- Main symptoms
- How to confirm the diagnosis
- What causes portal hypertension
- How the treatment is done
Portal hypertension is the increase in pressure in the vein system that takes blood from the abdominal organs to the liver, which can lead to complications such as esophageal varices, hemorrhage, enlarged spleen and ascites, which consists of abdominal swelling.
Usually, this type of hypertension happens when there is already an injury or disease in the liver, such as cirrhosis or schistosomiasis, for example and, therefore, it is more common in liver patients.
To reduce the pressure in the liver vessels it is necessary to treat and try to cure the liver problem, however, if it is not possible, the doctor may prescribe medications to try to regulate the pressure and, in the most severe cases, may even advise surgery, for example.
Main symptoms
It is not always possible to identify symptoms in a case of portal hypertension, however, people who have a liver disease that can result in cirrhosis have a high risk of developing this condition.
In cases where it is possible to identify any sign of portal hypertension, the most common symptoms include:
- Swollen belly; Esophageal varices; Vomiting with blood; Very dark and fetid stools; Swollen feet and legs; Hemorrhoids.
In the most severe cases, mental confusion and even fainting can occur, caused by the arrival of toxins in the brain. But this complication can happen in any case of severe liver disease, since the organ is no longer able to filter the blood properly, not needing to be only related to portal hypertension.
It is also common for people who have portal hypertension to experience jaundice, which is when the skin and eyes turn yellow, but this sign appears as a sequel to the liver disease.
How to confirm the diagnosis
In most cases, the hepatologist can identify a case of high blood pressure when the person has a history of liver disease and symptoms such as swollen belly, dilated veins and hemorrhoids, for example.
However, several laboratory tests, such as endoscopy, ultrasound or blood tests, may also be necessary to confirm the diagnosis, especially when there are no obvious symptoms of portal hypertension.
What causes portal hypertension
Portal hypertension arises when there is an obstacle to blood circulation in the liver veins. For this reason, the most frequent cause is cirrhosis, a condition in which scars appear in the liver tissue, which hinder not only the functioning of the organ, but also the circulation of blood.
However, there are other less common causes, such as:
- Thrombosis in the spleen or liver veins; Schistosomiasis; Liver fibrosis.
In addition, cardiac changes that impede normal blood circulation after the liver can also result in hypertension. In these cases, the most common problems are right heart failure, constrictive pericarditis or Budd-Chiari syndrome.
How the treatment is done
Most cases of portal hypertension have no cure, since it is also not possible to cure the underlying disease. However, it is possible to control the symptoms and prevent the appearance of complications. For this, the main types of treatment used include:
- High blood pressure medications, such as nadolol or propranolol: decrease the pressure in the blood vessels and, therefore, reduce the risk of rupture of esophageal varices or hemorrhoids; Laxative remedies, mainly lactulose: which help to eliminate excess ammonia and toxins that are accumulating in the body, helping to combat confusion; Endoscopic therapy: it is mainly used to treat esophageal varices and prevent them from rupturing. Surgery: it can be done to divert some of the liver's blood circulation and, thus, reduce the pressure in the portal system, or else, to do a liver transplant, for example.
In addition, salt restriction and the use of diuretics, such as furosemide, are recommended to control ascites and prevent kidney complications.
It is also important that the person with portal hypertension has some daily care to control liver disease and prevent worsening of hypertension and other complications. Therefore, it is recommended to avoid the consumption of alcoholic beverages and bet on a low-fat diet. See more about what to take care of when you have liver disease.
