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Pain in the upper right abdomen: is it the liver, and is it cancer? | CION Cancer Clinics
Pain in the upper right side of the tummy is rarely liver cancer. Gallstones, acidity, gas, a strained muscle or an inflamed liver are far more common causes. Early liver cancer is usually painless. This page sets out the usual explanations, the warning signs that need a doctor this week or today, and what an examination and ultrasound will look for. At CION Cancer Clinics, our team goes through your scan, blood test and biopsy reports with you and plans the next step.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- Is pain under the right ribs a sign of liver cancer?
- What usually causes pain in the upper right abdomen?
- What will the doctor do to find the cause?
- What do the words on an ultrasound report mean?
- Four beliefs about liver pain, and what is actually true
- What this page cannot tell you
- Common questions about upper right abdominal pain
The short answer
Is pain under the right ribs a sign of liver cancer?
Rarely. Pain in the upper right side of the tummy is far more often caused by gallstones, acidity, gas, a strained muscle or an inflamed liver from a virus or fatty liver. Liver cancer usually causes no pain at all until it is large, so an ache on its own is a weak clue.
Why this spot worries people
The liver sits right there, under the lower right ribs, so it is natural to fear the worst. But the gallbladder, the first part of the bowel, the right kidney, the bottom of the right lung and the muscles of the chest wall all sit close by. Pain from any of them can feel like liver pain. The full spread of causes is on our page about right-sided pain.
When the liver itself is the source
The liver hurts mainly when its outer covering is stretched. That happens with a swollen liver from hepatitis, heart strain or a large growth. It is felt as a dull, heavy ache, not a sharp stab. If you already have cancer elsewhere and a scan shows spots in the liver, read our page on primary and secondary liver cancer, because that is a different situation.
This page cannot tell you what is causing your pain. It can help you decide how quickly to have it checked.Common causes first
What usually causes pain in the upper right abdomen?
These are the explanations doctors think of first. Most are treatable, and none of them is cancer.
Gallstones
The most common cause. The pain often comes after a heavy or oily meal, builds up, lasts a while and may spread to the right shoulder blade or back. An ultrasound usually shows the stones clearly. See gallstones or cancer.
Acidity, gas and indigestion
A burning or bloated feeling, often with burping, linked to meals, spicy food or long gaps without eating. It tends to come and go.
An inflamed or fatty liver
Hepatitis from a virus, alcohol or fatty liver can swell the liver and cause a dull ache. Blood tests and an ultrasound usually show this.
Causes outside the liver
- A pulled muscle or a bruised rib, worse when you twist or press
- A kidney stone or kidney infection, often felt in the back
- A chest infection at the base of the right lung
- Shingles, before the rash appears
- A liver abscess, usually with high fever
Not sure whether this applies to you?
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When the pain cannot wait
Go to hospital today if the pain is severe and constant, or comes with high fever and shivering, yellow eyes, vomiting blood, black stools, confusion, or a swollen and tender tummy. See a doctor this week if a dull ache keeps returning, or comes with weight loss, poor appetite, a lump under the ribs, or a known history of cirrhosis or hepatitis B.
At the appointment
What will the doctor do to find the cause?
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Questions about the pain
When it started, what brings it on, whether food makes it worse, where it spreads, and whether you have fever, yellowing or weight loss. Mention any alcohol use honestly. It helps the doctor, and it is not a judgement.
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An examination
The doctor presses gently under the ribs to feel the liver and gallbladder, checks the eyes for yellowing and looks for fluid in the tummy.
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Blood tests
Liver function tests, a blood count and often hepatitis B and C tests. An AFP test may be added if the liver is the concern.
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An ultrasound of the abdomen
Quick, painless and the most useful first scan. It shows stones, a fatty liver, a swollen liver and most spots inside it. CION arranges scans through accredited diagnostic partners.
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A closer look only if needed
If the ultrasound shows a spot in the liver, a triple-phase CT or MRI usually follows. A CION oncologist can review the result with the tumour board and explain what it means.
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On your report
What do the words on an ultrasound report mean?
- Hepatomegaly
- The liver is larger than usual. It has many causes, including fatty liver and hepatitis, and is not a diagnosis on its own.
- Fatty liver, or increased echogenicity
- Fat has built up in the liver. It is very common and usually harmless on its own, though it is worth acting on.
