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Intermittent pain on the right side
I have been experiencing occasional pain on the right side, below the ribs, for about 3 months. The pain stopped completely for some time but started occurring occasionally again. I had an ultrasound, which showed mild hepatomegaly (mildly enlarged liver). I took two bottles of Adlive, after which the pain improved, but it later returned occasionally. The pain is now less than before. Please advise what could be the possible cause and whether I need any medicine.
Answers (19)
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Pain under the right ribs with a mildly enlarged liver on ultrasound at 19 is almost always early fatty liver, and the temporary relief with a liver tonic fits that - it does not treat the cause. Gallbladder sludge or acidity can also give this on-off right-sided pain. Get LFT, fasting sugar/HbA1c, lipid profile and hepatitis B and C screening once; that tells us whether it is simple fatty liver or something needing treatment. The real medicine here is weight and diet - cut sugar, fried food, cold drinks and any alcohol completely, walk 45 minutes daily; liver size usually normalises in a few months. If the pain becomes severe, comes with vomiting, yellow eyes or dark urine, get seen the same day. Bring your ultrasound and reports on a Practo consult with me and we will plan it properly.
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Your ultrasound is largely reassuring — apart from mild hepatomegaly, everything else (gallbladder, pancreas, spleen, kidneys, appendix) is normal. That said, a mildly enlarged liver on its own doesn't typically cause pain, so this intermittent pain pattern is worth looking at separately rather than assuming it's directly from the hepatomegaly. Improvement with Adlive (a liver support supplement) doesn't necessarily confirm liver involvement, since symptoms like this can also fluctuate on their own. What's missing here is an LFT (liver function test) to actually check if the liver enlargement is functionally significant, and depending on that, possibly a hepatitis screen to identify why the liver is enlarged in the first place — since 'mild hepatomegaly' is a finding, not a diagnosis, and needs a cause. I'd suggest a consult so we can go through your LFT and full history together and figure out what's actually driving both the enlargement and the pain.
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Intermittent right upper abdominal pain with mild hepatomegaly on USG.
Symptoms have improved, but the underlying cause should be evaluated
Next Steps
Review LFT (AST/ALT, ALP, GGT, bilirubin) and CBC
Physician/gastroenterology consultation if pain persists or recurs
Further imaging may be considered if USG is inconclusive or symptoms continue
Health Tips
If you are a known alcoholic - Avoid alcohol and unnecessary medications/supplements
Avoid very fatty/oily meals; take a balanced diet
Maintain healthy weight and regular physical activity
Seek urgent care if severe/persistent pain, fever, vomiting, jaundice or dark urine develops
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You should get your LFT and PT/INR and if associated with fever test for HCV, HBs antigen and HEV
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Please share detailed medical history, get liver function tests done and share results. Then I can help you further.
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Right sided pain can be due to gallbladder, liver, stomach or other musculoskeletal issues mild hepatomegaly doesn’t give the cause.
Please book a consultation with the ultrasound report and any blood tests so we can assess this properly and decide whether medication or further evaluation is needed.
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Most likely: Right-sided pain below the ribs can arise from the liver, gallbladder, stomach/intestine or abdominal muscles. Mild hepatomegaly on ultrasound does not by itself explain the pain.
Next Steps
Review the ultrasound and LFT reports. Depending on findings, your doctor may advise further evaluation such as repeat ultrasound or additional blood tests.
Health Tips
You can consult me with your reports and complete history so I can assess the possible cause and guide you regarding the need for treatment.
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* Get LFT (AST/ALT, ALP, GGT, bilirubin, albumin).
* Consider HBsAg and anti-HCV if not previously tested.
* Check fasting glucose/HbA1c and lipid profile, especially if overweight, to assess for fatty liver/metabolic risk.
* If LFTs are abnormal or hepatomegaly persists, follow up with a physician/gastroenterologist and consider repeat ultrasound as advised.
* Avoid alcohol and unnecessary supplements/medications.
Health Tips
Maintain a balanced diet, limit very fatty foods, and maintain a healthy weight. Do not take painkillers or “liver tonics” routinely without medical advice.
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