Portal hypertension is an abnormally high blood pressure in the hepatic portal system. There can be a blockage in the vessels in the liver due to damage to the liver resulting in improper blood flow through the liver. Due to this, there can be an increase in the blood pressure. An increase in the blood pressure may make your veins swollen, large within the stomach, oesophagus, umbilical area, or rectum. The main cause of portal hypertension is cirrhosis, a liver disease. A person may suffer from a life-threatening condition as varices can bleed and rupture. You can develop the problem of portable hypertension without cirrhosis but is it rare. If you have portable hypertension without cirrhosis then it is known as idiopathic non-cirrhotic portal hypertension or INCPH.
Portal Hypertension Symptoms
Check out various symptoms or signs of portal hypertension:
– The first symptom of portal hypertension that is generally experienced by the people is gastrointestinal bleeding. Gastrointestinal bleeding may lead to tarry and black stools. People may have blood in the stools due to gastrointestinal bleeding.
– Ascites is a common symptom of portal hypertension. In ascites, excess fluid more than required accumulates in the belly. People with ascites generally notice that their belly size has increased. Ascites can lead to bloating, shortness of breath, and cramps.
– Due to a problem in circulation associated with the liver, a person with portal hypertension may become confused or forgetful.
– Portal hypertension may reduce the level of platelets and blood cells that may lead to the formation of blood clots or white blood cells.
Portal Hypertension Causes
Cirrhosis, a liver disease, is the main cause of portal hypertension. In cirrhosis, the liver does not work properly due to damage to the liver from a long-term. This condition can occur due to a disease like hepatitis or consumption of alcohol. Whenever there is damage to the liver, it tries to heal itself. It can lead to the formation of scar tissue. Due to excess scarring, the liver is not able to perform its work. Check out some of the other possible causes of cirrhosis:
– Liver infections can lead to the problem of cirrhosis.
– The intake of certain medications including methotrexate can cause cirrhosis.
– Bile ducts which are developed poorly can cause the condition of the liver damage, cirrhosis.
– The other causes of cirrhosis are a buildup of iron in the body, cystic fibrosis, and fatty liver disease which is non-alcoholic.
The inner walls of the portal vein that are normally smooth may become irregular due to cirrhosis. This can lead to an increase in the resistance of the blood flow resulting in high blood pressure in the portal vein. There can be a blood clot in the portal vein due to which the pressure of the flow of the blood can increase against the blood vessels walls.
How is it diagnosed?
You should reach out to a doctor as soon as you experience the symptoms of portal hypertension. Your doctors conduct a physical examination of the anus or the abdomen to check the presence of varices or ascites to diagnose portal hypertension. Your doctor may find a difficulty to diagnose this problem when symptoms are not visible. Portal hypertension is generally noticed when it leads to some complication. When a person experiences the problem of gastrointestinal bleeding or ascites then the doctor will find out the underlying cause of gastrointestinal bleeding or ascites such as portal hypertension. Your doctor may ask you to get various diagnostic tests done including lab tests, endoscopic exams, and X-ray tests. Your doctor may ask you to get an ultrasound done to check the condition of the portal vein and how blood is flowing through the portal vein. If your doctor could not find out the result after an ultrasound then he or she may ask you to go for a CT scan. Elastography is another screening method commonly used to measure the elasticity of the liver and tissue surrounding the liver. If your doctor finds out that the elasticity is poor then it indicates you have the disease of portal hypertension. If you are experiencing the problem of bleeding in the gastrointestinal tract then you may have to undergo an endoscopic examination. In endoscopic examination, your doctor uses a flexible, thin device attached with a camera to check the internal organs of your body. Your doctor may insert a catheter attached with a blood pressure monitor into a vein in your liver for taking a measurement to determine the blood pressure in the portal vein.
Prevention
You cannot prevent some diseases associated with the liver such as errors of metabolism that are inborn including iron and copper. You can also not prevent the problems of congenital anatomy. Check out some of the tips that will help you to prevent portal hypertension:
– Excess consumption of alcohol can lead to portal hypertension. So, a person should drink in moderation to avoid the risk of portal hypertension.
– You should follow various important tips to avoid hepatitis. Hepatitis B and hepatitis C may lead to the condition of cirrhosis. You should take the vaccinations for hepatitis after consulting with your doctor if you should have them or not.
– You must consult with a doctor before taking any over-the-counter medication, herbal medicine, or prescription drug. There are some medications that can make your liver problem worse.
– The problem of portal hypertension arises when the health of the liver declines. To avoid this problem, you should make healthy and good lifestyle choices.
