The portal vein connects the liver with the intestines, and supplies the majority of blood and oxygen to the liver. When scar tissue builds in the liver, it can cause an increase in the blood pressure of the portal vein. When this happens the blood is forced into smaller veins in the stomach and esophagus. Because these veins, or varices, are more fragile, this extra blood flow can cause breaking and internal bleeding.
As with many vascular conditions, there are no symptoms of portal hypertension itself, but the complications of the condition do have symptoms, including loose, black stools and bloody vomiting.
Because portal hypertension is associated with a diseased liver, patients suffering from this condition can also suffer disease when the brain is exposed to toxins that are not cleared from the body by the liver, as they normally would be.
Risk Factors for Portal Hypertension
Liver damage is the primary cause of portal hypertension, so when discussing risk factors for the condition, a patient should consider those associated with this damage. These include:
- Blood clots
- Chronic viral hepatitis
- Congenital disorders
- Primary biliary cirrhosis
Treating Portal Hypertension
Most treatment for this condition is begun at the point of severe varices bleeding. This is considered a medical emergency, and is treated as such with the standard treatments for severe bleeding: Administering IV fluids and blood transfusions as necessary, as well as performing an endoscopy to accurately pinpoint the source of the bleeding.
After treating the emergency of the blood loss and locating where the bleeding stems from, the damaged varices are removed through endovascular methods. In many cases, treatment will include IV medications to lower the blood pressure in the portal vein. Lifestyle changes and a regimen of fluid-removing diuretics will help with recovery over the long term. In some cases, the liver damage is severe enough to warrant a transplant.