Portal hypertension is high blood pressure in the portal venous system.
These are the veins that come from the stomach, intestines, spleen, and pancreas, and they merge into the portal vein that further branches out into smaller vessels and extend to the liver.
If the vessels in the liver become blocked, this can contribute to liver damage and interrupted blood flow. As a result, the pressure builds up in the portal venous system.
Causes of portal hypertension
The main cause of portal hypertension is the obstruction in the vessels that connect to the liver. This can result from cirrhosis of the liver and the scar tissue that forms in cirrhosis as a means to heal the liver. But instead of healing, this scar tissue blocks these vessels, reducing blood flow and increasing pressure.
Other causes of portal hypertension include blood clots, a parasitic infection, and focal nodular hyperplasia, which is a disease commonly seen in HIV patients.
Some other common causes of portal hypertension are alcohol abuse, hepatitis B and C, fatty liver, cystic fibrosis, and the buildup of excess iron known as hemochromatosis.
In some cases of portal hypertension, the cause is never found.
Signs and symptoms of portal hypertension
Signs and symptoms of portal hypertension include gastrointestinal bleeding, which is evident in tarry or bloody stool, ascites, confusion or forgetfulness due to poor liver function, and reduced levels of platelets or white blood cells. Other symptoms associated with portal hypertension include enlarged veins, enlargement of the spleen, as well as anemia and vomiting blood.
Diagnosing and treating portal hypertension
Portal hypertension is diagnosed normally after a complication has already occurred. Your doctor may perform a blood test, CT scan, X-ray, MRI, or an endoscopy to confirm the presence of portal hypertension.
To treat this condition, your doctor will often recommend that you avoid agents that may damage the liver such as alcohol, acetaminophen, and excess consumption of salt and protein. You may also be prescribed medications like beta blockers and nitroglycerin, while an endoscopy procedure may be needed to tie off enlarged veins in the esophagus that can lead to life-threatening bleeding. If portal hypertension progresses enough, a liver transplant may be necessary.