– It is important that you do physical exercises daily to keep yourself fit and fine. Adopting a healthy lifestyle helps to keep your liver healthy.
– You should reduce the quantity of salt or sodium in your diet. You should not consume more than 2 grams of salt or sodium in a day.
– You can consult a dietician for a diet plan.
– You should avoid smoking.
Portal Hypertension Treatment
There are some lifestyle changes that play a very important role in treating the problem of portal hypertension. Reduce or avoid the consumption of alcohol, quit smoking, work out daily and improve your diet are some of the lifestyle changes that are helpful to treat portal hypertension.
Your doctor may prescribe you to have beta-blockers to relax the blood vessels and reduce the blood pressure. There are some other medicines including isosorbide and propranolol that are used to decrease the pressure in the hepatic portal vein. The risk of internal bleeding is also reduced with the help of these medicines.
If you have the problem of ascites in which excess fluid builds up in the belly, your doctor may recommend you to have a diuretic to reduce the levels of fluid in the body.
If a person has the problem of bleeding in the blood vessels of the liver then the doctor may recommend the patient banding or sclerotherapy treatment. This method is used to stop the bleeding in the blood vessels of the liver. In banding, rubber bands are placed by the doctor to block the unhealthy flow of the blood to bigger veins called as varicose veins or varices in the digestive system.
Transjugular intrahepatic portosystemic shunt (TIPS or TIPSS) is another therapy that is very popular. In this method, a stent is placed by the doctor in the middle of the liver. If a person suffers from acute bleeding then this treatment method is used to control the bleeding. New pathways are created with this so that blood can flow from the hepatic portal vein into other blood vessels.
Complications
Check out various complications associated with portal hypertension:
– Portal hypertensive gastropathy: Portal hypertensive gastropathy is one of the major complications associated with portal hypertension. Due to this condition, the mucous membrane of the stomach is affected and blood vessels become larger in size.
– Cognitive disorders: When a liver problem continues for a long-term then it may lead to various cognitive disorders. A person may forget the things easily and become confused due to portal hypertension.
– Acute bleeding: Sometimes, portal hypertension can lead to acute bleeding. The transjugular intrahepatic portosystemic shunt is a therapy prescribed by the doctor to stop the bleeding. There can be a blockage in the pathways created in transjugular intrahepatic portosystemic shunt treatment method. This can lead to more bleeding.
– Life-threatening problem: In some cases, portal hypertension can be life-threatening. Sometimes, portal hypertension can cause varices to rupture and bleed.
Conclusion
In portal hypertension, the blood pressure increases in the hepatic portal system. The first sign of portal hypertension is gastrointestinal bleeding. Ascites, confusions, and forgetting things are some of the common symptoms of portal hypertension. The main cause of portal hypertension is cirrhosis, a liver disease. There is a possibility that a person can have portal hypertension without cirrhosis. Though, such cases are rare. The condition when a person has portal hypertension without cirrhosis is known as idiopathic non-cirrhotic portal hypertension or INCPH. The other causes of portal hypertension are poorly developed bile ducts, a buildup of iron in the body, consumption of certain medicines including methotrexate, liver infections, cystic fibrosis, and non-alcoholic fatty liver disease.
You should reach out to the best doctor as soon as you experience the symptoms of portal hypertension. It can be life-threatening if not treated properly on time. Your doctor may conduct a physical examination of your anus and stomach to diagnose various problems associated with portal hypertension. This problem is generally noticed when it leads to a complication. Doctors find a difficulty in diagnosing if the symptoms are not obvious or unclear. There are various tips that help to prevent the condition of portal hypertension. One should reduce the consumption of alcohol and salt, quit smoking, do regular physical exercises and follow a healthy lifestyle.
Doctors suggest different treatment options for treating portal hypertension depending on the cause of the individual. The doctor may prescribe the patient to have beta-blockers or diuretics. Transjugular intrahepatic portosystemic shunt and banding or sclerotherapy are some other treatment options used for treating portal hypertension. You should talk to your doctor before taking any medication. There are certain medications that can make the condition of your liver worse. It is important that a person who is suffering from portal hypertension should follow a healthy lifestyle with the other treatment options prescribed by the doctor.
Many complications are associated with portal hypertension. Portal hypertensive gastropathy is the major complication of portal hypertension. Sometimes, this problem can lead to acute bleeding. Some people may experience confusions and forgetfulness due to portal hypertension. Portal hypertension can be life-threatening as varices can rupture and bleed. That is why it is important that you book an appointment with the best doctor as soon as you experience the symptoms associated with portal hypertension such as tarry and black stools, bloating, shortness of breath, and cramps.
