Hi Thanks for posting your query on HCM I have read and understood your concern Piroxicam is a nonsteroidal anti-inflammtory drug(NSAID) very effective in the treatment of pain.Like other NSAIDs it may have a series of side effects include heartburns/gastritis espcially when taken on an empty stomach. When you say liver pains, i feel it may be gastic related since pain aggravated by hunger. However, examination by the Doctor may be needed to confirm diagnosis.I will suggest you try the following: -Avoid going on an empty stomach -Stop piroxicam -You may take a COX 2 inhibitor like celebid for the pains -A proton pump inhibotor like omeprazole and an antacid like maalox may help control symptoms. If symptoms persist, you see the Doctor for evaluation. Hope this will help.You may write back if more concerns Best regards Dr Mbuomboh