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Portal Hypertension

Date : 14-Sep-2020

Portal Hypertension is a medical term used to refer to increased blood pressure in the blood vessels (Portal Vein) heading to the liver. Inside the human abdomen, the veins coming from the stomach, intestine, spleen and pancreas, join the portal vein, divide into smaller veins, which flows into and through the liver. If any form of liver damage blocks the flow of blood, then the blood pressure in the portal system increases, leading to the swelling of the veins in this area. Such veins can burst, leading to potentially life-threatening medical complications.

The main symptoms are:

  • Gastro-intestinal bleeding, vomiting of blood, blood in the faeces or dark, tarry faeces.
  • Accumulation of fluids in the abdomen, a condition called Ascites.
  • A confused and forgetful condition of the patient, caused by poor liver function.
  • Reduced platelet levels. These are the blood cells that form clots and fight infection.

The most common causes are:

  • Cirrhosis of the liver. This is the scarring caused, when the liver tries to repair the damage caused to it by alcohol abuse, hepatitis infections, and some rarer forms of liver damage. This scar tissue blocks the flow of blood through the liver.
  • Blood clots in the portal vein.
  • Blockages of the vein connecting the liver to the heart.
  • Schistosomiasis. An infection caused by freshwater parasitic worms which enter the blood through the skin and move to the liver, intestine and other organs.
  • Focal Nodular Hyperplasia. This is a harmless tumor of the liver, which rarely grows or bleed, but can still put pressure on the veins.

How is Portal Hypertension treated?

Treatment for this condition focuses mainly on the prevention and the management of the various complications caused by the disease. These may include:

Endoscopic Therapy: This is often considered the first line of defence, mainly to stop the internal bleeding, if any. This can be either banding, where the surgeon uses a surgical rubber band to block the vein and stop the bleeding; or it can be Sclerotherapy, where a blood clotting solution is injected into the wound.

Medications: This can include Non Selective Beta Blockers. Beta Blockers are blood pressure medication, and Non Selective Beta Blockers are a subdivision of these. These are used with patients with risk of bleeding.

Lifestyle Changes: This can include: Total stoppage of alcohol intake and any forms of recreational drugs; Abstain from using over the counter drugs and herbal medicine without doctor’s advice; A very strict low salt, reduced protein diet.

Blog reviewed by: Dr. Patta Radhakrishna
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