If you were diagnosed with a fatty liver disease, you probably know too well about the pain right under the right rib. The same pain that most doctors tell you shouldn’t exist… yet it’s there, annoying and potentially scary.
That’s what we’re going to talk about today and learn why we actually feel that pain, whether or not is normal and what can you do to relieve it at least a bit.
“Fatty Liver Causes No Pain!”
That’s what my hepatologist told me when I mentioned I had pain under the right rib. “It’s not related to the liver,” she said. She told me that the liver didn’t hurt. That the pain that I feel is probably something I’m imagining.
Of course, the pain is real. You probably have it (or had it). I had it, and most people diagnosed with NAFLD/MASLD will probably experience it, at least to some degree.
This pain can be throbbing, dull, or even stabbing, and usually appears well before being diagnosed (in many cases, it is the reason why the diagnosis is confirmed – this was also my situation).
Even if the pain sometimes goes away (even without dieting), it’s important to know that you are not alone.
Is pain under the right rib normal with Fatty Liver?
No pain should be considered “normal.” However, this is one of the most common fatty liver disease symptoms, and it’s usually one of the signals your body sends you to tell you something’s not right.
The main reason behind this pain is the enlargement of the liver. As excess fat accumulates in the liver, the organ grows larger and starts to press on neighboring tissues.
This pressure is what causes the discomfort or pain you feel under your right rib. This is also why you will mostly notice the pain intensifying in the evening. After a day filled with potentially unhealthy meals and less distraction, the pain/discomfort is more apparent.
It may also worsen when lying on your back, as the liver’s pressure shifts to a different angle. Some people also experience a more intense pain if they lay on their right side.
So although the doctors claiming that the liver doesn’t hurt are technically correct, it’s still the liver that’s causing the pain under the right rib due to it being enlarged.
Of course, this pain can also be associated with other conditions. This is why it’s extremely important to visit a doctor as soon as possible if you’re experiencing it.
Research on this specific symptom is still limited, and I feel that more studies are needed to fully explain why this pain occurs.
This is what you should do to get rid of the pain
You might be tempted to think about painkillers to manage the pain, but these won’t help. Actually, painkillers might do even more damage to your liver.
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, no matter how difficult it seems at first. As your liver heals and shrinks in size, the pain will go away. This happens as soon as two weeks after starting to diet.
Of course, it depends on the severity of your fatty liver and how well your body responds to the diet, but it gets better sooner rather than later.
Note: Check out my book, From Fatty Liver to Healthy Liver, to see exactly what I did to reverse my condition (and get rid of the pain).
You don’t have to fully reverse your fatty liver before your pain completely goes away. In my case, things started to improve after a couple of weeks, and six months later, I only felt this pain on very rare occasions. But I was very strict about my diet and lifestyle changes.
But until then, there are some other natural things you can try to get at least some relief:
- Adjusting Your Position: I learned that altering my posture (straightening my back if sitting or standing up) or changing my sleeping position (usually, switching to my left side, although some find better relief when they sleep on their right) can ease the pressure on the liver.
- Warm Compress: Applying a warm pad on the affected area might also bring relief. Just be sure the warmth is gentle and not too hot to avoid irritation. You can also try to apply it on your shirt or a piece of cloth and not directly on the skin.
- Identifying Trigger Foods: In my case, eating greasy foods always worsened the pain. Others report that sweets make it worse. These are two types of foods we shouldn’t eat anyway, so monitor what makes the pain worse and stop consuming those foods.
Does the severity of the pain indicate the severity of your condition?
While many people believe that increased pain or discomfort means that their condition is worsening, the pain itself shouldn’t be associated with how severe your fatty liver is.
Worsening pain doesn’t necessarily mean that your liver is getting worse, while easing pain doesn’t necessarily mean that things are getting better.
Sure, the pain will gradually go away (until it goes away completely) as you work on reversing your condition, but it’s not used as an instrument for deciding your fatty liver grade or the severity of the condition.
When to Seek Medical Help
Even though many people with NAFLD/MASLD experience this pain, it is important to get a professional diagnosis. While the discomfort is common with a fatty liver, it might sometimes signal other health issues, such as gallbladder problems or irritable bowel syndrome.
I cannot stress enough that if the pain is severe or accompanied by other symptoms, you should seek medical advice immediately. A proper medical evaluation is necessary to rule out these conditions.
Remember, I am sharing my personal journey and observations, not medical advice. Always discuss any concerns with your doctor.
I hope that by sharing my story and the insights I’ve gathered, you will feel more informed and supported on your path to recovery. If you have other questions or things to add, please comment below!
