Where is the liver area? The hepatic area is the part of the body where the liver is located, exactly in the right upper abdomen, inside the ribs, under the right septum. In outpatient clinics, we often encounter patients who come to the clinic with their hands pressed against their right abdomen and their faces expressions of apprehension and nervousness. Old hepatitis patients suspect that hepatitis has struck again, while those who do not have hepatitis are the first to be alerted to that area because of hearsay or because they have seen family members or relatives and friends with pain in the liver area during hepatitis attacks, and they worry if they have hepatitis. In fact, many patients do not have any obvious symptoms when hepatitis occurs, but are in good spirits, can eat and sleep, move around as usual, and do not feel any loss of strength, in short, everything seems to be normal, only to find out by chance that they have hepatitis when they go to school, join a job, get married, go abroad, or have a routine health checkup, and some are in a serious state. Of course, viral hepatitis (such as hepatitis A, hepatitis B, hepatitis C, hepatitis D or hepatitis E, etc.) is not the only cause of pain in the right side of the abdomen. Other causes, such as bacteria, parasites, protozoa, and medications, can also cause hepatitis and lead to pain in the right side of the abdomen. Why does pain occur in the liver area? The liver tissue itself is not painful because it does not have nociceptive nerves, so patients do not feel pain when they have a liver puncture or other causes of damage to the liver parenchyma. However, the liver area does become painful, why? The reason lies in the liver’s envelope. The organism has a self-protective instinct, and in order to protect the liver and separate the liver envelope from other internal organs, the liver has a very thin envelope on its surface. This envelope is rich in painful nerves, and pain is felt regardless of the stimulus. This is why a little anesthetic is administered during liver puncture to anesthetize the outer envelope and make it painless. When hepatitis occurs, regardless of the cause, the liver tissue becomes congested and edematous due to inflammation, causing the liver to become enlarged and pulling the outer envelope tight, so the nociceptive nerves are stimulated and pain arises. This is also the reason why the patient feels pain when the doctor touches the patient’s enlarged liver on physical examination. Common diseases of liver pain in The pain in the liver is a milder persistent vague pain. As mentioned earlier, in hepatitis the liver tissue becomes congested and edematous due to inflammation and this does not dissipate easily in the short term; this also determines that the pain is continuous in nature, i.e. it is present 24 hours a day; the pain also does not travel to other parts of the body as it does in gallbladder pain, etc. It is important to note that the pain in liver tumor is somewhat similar to liver pain in hepatitis, but due to the rapid reproduction of cancer cells and rapid expansion of the liver, the pain is much more intense than that in hepatitis, and some of them even reach unbearable level, which often requires the use of strong painkillers. The liver area involves a number of adjacent organs and some pains need to be differentiated. For example, the gallbladder, the bile duct, the intestines in the upper right abdomen and the lower end of the stomach are all neighbors of the liver, usually each doing its own job and not interfering with each other, but sometimes these neighbors can be afflicted and become ill and produce pain, some of which can easily be confused with liver pain, causing people to misunderstand and think that something is wrong with the liver. However, these internal organs are tubular and hollow, and although pain can occur when inflammation or obstruction occurs, the nature of the pain is different, mostly of a more intense spasmodic colic, often presenting intermittent episodes, i.e., pain stops pain. Because most of these hollow organ infections are bacterial in nature, they are also often distinguished by more pronounced febrile symptoms and elevated white blood cells. Sometimes, there is also pain in the skin of the liver area, but it is often a transient, lightning-like stabbing pain, mostly of a cutaneous neuropathic nature.