- Cholelithiasis
- Gallstones. A frequent cause of right-sided pain after meals.
- Lesion or SOL
- A spot in the liver, called a space-occupying lesion. Most are harmless, such as cysts or a haemangioma, but a spot needs the follow-up scan your doctor advises.
Commonly believed
Four beliefs about liver pain, and what is actually true
"Pain on the right side means the liver is damaged."
Several organs share that space. Gallstones and indigestion are far more common causes than any liver illness.
"If it were cancer, it would hurt a lot."
The opposite is closer to the truth. Early liver cancer is usually painless, so the absence of pain does not rule anything out in someone with cirrhosis or hepatitis B.
"A liver tonic will settle the pain."
No tonic treats the cause of pain, and some herbal products can injure a liver that is already unwell. Tell your doctor what you take, without worry about being judged.
"Painkillers are safe to keep taking until it passes."
Some common painkillers irritate the stomach or are unsafe in liver disease. Ask a doctor before taking them regularly. Our page on painkillers and a damaged liver explains more.
Being straight with you
What this page cannot tell you
It cannot tell you what is causing your pain, and it cannot tell you whether it is or is not cancer. Pain is felt differently by different people, and the same ache can come from very different places. An examination, blood tests and an ultrasound answer that question far better than any description online.
Who this page does not suit
If you have just had an operation, a liver procedure such as TACE, or an injury, pain under the ribs means something different. Ask the team that treated you. If you are pregnant, severe upper right pain needs urgent review by your obstetrician the same day. Children with tummy pain should see a paediatrician.
Who can help
Your family doctor or a physician is the right first step for most new pain. A gastroenterologist sees gallbladder and liver problems. If a scan has already shown a spot in the liver, or you live with cirrhosis or hepatitis B, a CION oncologist can review your reports and tell you plainly what should happen next.
If you are unsure how urgent your pain is, call the helpline and describe it.Questions we are asked
Common questions about upper right abdominal pain
What does liver pain feel like?
When the liver is the source, the pain is usually a dull, heavy ache or a feeling of fullness under the right ribs, sometimes felt in the back or right shoulder. It is rarely sharp. A sharp, cramping pain after meals points more towards the gallbladder.
Can gas cause pain on the right side under the ribs?
Yes. Trapped gas in the bend of the bowel near the liver is a common cause. It tends to shift, ease after passing wind or a bowel movement, and come with bloating. If it keeps returning or comes with other symptoms, have it checked.
Is the pain worse when lying on the right side a bad sign?
Not by itself. Lying on a tender area makes most aches feel worse, whether from a muscle, a rib or the gallbladder. It does not point to cancer. Mention it to your doctor along with when the pain started.
Can fatty liver cause pain?
Fatty liver usually causes no pain, though some people feel a dull ache or heaviness. If you have pain and a report saying fatty liver, the doctor will still look for other causes such as gallstones before blaming the fat.
Which test should I ask for first?
An ultrasound of the abdomen, with liver function tests and a blood count, answers most questions. Your doctor may add hepatitis tests. Further scans are only needed if the ultrasound finds something that needs a closer look.
The ultrasound found a spot in my liver. What now?
Most liver spots are harmless, such as simple cysts or a haemangioma. Some need a triple-phase CT or MRI to be sure. Please have the follow-up your doctor advises rather than waiting to see if the pain settles.
I have cirrhosis and new pain. Should I worry?
Any new symptom in someone with cirrhosis is worth reporting promptly, because the doctor will want to check the liver and its blood flow. If the pain comes with fever, confusion or a swollen tummy, go to hospital today.
How can CION help?
If a scan or blood test has raised a question about the liver, a CION oncologist can review your reports, arrange any further scans through partners and talk you through what they show. Call the helpline and someone will tell you whether a consultation is the right step.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- NHS — Gallstones
- NHS — Symptoms of liver cancer
- Cancer Research UK — Symptoms of liver cancer
- RadiologyInfo.org (RSNA/ACR) — Abdominal Ultrasound Exam
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Is it liver cancer or gallstones?The most common cause of this pain, compared side by sidePain in the right shoulder blade and the liverIf the ache spreads up to your back or shoulderWhy early liver cancer usually has no symptomsWhy pain is a weak clue, and who should be checked anywayRight-sided abdominal pain: the full list of causesEvery organ that can hurt in this spot
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