Portal Hypertension

Portal hypertension is elevated blood pressure in the portal vein, the major vein that carries blood to the liver.

Portal hypertension is most often caused by cirrhosis, or scarring of the liver, which prevents adequate blood flow through the liver. With blood flow impaired by scar tissue, the increased pressure causes large veins (varices) to develop in the stomach and esophagus. These are fragile and can bleed easily. Acute bleeding from portal hypertension requires immediate medical attention.

Symptoms of portal hypertension

Portal hypertension may cause symptoms including:

  • Gastrointestinal bleeding (variceal hemorrhage), vomiting blood, or blood in the stools
  • Ascites (fluid accumulation in the abdomen)
  • Confusion, forgetfulness (encephalopathy)
  • Jaundice
  • Edema (swelling of legs and feet)
  • Reduced levels of platelets or white blood cells

Treatment for portal hypertension

Treatments for portal hypertension aim to reduce pressure and to prevent complications, particularly controlling and preventing bleeding from varices.

Treatments may include:

  • Medications to decrease portal pressure and gastrointestinal blood flow, and antibiotics.
  • Endoscopic therapies to stop variceal hemorrhaging. Endoscopic options may include banding, sclerotherapy, and balloon tamponade to obliterate or compress the veins.
  • Shunting, or placement of tiny tubes, to provide sufficient blood flow around the liver, reduce portal hypertension, and prevent varices.
  • Liver Transplantation, which is the only effective therapy for end-stage liver disease