What is portal hypertension?

This is high blood pressure in the portal vein and other smaller blood vessels that branch off from it. The portal vein delivers blood from the gastrointestinal tract (or digestive system) and spleen to the liver.

Portal hypertension happens when something blocks or slows blood flow through the portal vein. Then, blood backs up into nearby blood vessels. This can cause blood vessels in the esophagus or stomach to get bigger. In severe cases, the blood vessels can break open and cause bleeding.

Portal hypertension commonly happens because of "cirrhosis." This condition involves scarring of the liver. The scars can block blood flow through the liver, causing high blood pressure in the liver and nearby veins. Other things can also cause portal hypertension.

What are the symptoms of portal hypertension?

Many people do not have any symptoms of portal hypertension until it leads to problems. Then, symptoms can include:

• Bleeding from swollen blood vessels (varices) – A person might vomit blood, or have bowel movements that look like tar or contain blood.

• Swelling in the belly and legs

• Confusion, and other thinking problems such as changes in mood or sleeping patterns

Will I need tests?

Maybe. Your doctor will do an exam and ask about your "health history." This involves asking about any health problems you have or had in the past, past surgeries, and any medicines you take. It helps your doctor figure out if you have any health problems that could increase your risk of portal hypertension, like cirrhosis.

They might also order lab tests, an ultrasound, or other imaging tests. Imaging tests create pictures of the inside of the body.

How is portal hypertension treated?

Treatment depends on what is causing the portal hypertension. Your doctor will also work to treat any problems it has caused.

Treatment might include:

• Lowering salt ("sodium") in your diet

• Medicines to help get rid of extra fluid

• Medicines to lower the risk of bleeding

• A procedure to stop bleeding from swollen blood vessels

• A procedure to improve blood flow through the liver

When should I call the doctor?

Call for emergency help right away (in the US and Canada, call 9-1-1) if you have any signs of bleeding from esophageal varices. These include:

• Vomiting blood

• Dark-colored or black bowel movements

• Bloody bowel movements or diarrhea

• Feeling lightheaded

• Passing out

Call your doctor or nurse for advice if you have:

• Symptoms of infection, such as a fever over 100.4°F (38°C) or chills

• Belly pain

• Swollen legs or ankles

• Trouble breathing

• Extreme tiredness

• Confusion