What is liver pain? Liver pain can be hard to identify and localize because pain from abdominal organs, such as the liver, is often perceived in a vague, ill-defined manner by the brain. The liver’s pain receptors lie primarily on its surface, especially in the capsule covering a portion of the liver, meaning that pressure on the capsule is most often the source of pain. This pain is usually felt in the upper right part of the abdomen, often under the rib cage, and is almost always associated with a swelling or enlargement of the liver, acute inflammation or distention of the liver’s surface, or any other sort of injury that puts pressure on the capsule. A number of disorders can cause right upper quadrant, or liver, pain. Causes of pain originating in the liver itself include chronic hepatitis (liver inflammation), fatty liver disease, liver abscess, and liver cancer. Other conditions that can produce liver pain by irritating or putting pressure on the liver include ascites (buildup of fluid in the abdomen), gallstones, gastritis (stomach inflammation), pain from pneumonia located in the lower portion of the right lung, and irritable bowel syndrome. Pain that originates in the liver is often referred to, or perceived in, the right shoulder. Liver pain may be confused with a more general abdominal pain, unless it occurs specifically in the upper right abdomen. Even then, right upper quadrant pain can be due to gallstones, intestinal pain, pancreatitis, or other abdominal disorders. Because pain in the liver area can be caused by many different conditions, some of which are serious, it is important for you to contact your health care provider to determine the underlying cause. Seek immediate medical care (call 911) if you experience serious symptoms associated with complications of hepatitis, such as confusion, hallucinations, problems with memory, extreme fatigue, fainting, fever (especially if combined with a swollen abdomen), or vomiting blood. Seek prompt medical care if you have pain in the upper right abdomen or shoulder, along with any of the following symptoms, including difficulty breathing, fatigue, an eating disorder, itchy skin, pain with breathing, or pain with coughing.