I was diagnosed with a fatty liver back in 2014 and managed to reverse it by mid-2015. Since then, I’ve been studying it, continuously updating my knowledge with the latest scientific findings and practical approaches to give others the help they need to reverse their condition.
My approach to managing fatty liver is holistic, balancing scientifically-backed information with real-life, practical advice based on personal, direct experience.
I am also the admin of the Fatty Liver Support Group on Facebook and the Fatty Liver Subreddit.
Thank you so much for this information – it has been incredibly helpful and assuring that it is infact ‘normal’ NAFLD related.
Always happy to be helpful!
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.
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.
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
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 ?
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.
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.
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!
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.
Yes, that pain is common with many people who have a fatty liver. I had it as well and it disappeared after reversing it.
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.
I was diagnosed with fatty liver about a year ago. I was only a little overweight and I went on the noom diet and lost 15 lbs. I was at 130 and very happy with that weight at 5’2. Anyway my liver enzymes were high so they checked my liver again.
I am also on a few meds for depression and anxiety so am thinking maybe they have damaged the liver. Anyway they said this time that the fatty liver got worse and I made an appointments with my gastro dr.
He doesn’t hav3 an opening for a month. But this week I’ve started having the pain under my right ribs. It isn’t dull it is a sharp stabbing pain. And worse when I sit down. I am not a drinker and I don’t have diabetes. Last month I got I’ll for a few weeks.
Soo tired. Couldn’t get out of bed for weeks I’ve been eating more because I’ve been losing weight unintentionally. I was tested for Covid 3 times Negative I’m worried because there is nothing you mentioned that I’m not already doing to reverse the liver fat I will call the drs office back tomorrow and try to get in earlier.
Kathy, I think that one of the things that make it worse is the stress you’re going through. The anxiety and depression – all these are, in my opinion, terrible for our overall health.
I was in a similar situation due to various other problems and my stress levels were at an all time high. I started to feel bad and, even though I had reversed my fatty liver so many years ago, the pain came back.
It took me a couple of months of getting back on track – rest, eliminate all stress in my life (as much as possible), meditate, take walks… both problems disappeared together.
So I would strongly recommend you to work as hard as possible on getting back on track as I believe stress is the root of your problem here. It’s a lot easier said than done, I know, but not impossible. Search online (if you haven’t done so already) how to get rid of stress and apply all methods you find – they WILL help and you will get over this.
Thank you for your helpful advice! I got the pain right after my diagnosis. Dr. (Gastro) says he doesn’t know why I have NAFL. Not a drinker, for decades have had a healthy diet. I lost weight 10 # unexplained. In last 2 yrs. not able to regain any weight down to 103. I’m a pre-diabetic & have taken high blood pressure meds for yrs. I can’t afford to lose more weight. My ? is would it be best if I saw a Liver Dr? I also have stiffening of the wall in my bladder. Have you heard if it is related to NAFL? I will go on the modified Mediterranean diet. I’m concerned about having a scan or MRI with contrast due to possible Kidney damage they can cause. Thank you for hosting this blog.
Sorry to hear about this, Angie. It really sucks when the reasons are not clear. But yes, it might be the BP medicine that has caused it (this doesn’t mean that you should stop taking them!) Or just some strange genetics that some of us are “blessed” with.
As long as you are of normal weight, active and eat healthy, there might be little you could do. Make sure that you don’t eat any added sugar (which you probably don’t due to your other diagnosis), and also try to keep fats – especially saturated ones – to a minimum. Eat plenty of vegetables and little processed food.
As long as your diagnosis followed an ultrasound, I think that the Gastroenterologist should be enough. It would never hurt to see a hepatologist, as they might have additional opinions about the potential cause, but usually most doctors downplay this disease.
If you didn’t get an ultrasound – that would be the first thing you should have. I hope your health improves!
Thank you so much! You have given me more information than any of my doctors. When fatty liver first showed up on my report several years ago my doctor didn’t even mention it to me. So, I assumed it was insignificant.
I first had the pain immediately after my gallbladder operation. This lasted a little over a week. Then again immediately after my appendix operation eighteen months later. This pain lasted about two weeks, then went away.
Suddenly, about a month later, it came back so severe I had to go to the ER. Pressure on the painful area relived the pain for me. Yes. I believe the problem is a fatty liver. We will see Monday. Again, thank you so much.
Thanks for the nice words. I hope all is well and you started dieting to get back on the right track.
I want to take turmeric extract for my inflammation. Do you think that’s OK with my NAFLD?
Turmeric is said to be of solid help for NAFLD, so it should be OK, yes.