portal hypertension

What is Portal Hypertension?

November 12, 2018

Receiving a dire medical diagnosis comes with a long list of emotions. Confusion. Shock. Ambivalence. Worry. All of them can be even more intense when you’re not really sure what it means. What is the doctor talking about? What can you do to make things better? Will this affect other organs? Is there a cure?

This is often the case with conditions like portal hypertension. Unless you work within the medical field or have a loved one dealing with it, chances are that it’s a relatively new term in your life.

With aims to ease your mind and provide you with all information possible, below is an overview of portal hypertension and information about how to go about dealing with the challenges of this disease.

What is Portal Hypertension?

People with chronic liver disease can develop something called portal hypertension. This occurs when the scar tissue that is laid down by the liver when injured becomes excessive and leads to altered blood flow. As a result, there is increased pressure in the main vein that feeds the liver, the portal vein.

As the pressure in the portal vein increases, blood that is meant to flow to the liver is diverted away from the liver, much like a traffic jam on a highway leads to cars taking side roads to get to their destination. In the case of cirrhosis and portal hypertension, the blood flow finds its way back to the heart by diverting through the spleen, esophageal veins and other collateral vessels. This can lead to low platelets and rupture of the thin walled esophageal veins and subsequent profound bleeding.

What causes Portal Hypertension?

There are several causes of portal hypertension, such as blood clotsHIV, and schistosomiasis. However, the most common culprit for developing the condition is cirrhosis of the liver.

Cirrhosis is scarring of the liver, often caused by either hepatitisfatty liver disease, or chronic alcoholism.

Symptoms of Portal Hypertension

If you have liver disease, it’s crucial to pay attention to the following symptoms, as they are often signs that you have also developed portal hypertension:

  • Gastrointestinal bleeding
  • Blood in the stool
  • Vomiting blood
  • Accumulation of fluid in the abdomen
  • Varicose veins on the abdomen
  • Bloating of the abdomen
  • Cramps
  • Forgetfulness
  • Shortness of breath

Portal Hypertension Diagnosis and Treatment

If you have a diseased liver and/or are experiencing symptoms of portal hypertension, your medical provider will ask detailed questions about your lifestyle, medical history and conduct a series of lab tests, along with administering an endoscopic examination, MRI and other assessments of the liver.

If conservative treatments do not help control hypertension, doctors may resort to two more advanced procedures:

  1. Transjugular intrahepatic portosystemic shunt (TIPS). Through this procedure, your medical provider will use a small metal device to connect the portal vein to the hepatic vein.
  2. Distal splenorenal shunt (DSRS). This is a surgical procedure in which the surgeon detaches the splenic vein from the portal vein in order to relieve the high pressure within the affected portal vein. The splenic vein is then reattached to the vein that leads to your left kidney.

If you have late-stage liver disease and are not a candidate for these treatments and procedures, your doctor may recommend a liver transplant.

Risk Factors for Developing Hypertension

The most common risk factors for developing portal hypertension include:

  • Excessive consumption of alcohol
  • Non-alcoholic Fatty Liver Disease
  • Chronic exposure to hepatitis B or C
  • Using intravenous drugs (injecting drugs into your vein)
  • Having received a blood transfusion before 1992
  • Having unprotected sex with multiple partners

Complications of Portal Hypertension

Complications of portal hypertension are the same as those from the underlying liver disease, such as gastrointestinal bleeding, increased buildup of fluid in the abdomen, mental status changes or yellowing of the skin.

In addition, both surgical procedures described above (TIPS and DSRS) come with their own sets of complications. These may include blood blockage, or recurrent bleeding.

Lifestyle Changes to Manage Portal Hypertension

Lifestyle changes, such as quitting alcohol, incorporating regular exercise, eating healthier, reducing sodium consumption, and quitting smoking can help keep complications at bay.

If You Have Portal Hypertension, Let Us Help You.

At Pinnacle, we conduct research specializing in liver disease. We work with over 70 referring physicians in San Antonio and Austin, providing clinical trials in liver disease. Contact us to discuss how we can help you.