Portal hypertension is caused by high blood pressure in the portal vein, which can lead to varices and internal bleeding. Symptoms include midsection swelling, vomiting, and memory loss. It is often caused by liver damage from cirrhosis or hepatitis C. Treatment includes dietary changes, medication, and surgery.
Portal hypertension is a condition in which the liver does not get enough blood due to high blood pressure in the portal vein. The portal vein is responsible for driving blood out of the stomach and intestines, where it then breaks into smaller veins. These smaller veins carry blood to the liver, the organ responsible for helping convert nutrients from food into energy. If the veins connected to the liver have difficulty carrying blood, the body can form new veins in the stomach and intestines known as varices to help transport blood more quickly. Varicose veins are thinner than normal veins and more likely to burst and cause internal bleeding.
Mild cases of portal hypertension may not have obvious symptoms. As the condition progresses, a person may notice swelling in their midsection. This swelling is known as ascites and is due to a backup of fluid in the stomach. A person with the condition may also have vomiting or black stools, indicating bleeding from the intestines. In severe cases, the condition can prevent the body from absorbing protein from food and lead to difficulty concentrating or memory loss, a symptom referred to as encephalopathy.
Most cases of portal hypertension are due to other disorders or conditions that cause liver damage. One of the more common culprits is cirrhosis, a disease that causes the liver to develop hard tissue to replace deteriorated sections of once healthy liver tissue. Cirrhosis is typically due to alcohol abuse, which can cause damage to liver tissue. Other possible causes of portal hypertension are hepatitis C and thrombosis, or blood clots of the portal veins.
Doctors generally recommend dietary changes as a form of treatment for the initial stages of portal hypertension. Because the condition can cause the liver to not receive as much blood as normal, an affected person may not be able to get enough nutrients from food. You may need to be especially careful about eating foods that are nutrient dense enough to counteract the loss of some nutrients that your liver may not be absorbing. A person with the condition may also need to limit their sodium intake because high sodium levels can make ascites worse.
Portal hypertension also typically needs to be treated with medications to help lower blood pressure. More severe cases of portal hypertension can be treated with surgery to physically reroute the veins leading to the liver. A common surgical treatment procedure is a transjugular intrahepatic portosystemic shunt (TIPS), an operation in which a surgeon attaches the portal vein to veins in the liver known as the hepatic veins. This procedure helps ensure that blood reaches the liver more easily because they have less distance to travel.
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