Portal Hypertension

Medically reviewed by Drugs.com. Last updated on May 6, 2024.

• Care notes
• Aftercare
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Portal hypertension is high blood pressure in the portal vein of your liver. Your portal vein is the main blood supply for your liver. Follow-up care is important, because this condition can be life-threatening. Talk to your healthcare provider if you need help to stop drinking alcohol. Ask which medicines you should not take with this condition.

WHILE YOU ARE HERE:

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

• Beta-blockers lower the blood pressure in your portal vein. This is done by slowing your heart rate and making your blood vessels wider. This may prevent damage to your liver and help prevent bleeding.
• Vasoconstrictors may be given to help slow bleeding in your blood vessels. This will decrease the pressure.
• Diuretics may be used to help decrease swelling in your abdomen by helping your body get rid of extra fluid.
• A laxative may be used to flush toxins from your system through your bowel movements. The liver normally filters toxins out of the blood. Liver damage can prevent it from filtering the toxins. They can build up in your brain and cause a serious condition called hepatic encephalopathy.
• Antibiotics may be given to help fight or prevent an infection caused by bacteria.

Monitoring:

Your healthcare provider will monitor you to check for signs that you are developing esophageal varices or hepatic encephalopathy. Ask your him or her for more information on these and other conditions you may develop from portal hypertension.

• An EKG may be used to record the electrical activity of your heart. This will tell healthcare providers if your bleeding or high pressure is causing heart problems.
• Hepatic vein pressure gradient may be used to measure the pressure inside the portal vein.

Tests:

• Blood tests will be done to show how well your liver is working, or if you have problems with blood clotting.
• An ultrasound, CT, or MRI scan may be used to show blood flow problems in your liver or to measure blood pressure in your liver. You may be given contrast dye to help your liver or portal vein show up better on the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.
• An EGD uses a scope to see the inside of your digestive tract. A scope is a long, bendable tube with a light on the end of it. A camera may be hooked to the scope to take pictures. Healthcare providers will check for problems in the lining of your esophagus and stomach. Samples may be taken from your digestive tract and sent to a lab for tests. Small tumors may be removed, and bleeding may be treated during an endoscopy.
• A liver biopsy may be done to test your liver to confirm your condition. Your healthcare provider will use a very thin needle to remove a small piece of your liver. The liver sample will be sent to a lab for tests.

Treatment:

• A blood transfusion may be needed if you lose a lot of blood.
• Bleeding treatment may be needed if the veins in your esophagus burst or begin to bleed. You may need surgery to have a band placed over bleeding veins in your esophagus. You may need a procedure that places a balloon against the bleeding veins. You may need a tube to be placed in your stomach through your nose to remove any blood from your stomach. Medicine may be injected into your blood vessels to help stop bleeding.
• Fluid removal may be needed if the fluid in your abdomen prevents you from breathing easily. A needle will be used to remove the fluid from your abdomen. You may need to have fluid removed several times.
• Surgery may be used to place a shunt inside your liver. A shunt is a small tube used to help create a path for your blood to flow through. This will help reduce pressure buildup in your liver.
• A liver transplant may be needed to replace your liver with a healthy liver from a donor. Ask your healthcare provider for more information about a liver transplant.

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• propranolol
• nadolol

RISKS:

You may develop swollen veins in your esophagus. These are called esophageal varices. These veins may start to bleed, and cause severe blood loss. Your brain may become damaged if your liver can no longer filter toxins from your blood. Blood pressure and fluid may build around your lungs and abdomen. This may make it hard to breathe. These conditions can be life-threatening.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.

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