Pain or discomfort under the right ribs can understandably make you worry, especially if you have recently been diagnosed with fatty liver disease. The liver is located in the upper-right part of the abdomen, so it is reasonable to wonder whether fatty liver is responsible.

Fatty liver can sometimes be associated with a dull ache or feeling of fullness in this area. However, pain under the right rib is not specific to fatty liver. Several other conditions can cause similar discomfort, so persistent or unexplained pain should be assessed rather than automatically attributed to the liver.

Can Fatty Liver Cause Pain Under the Right Rib?

Many people with fatty liver have no symptoms at all. When symptoms occur, some patients describe a mild ache, pressure, or fullness in the upper-right abdomen.

This may occur when the liver becomes enlarged or irritated. However, the intensity of pain does not necessarily indicate how severe the liver condition is. Some people with significant liver disease may have few symptoms, while others with mild disease may notice discomfort.

What Else Can Cause Right-Sided Rib Pain?

Because several organs and structures are located in this area, right upper abdominal pain can have many possible causes, including:

• Gallbladder problems: Gallstones or inflammation can cause pain under the right ribs, sometimes after eating.
• Digestive conditions: Indigestion, gas, stomach ulcers, or other gastrointestinal problems can cause upper abdominal discomfort.
• Muscle or rib problems: Strained abdominal or chest muscles can cause pain that becomes worse with movement or certain positions.
• Other liver conditions: Viral hepatitis and other liver diseases can sometimes cause upper abdominal discomfort.

This is why a proper medical assessment is important before assuming that fatty liver is the cause.

What Tests May Be Needed?

Your doctor will first ask about the location, duration, and nature of your pain and whether it is related to meals, movement, or other symptoms. Depending on your medical history, tests may include:

• Liver function tests to assess certain markers of liver health
• Abdominal ultrasound to examine the liver and gallbladder
• Blood tests to look for inflammation, infection, or other conditions
• Additional imaging or investigations when clinically appropriate

It is important to remember that normal liver blood tests do not always rule out fatty liver or other liver problems. Your results need to be considered together with your symptoms and imaging findings.

When Is Right Rib Pain an Urgent Concern?

Seek prompt medical attention if abdominal pain is severe, sudden, or accompanied by symptoms such as:

• Yellowing of the skin or eyes
• Persistent vomiting
• High fever or chills
• Significant abdominal swelling
• Confusion or unusual drowsiness
• Black or bloody stools

These symptoms can indicate a condition that needs urgent evaluation and should not simply be attributed to fatty liver.

If You Have Fatty Liver, What Can You Do?

If fatty liver is confirmed, treatment usually focuses on addressing the factors contributing to fat accumulation in the liver. Depending on your circumstances, this may include gradual weight loss when appropriate, regular physical activity, a balanced diet, and good control of diabetes, cholesterol, and blood pressure.

If you need structured support with weight management, a personalised Weight Loss Programme may be considered following a medical assessment.

When Should You See a Gastroenterologist?

If pain under your right ribs persists, keeps returning, or is accompanied by abnormal liver tests, it is worth arranging a medical assessment. You do not need to wait for the pain to become severe before seeking advice.

At the Gastroenterology Clinic at DRHC Dubai, patients can receive an assessment for fatty liver, abdominal pain, and other digestive or liver conditions. The appropriate tests can be selected based on your symptoms and individual risk factors.