Re: ALT 44 and slight pain in upper right abdomen & under right rib cage
Fatty Liver is epidemic now days, and from what I've read on the subject, the reason is the switch in the (fast) food industry from saturated fats and oils to polyunsaturated fats and oils (especially canola) combined with the switch from sugar to high fructose corn syrup in all things sweet now days.
All fast foods used to be fried in beef tallow, but in the last few decades everyone switched to trans-fats and then later to "stabilized canola" oil. Canola oil has been found to destroy all vitamin-E in the body, and it is vitamin-E that prevents "lipid peroxidation" of polyunsaturated fats in the liver. Canola oil is now also used in margarine and salad oil, making things even worse.
Polyunsaturated fats and oils are supposed to be better for your heart, but your liver actually prefers saturated fats, and a liver full of polyunsaturated fat with no vitamin-E to prevent lipid peroxidation becomes rather unhappy very easily.
Alcohol generates "acetaldehyde" as it is metabolized in the liver and this acetaldehyde is a very powerful pro-oxidant when it reacts with polyunsaturated fats and oils. This nasty mix is causing substantial problems for many young people who consume a lot of fast food, and drink more alcohol than may be good for them.
The last two ribs in your rib cage are known as "floating ribs", as they are not attached to the sternum like the other ribs are. These floating ribs are however attached to the vertebrae in your spine, and a fatty liver that is angry and swollen due to lipid peroxidation will push these floating ribs out, "torquing" your spine and causing back pain, as well as the pain under your ribs.
The solution is to either avoid all alcohol, or greatly reduce your consumption of polyunsaturated fats and oils (especially canola), and also cut back on high fructose corn syrup. Deep fried foods, margarine, and salad oils are where you are most likely to get massive doses of polyunsaturated canola, and soft drinks are where you will likely get overdosed on high fructose corn syrup.
Supplementing with vitamin-E may reduce lipid peroxidation, but enough canola will destroy even supplemented vitamin-E. It's an unfortunate state of affairs for young people now days who tend to live on fast food and drink to excess, but if you do your research on this matter, you will find this is indeed what is most likely causing America's fatty liver crisis.
Best of Luck to you!