Portal Hypertension

Portal hypertension is high blood pressure in portal system of the liver, which involves the veins that filter blood from the intestines through the liver. It may cause complications such as fluid buildup in the abdomen (ascites) or enlarged veins (varices) in the esophagus or stomach. In the U.S., cirrhosis (liver scarring) is the most common cause of portal hypertension.

Portal Hypertension: What You Need to Know

Prevention

Practice portal hypertension prevention by limiting the risk factors that you can control:

• Reduce your risk of cirrhosis:
  • Drink alcohol in moderation, if at all
  • Aim for a healthy weight
  • Be careful with chemicals
• Reduce your hepatitis C risk
  • Use a condom
  • Don't use intravenous drugs, but if you do, use a clean needle
  • Use clean, safe shops for piercings or tattoos
• Get the hepatitis B vaccine

Teamwork

Portal hypertension is best managed by a group of specialists that includes gastroenterologists, radiologists, pathologists, surgeons, nurses and dieticians. Our physicians and other support staff work together as a team, providing expert care.

Experienced, Trusted Expertise

The University of Vermont Medical Center's Gastroenterology and Hepatology Outpatient Clinic is managed by six board certified subspecialists. We perform more than 9,000 various diagnostic and therapeutic endoscopic procedures every year.

What is Portal Hypertension ?

The liver is one of the largest organs in your body. It fills the upper right side of the abdomen inside the rib cage, and is located beneath your diaphragm and above your stomach. The liver performs several essential functions, including detoxifying harmful substances in your body, cleaning your blood and making vital nutrients.

Your portal vein is the major route for blood flowing from your digestive system into your liver. Normally, blood from the spleen and intestines is filtered through the liver by way of the portal vein. But when flow of blood through the liver slows, usually due to the buildup of scar tissue caused by cirrhosis, pressure may build up in the portal vein. This causes portal hypertension.

Portal hypertension is different from the high blood pressure (systemic hypertension) that many people develop as they get older.

Portal hypertension can cause fluid from the liver to leak into your abdomen (ascites). It can also divert blood from the portal vein to other veins, causing these veins to become swollen (varices). Varices are weak veins and tend to bleed easily, which can be life-threatening.

Portal hypertension symptoms may include:

• Vomiting blood - See a doctor immediately
• Confusion , forgetfulness or drowsiness - See a doctor immediately
• Difficulty breathing - See a doctor immediately
• Blood in stools
• Abdominal pain
• Abdominal swelling
• Dehydration
• Black, tarry stools

The most common cause of portal hypertension is cirrhosis, but in some cases the cause is unknown. Several factors can increase your risk of developing portal hypertension, including:

• Cirrhosis: liver scarring is progressive and irreversible
• Alcohol addiction: UVM Medical Center offers an alcohol and drug addiction program
• Liver diseases:
  • Hemochromatosis
  • Wilson's disease
  • Nonalcoholic Steatohepatitis (NASH)
• Liver damage from hepatitis C or B infection
• Schistosomiasis: a parasitic infection sometimes found in developing countries that rarely occurs in North America
• Focal Nodular Hyperplasia: a disease in people infected with HIV/AIDS

Diagnosis and Treatment: Portal Hypertension

The UVM Medical Center's physicians are highly trained in performing procedures to diagnose and treat portal hypertension such as endoscopy and liver transplant .

Learn more about portal hypertension diagnosis and treatment.