Is portal hypertension related to Liver diseases? Yes. Though other causes of portal hypertension include blood clots in the portal vein, parasitic infections, and certain genetic disorders, cirrhosis and other liver conditions remain the most common cause. As the liver becomes progressively damaged over time as a result of various Liver diseases, normal liver tissue is replaced by scar tissue. This condition where your liver is scarred and damaged is called cirrhosis. Treating the portal hypertension often involves treating the underlying liver disease.

What is portal hypertension?

The nutrients from the food we eat are transferred to other organs through blood. The blood from our digestive organs is first filtered by our liver and then sent to the heart from where it is sent to other organs. The vein responsible for carrying blood from our digestive system to the liver is called the portal vein. Unlike most veins that carry deoxygenated blood back to the heart, the portal vein carries nutrient-rich, oxygenated blood to the liver for cleaning and filtering toxins. With liver disease like cirrhosis, blood flow can be blocked through the liver. This raises the pressure in the portal vein resulting in Portal hypertension.

What causes portal hypertension?

The most common cause of portal hypertension is liver cirrhosis, a condition characterized by extensive scarring of the liver tissue. Chronic alcohol consumption and Infections with hepatitis B or C viruses can lead to liver inflammation and scarring. Accumulation of fat in the liver, causing Nonalcoholic fatty liver disease can progress to cirrhosis. The immune system mistakenly attacks liver cells, leading to inflammation and, in some cases, cirrhosis. Blood clotting in the hepatic veins and blood clotting within the portal can obstruct blood flow from the liver and cause blockage and increased pressure respectively. Congenital hepatic fibrosis, a rare genetic disorder leading to abnormal liver development and fibrosis and Schistosomiasis, Infection with certain parasitic worms can cause liver damage and portal hypertension.

What are the symptoms of portal hypertension?

Since portal hypertension is often a complication of liver condition, early detection and management of the underlying liver disease are crucial to prevent and manage complications associated with portal hypertension. Call your doctor right away if you notice any of these symptoms:

Enlarged liver and spleen causing pain in the left upper abdomen.
Enlarged veins (varices) of the esophagus and stomach causing blood in vomit.
Internal hemorrhoids
Yellowing of the skin and eyes
Weight loss
Fluid build-up in the belly (ascites), leading to abdominal swelling and discomfort.
Kidney malfunction
Low platelets

How is portal hypertension diagnosed?

Diagnosing portal hypertension involves a comprehensive approach. You will be asked about your health history, symptoms, risk factors, and family history of disease. Blood tests, including liver function and complete blood count, provide important information. Imaging studies, such as ultrasound, CT scans, and MRI help enlarged veins around the liver and assess the risk of bleeding. Endoscopic procedures aid in detecting complications like esophageal varices. Colonoscopy examines the large intestine and can help identify sources of bleeding from the lower digestive tract. In some cases, a liver biopsy assesses the severity of fibrosis and cirrhosis.

How is portal hypertension treated?

Depending on the specific liver disease causing portal hypertension, medications may be prescribed to slow the disease progression or manage symptoms. You may need to take medicines like beta blockers to reduce portal pressure by decreasing the blood flow to the liver. Diuretics and Paracentesis may be prescribed to drain the excess fluid. Maintaining good nutritional status is important. Avoiding alcohol is crucial to prevent further liver damage. For individuals with advanced liver disease, liver transplantation may be considered as a definitive treatment.

Conclusion

Portal hypertension is like high blood pressure of the portal vein. The portal vein collects nutrient-rich blood from your intestines and carries it to the liver. Cirrhosis, scarring of the liver, is one of the most common causes of this health issue. Symptoms include an enlarged liver and spleen, varicose veins and weight loss from malnutrition. Internal bleeding and fluid buildup in the stomach are the possible complications. Certain medicines may help in treatment of portal hypertension. In severe cases, a liver transplant might be recommended.