Portal Hypertension

Medically reviewed by Drugs.com. Last updated on Apr 2, 2024.

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What is portal hypertension?

Portal hypertension is high blood pressure in the portal vein of your liver. Your portal vein is the main blood supply for your liver. Certain diseases cause scar tissue that narrows the veins in your liver. The scar tissue slows blood flow through your liver. This causes the blood pressure in your liver to rise.

What causes or increases my risk for portal hypertension?

• Cirrhosis (liver failure) caused by alcohol abuse or hepatitis
• Blood clot or blockage of blood in your portal vein or in a vein that brings blood from the liver to the heart
• Schistosomiasis (a parasite), or a liver virus
• Heart failure
• Too much iron in your blood
• Family history of portal hypertension, or a narrowed portal vein at birth

What are the signs and symptoms of portal hypertension?

• Pale skin, swollen fingers, or red or itchy skin or palms
• Yellowing of the whites of your eyes, or dark brown urine
• Swelling of your abdomen, swollen veins across the abdomen, or spider veins on your stomach or back
• Tumors with new, visible blood vessels
• Enlarged breast tissue in men, or shrunken testicles
• Fast or pounding heartbeat
• Confusion
• Muscle twitches or hand movements that you cannot control
• Loss of appetite or sudden weight loss

How is portal hypertension diagnosed?

Your healthcare provider will ask about your signs and symptoms and history of liver problems. He or she may also ask if you have had an injury to your abdomen or blood clotting problems. Tell him or her if you have used birth control pills or taken vitamin A recently. You may also need any of the following:

• Blood tests may be used 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. The tests may also be used to measure blood pressure in your liver. You may be given contrast liquid to help your liver and portal vein show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.

How is portal hypertension treated?

• Beta-blockers lower the blood pressure in your portal vein by slowing your heart rate and making your blood vessels wider. A lower pressure may prevent damage to your liver and help prevent 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 needed to improve blood flow in your liver. You may need a liver transplant if surgery does not improve your condition. Ask your healthcare provider for more information about the types of surgery you may need.

Treatment options

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

• propranolol
• nadolol

What can I do to manage portal hypertension?

• Limit sodium (salt) as directed. Too much sodium can affect your fluid balance. Check labels to find low-sodium or no-salt-added foods. Some low-sodium foods use potassium salts for flavor. Too much potassium can also cause health problems. Your healthcare provider will tell you how much sodium and potassium are safe for you to have in a day. He or she may recommend that you limit sodium to 2,300 mg a day.
• Follow the meal plan recommended by your healthcare provider. A dietitian or your provider can give you more information on low-sodium plans or the DASH (Dietary Approaches to Stop Hypertension) eating plan. The DASH plan is low in sodium, unhealthy fats, and total fat. It is high in potassium, calcium, and fiber.
• Do not drink alcohol. Alcohol will narrow your blood vessels more, damage your liver, and make your condition worse. Talk to your healthcare provider if you need help quitting.
• Talk to your healthcare provider before you take any medicines. Certain medicines can damage your liver. Examples include antibiotics, acetaminophen, and birth control pills.

Call 911 if:

• You have chest pain or shortness of breath.

When should I seek immediate care?

• You vomit blood.
• You have bloody or black bowel movements.
• You have swelling in your legs.

When should I contact my healthcare provider?

• Your abdomen swells.
• You urinate very little.
• Your heartbeat is faster than normal for you.
• You have increased confusion or forgetfulness.
• You have questions or concerns about your condition or care.

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. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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