Portal Hypertension: Causes, Symptoms, Daignosis, Prevention and Treatment

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Portal Hypertension
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Portal Hypertension

• Portal hypertension is high blood pressure which
  is caused in the portal vein, the blood vessel
  that connects the intestines and the liver.
  Generally, the condition develops in people who
  have liver damage.The scar tissues that are
  present in the liver obstruct normal blood flow
  further causing blood to back up into the portal
  vein and increasing blood pressure.Further this
  backup causes the blood to force its way into
  small, thin-walled veins at the base of the
  esophagus and within the stomach. These blood
  vessels that are known as varices gets stretched,
  swollen, and twisted and are in danger of
  breaking and bleeding.

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Causes and Risk Factors

• People who are having portal hypertension also
  have a damaged liver. The causes of a damaged
  liver include 
• Cirrhosis
• Chronic viral hepatitis
• Blood clots
• Various congenital disorders and
• Primary biliary cirrhosis, an autoimmune disease.

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Diagnosis of Portal Hypertension

• Portal hypertension is suspected if a person
  with liver disease also has ascites, varices, or
  encephalopathy.To confirm the diagnosis of
  portal hypertension, a doctor may order one or
  more of the following tests
• Computed tomography (CT) scan
• Ultrasound or
• Endoscopy (physicians insert a viewing tube
  called an endoscope through the mouth and down
  into the beginning of the small intestine).

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What are the symptoms of Portal Hypertension?

• By itself, portal hypertension has no symptoms.
  The mentioned below are some complications of
  portal hypertension, however, cause symptoms
  Causes 
• Bloody vomiting, and
• Black, loose stools.The settlement of fluid in
  the abdomen (ascites) happens when a liver
  becomes so damaged that it can no longer make the
  protein albumin, which holds fluid inside blood
  vessels.When the brain comes in contact with
  toxins like ammonia that a damaged liver cannot
  clear from the body, a brain disease called
  encephalopathy results.

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What are the symptoms of Portal Hypertension?
Continue

• Some signs of encephalopathy include 
• Neglect of personal appearance
• Unresponsiveness
• Forgetfulness
• Difficulty in concentrating
• Confusion and
• Coma.

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Treatment Approach

• Treatment for portal hypertension begins when
  varices bleed majorly. Patients who experience
  this issue will receive the following
• Intravenous fluids
• Blood transfusions and
• Emergency endoscopy to confirm the source of the
  bleeding.
• Once the bleeding is located, doctors use one of
  the following endoscopic techniques to extract
  the varices 
• Sclerotherapy
• Latex banding or
• Balloon tamponade.

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Treatment Approach
Continue

• Along with these endoscopic therapies, patients
  receive intravenous blood pressure-lowering
  medications, like 
• Beta-blockers
• Long-acting nitrates
• Vasoconstrictors or
• Vasodilators.
• When endoscopic treatments are unable to cure
  varices effectively, doctors can place a stent,
  or a thin mesh-metal tube, to reroute blood and
  relieve pressure on the portal vein.

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Treatment Approach
Continue

• To treat ascites, doctors recommend lifestyle
  changes and over-the-counter treatments, like 
• Avoiding alcohol
• Eating a low-sodium diet and
• Taking diuretics to remove fluid from the body.
  If the abdomen gets extremely swollen, doctor can
  advise to have paracentesis (the insertion of a
  catheter into the abdominal wall to drain excess
  fluid.)
• To treat encephalopathy, a doctor may suggest
  one or more of the following 
• Substituting vegetable protein for animal protein
  or
• Lactalose, laxatives and antibiotics (medications
  that extract toxins from the intestines).

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Treatment Approach
Continue

• Patients become candidates for a liver
  transplant when they have portal hypertension
  with variceal bleeding and end-stage liver
  disease.

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