PORTAL HYPERTENSION

Overview and Facts

Portal hypertension is an increase of pressure within the portal vein that carries blood from the digestive organs to the liver. A blockage causes an increase in pressure in the blood flow through the liver. Growing pressure in the portal vein may cause large veins to develop across the esophagus and stomach to get around the blockage. The varices become sensitive and can bleed easily.

 

When there is an increased pressure in the portal vein, one of the effects is the development of huge, swollen veins within the esophagus, stomach, rectum, or umbilical area. Varices can rupture and bleed, resulting in potentially life-threatening complications.

 

The common cause of portal hypertension is cirrhosis or damaging the liver. It results from a liver injury curing due to hepatitis, alcohol abuse, or other significant reasons for liver damage. In cirrhosis, the scar tissue blocks blood flow through the liver and slows its processing functions. 

 

Thus, this article will further detail portal hypertension, its symptoms, diagnosis, and medications.

 

The portal hypertension is mainly caused by increased pressure in the portal vein that may cause huge, swollen veins within the esophagus, stomach, or umbilical area. This disease is fatal if left untreated. This disease is hard to cure. However there are available treatments that can manage and stop the complications, specifically the bleeding veins. Also, there are several ways to prevent and take care of the liver as prescribed by the doctors. Hence, this article will dig deeper into the facts, types, symptoms, and portal hypertension treatments.

Types and Symptoms

TYPES

 

These are the types of portal hypertension.

  • Pre- hepatic – It is due to the blockage of the portal.
  • Intrahepatic – The distortion of the liver architecture, which can be sinusoidal. 
  • Post – hepatic – due to venous blockage outside the liver. 

 

SYMPTOMS

 

Portal hypertension might not always be connected with certain symptoms that identify the occurrence inside the liver. However, if you have a liver disease that leads to cirrhosis, the chance of developing portal hypertension is high.

 

The common symptoms of portal hypertension include:

  • Gastrointestinal bleeding: Black, tarry stools or blood in the stools; or vomiting of blood due to the spontaneous rupture and bleeding from varices.
  • Ascites: An accumulation of fluid in the abdomen.
  • Encephalopathy: Confusion and forgetfulness caused by poor liver function and the diversion of blood flow away from your liver.
  • Reduced levels of platelets or decreased white blood cell count.

Diagnosis & Medications

DIAGNOSIS

 

Usually, doctors diagnose portal hypertension based on ascites or dilated veins or varices, as seen during a physical exam of the abdomen or the anus. 

  • Lab tests 
  • X-ray tests 
  • Endoscopic exams depending on how severe it is.
  • Evaluation of your medical history
  • A physical exam
  • Blood tests
  • Angiogram (an X-ray test that takes pictures of the blood flow within a particular artery)
  • Ultrasound
  • Endoscopy

 

The tests may vary depending on how severe the portal hypertension of the patient is. 

 

TREATMENT

 

Most causes of portal hypertension cannot be treated. Instead, treatment focuses on preventing or managing the complications, especially the bleeding from the varices. 

Diet, medications, endoscopic therapy, surgery, and radiology procedures all have a role in treating or preventing complications. Another treatment depends on the hazards brought by the symptoms and how well the patient’s liver functions.

 

  • Endoscopic therapy. It is usually the first line of treatment for variceal bleeding and consists of either banding or sclerotherapy. 
  • Nonselective beta-blockers (nadolol or propranolol) may be prescribed alone or combined with endoscopic therapy to reduce the pressure in varices and further reduce the risk of bleeding.

 

Since this disease is somehow hard to cure or worse, it cannot be cured anymore. Hence, it is important to take care of the liver to prevent future complications. These are some of the tips prescribed by physicians: 

 

  • Maintaining good nutritional habits and keeping a healthy lifestyle may help you avoid portal hypertension.
  • Do not use alcohol or street drugs.
  • Do not take any over-the-counter or prescription drugs or herbal medicines without first consulting your doctor or nurse.
  • Follow the dietary guidelines given by your healthcare provider, including eating a low-sodium (salt) diet.

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