Happy to help. I don’t know why so many doctors don’t even consider the possibility of pain being related to the fatty liver. It’s probably because they learn that the liver itself doesn’t hurt (which is true), but don’t go beyond that and realize that it can still cause pain 🙂 And yes, the main reason for an enlarged liver (when dealing with NAFLD) is the extra fat inside it.

  1. When I opened the article and saw ‘pain’ I was hoping you were going to discuss mastitis which I have in my left breast. It’s been checked (a really sore mammogram!) and I was assured it would go away once I was dieting/drinking properly but it’s still there some 3 months later. Have you advice or words of reassurance?

    • I am sorry to hear that, Paul. Unfortunately, I have never heard of mastitis related to fatty liver until now. However, what I can say is that 3 months might not be enough: it took me 1.5 years to reverse my fatty liver and the pain started to go away after several months and I would still get it every now and than later on, although not as bad. So stick to your diet, especially if this is what the doctor said as well.

  2. Thanks for this – most helpful that you have shared your experience. I have long periods now of no pain (After being diagnosed around 5 months ago) and then it comes back after 2/3 weeks. Usually associated with a bit of a cheat food wise.

    I am down around 18kg though and a lot healthier now so that’s something. From what you are saying it seems as if this does take time and I may have a good number of months/year ahead in order to have NO DISCOMFORT at all. Something to work towards.
    Many thanks again

    • Yes, there might be some work left to be done, but at least improvements are felt – and that’s a good thing. It proves that you’re doing the right thing avoiding all those foods that cause pain.

  3. I was just diagnosed with NAFL, my results said mild, what does that mean, I’m very nervous, I have an appt with my doctor to discuss this. I’m a diabetic, very nervous.

    • Mild is generally used to describe a stage 1 or 2 fatty liver. It can be reversed through proper dieting and exercising – but since you are also diabetic, you should pay a bit more attention to what you eat.

  4. i do have some occurrence of mild throbbing dull pain under my right rib cage on some occasional days but not always, would happen if i’m over working myself at exercising or sometimes doing outside activity with my daughter/wife. i hope this feeling will go away once i dropped down my weight currently at 223lbs to my ideal weight 155lbs (5ft 7″) guy. Doctors keep on telling me to get back in shape and follow strict diet plan.
    I’ve been following your blog diary so far, a lot have teach me good information from your experience

  5. I also encountered the same problem. Although my usually happens with sitting instead of standing. I went to 5 doctors and all of them says that it is chronic muskuskeletol. However I failed to believe it is muskuskeletol.

    I have lost 20 pounds in 2 months and the pain is dull ache and usually happens when sitting. I don’t have anything when sleeping. So not sure what is happening here. Can you comment ?

  6. Hi, I am 64, overweight, and got an elevated ALT reading 2 weeks ago for the first time (otherwise super healthy). No diagnosis yet but I immediately went on a stringent, calorie reduced Mediterranean diet, no alcohol, Tylenol, etc. I am pleased I have lost 5 pounds so far! But last night for the first time I felt the pain you are describing – doesn’t seem fair since I am doing everything right. Could this be a signal that I am still eating too much fat? Or that I am eating something that is hard on my liver? I had added a Vitamin D supplement in a coconut oil carrier for the first time that day. Could the very fact of losing weight be releasing toxins into my system that were stored in the fat? Any insight? Thank you!

    • Hi, be careful of the TYPES of fats you eat as well. In my case, I must avoid dairy fat, abd some others, and usually it is advised to avoid dairy with liver issues anyway. Currently looking into quercetin as a means to lower inflammation and liver fat.

  7. I was diagnosed with fatty liver a few months ago, right after I had my gall bladder removed. I know I need to lose weight. I’m about 40 lbs. over weight. I don’t really eat a lot of fatty foods. We very seldom eat fried foods but I do probably eat more dairy than I should, cheeses, cottage cheese, milk products, etc. However, I’m having trouble losing weight because it’s difficult to exercise because I had a back injury several years ago. My favorite foods are fruits and nuts, vegetables but also , occasionally a good steak. My pain has increased recently to the point that it interferes with my sleep. I’m starting today to improve my diet. I’ll keep you posted on my results. Thanks for this website.

    • Happy to help, Jeanie! From what you said, it seems that the main culprits are the cheese and nuts. Cut them off completely from the diet (lots of fats and calories) and you should start losing weight easier. If you can’t exercise, at least become more active than you are right now. If you’re close to zero activity, like most of us are, then simply walking for 30-40 minutes will give you a nice boost and help you lose more weight. Good luck and do keep us posted.

    • I am on the same boat. I think no one tells you about fatty liver but I find it interesting that I have it and found out after gallbladder surgery. It is related. I want to see a liver specialist cause my dr said it is significant amount of fat but did not tell me what stage it is.

  8. Hi Lynn,
    I so appreciated your articles. I’m not exactly sure how I came across them, they have been a life changer for me. I’ve been working on my diet and as you know, its quite a process. I have the fatty liver and am trying to reverse it. I’m feeling less discomfort and almost never feel that pain anymore. I am finding the foods I once enjoyed no longer give me the same pleasure knowing they harm me, rather then help me has made it easier to get rid of them. I believe it was last week I read the bread article and am now wanting to try that. Eating better, has given me energy. I haven’t started walking or working out, but next month I will begin. Little changes, little goals, little steps together make a BIG difference. Please keep the information coming!!! Thank you!!!!

    • I was really happy to read your comment, Sherri! I am delighted to hear that my hard work does make a difference and helps people out. Indeed, it’s not the easiest thing to do, but it is doable and it looks like you’re on the right path. Keep going and you will soon get rid of your fatty liver completely – the signs your body sends you prove that already!

  9. Hi Lynn,
    i have diagnosed with grade 1 fatty liver and was having mild elevated liver enzymes which came normal after few months of medicine and workout in the year 2019 but now i have started to get pain often and sometimes it goes for 2 weeks but its mild and uncomfortable. Something my doctor told that its not from your liver.My question is have you experienced the pain when you had fatty liver and which grade it was? I am pretty scared thinking if its causing me due to advanced liver problems.

  10. Thank goodness. TY! I got diagnosed with this because I have a dull uncomfortable pain in that same area for many months..and have pressure in the port hole all the time , a feeling like I have to go to the bathroom. (Even when I dont)…They did a colonscopy..a poop test and they did a ultrasound which found the fatty liver. They doctors keep telling me fatty Liver does NOT cause pain…it causes pressure lol

    1. How do you know what stage you are at? Another test?
    2. Should I ask the doc for a liver panel to see what the levels are?

    • 1. They can usually tell from the ultrasound, but there are indeed other tests for this.

      2. Definitely. The numbers might give you extra motivation to start dieting and focusing on it.


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