Portal Hypertension: Causes, Symptoms & Treatment

Instructor: Dan Washmuth

Dan has taught college Nutrition, Anatomy, Physiology, and Sports Nutrition courses and has a master's degree in Dietetics & Nutrition.

Portal hypertension is a condition of high blood pressure within one of the major blood vessels associated with the liver. Read this lesson for more detailed information about the causes, symptoms, and treatment of portal hypertension.

Noticing Symptoms of Portal Hypertension

Eric is a 54-year-old who has long suffered with alcohol abuse, resulting in cirrhosis of his liver. Recently, Eric has noticed that his stomach has started to protrude outward even though he hasn't been eating much food lately. In fact, he actually has a decreased appetite. He's also felt very confused lately and has noticed blood in his stools.

Worried about these symptoms, Eric decided to go to the ER to get checked out by a doctor. At the hospital, he was put through several tests. After evaluating all the results, doctors informed Eric that he has been suffering from portal hypertension which was caused by his cirrhosis.

The liver is a very important organ in the body that plays a major role in digestion and elimination of waste products from the blood. The portal vein is a large blood vessel that carries blood from several organs (including the stomach, pancreas, and spleen) to the liver. Portal hypertension is a condition in which blood pressure in the portal vein becomes too high, resulting in several possible complications.

Portal hypertension involves an increase of the blood pressure in the portal vein.
portal vein

Causes of Portal Hypertension

Portal hypertension is usually caused by conditions that block or obstruct blood from flowing through the liver. Blood then gets backed up into the portal vein and causes an increase in blood pressure in the portal vein. Conditions that can block or obstruct blood from flowing through the liver include:

  • Cirrhosis (the scarring of the liver due to alcohol abuse, hepatitis, and other causes)
  • Blood clots in the portal vein
  • Blood clots in the hepatic vein (the blood vessel that goes from the liver to the heart)

Risk factors for portal hypertension include:

  • Alcohol abuse
  • Hepatitis
  • Obesity
  • High cholesterol
  • Hypertension

Symptoms of Portal Hypertension

Common symptoms of portal hypertension include:

  • Ascites: accumulation of fluid in the abdominal cavity that causes the stomach to protrude outward
  • Gastrointestinal bleeding: bleeding in the GI tract can cause blood to show up in the stool
  • Hepatic encephalopathy: confusion and other mental problems caused by a build-up of waste products in the blood, particularly the waste products of protein that come from consumed food.

Ascites (accumulation of fluid in the abdomen) is a common symptom of portal hypertension.

Treatment of Portal Hypertension

Treatment of portal hypertension usually revolves around the symptoms and preventing further complications. Ascites can be treated by limiting the amount of salt and fluid a person consumes. Consumption of salt can cause the body to retain fluids. Therefore, restricting salt, as well as fluids, can help reduce the amount of fluid that accumulates in the abdomen.

Hepatic encephalopathy can be treated by restricting dietary protein. Since this symptom is caused by an increase of protein waste products in the blood, restricting the intake of dietary protein can help reduce accumulation. Additionally, certain medications can be given to help decrease blood pressure throughout the entire body, including the portal vein. These medications include beta-blockers and nitroglycerin.

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