Portal Hypertension - Causes, Treatment, Test, & Procedures

The centre for digestive and liver disease provides patients with the most advanced levels of surgical care and medical care, primarily targeted on safe and proven treatments of disorder linked to the gastrointestinal tract. Our multidisciplinary team of highly experienced surgeons, digestive disease specialists, interventional endoscopists, gastroenterologists, hepatologists, intensivists, radiologists, pathologists, oncologists, anesthetists, counselors, technicians, and specialized nurses, strive to provide maximal patient care at everytime.

We follow a patient-centered approach to give you comprehensive treatment for the management of gastrointestinal (GI) diseases related to the stomach, oesophagus, intestines, and rectum.

What is Portal Hypertension?

Portal hypertension is the increase of pressure inside the portal vein, which transports blood from the digestive organs to the liver. A blockage is caused in the blood flow through the liver by the increase in pressure.

What are the Causes of Portal Hypertension?

Usually, the common cause is the cirrhosis of the liver, but thrombosis (clotting) might also be the reason. Abuse of alcohol, a liver injury caused by hepatitis, or other reasons for liver damage causes cirrhosis.

What are the Eligible Candidates for Treatment of Portal Hypertension?

If you have liver diseases that result in cirrhosis, there is a chance of you developing portal hypertension. The primary symptoms and signs of portal hypertension include:

• Gastrointestinal bleeding: Rectal bleeding stools, or vomiting of blood.
• Ascites: Fluid build-up in the abdomen.
• Encephalopathy: Poor liver function and the diversion of blood flow away from your liver can cause confusion and forgetfulness.
• Low levels of platelets or reduced white blood cell count.

What Are The Several Diagnosis Tests Required For Portal Hypertension?

Portal Hypertension is often diagnosed by doctors using the following tests:

• Endoscopic examination
• X-ray studies
• Blood tests.
• Angiogram.
• Ultrasound.

What Are The Various Procedure To Treat Portal Hypertension?

The doctor will determine an individualized treatment plan through medications, diet, endoscopic therapy, surgery, or radiology. Treatment options will be based on the fact that the bleeding has to be stabilized and how well your liver is functioning.

The first level of treatment

If the doctor diagnoses you with variceal bleeding, then our expert’s doctors will treat you with endoscopic therapy or medications.

 Endoscopic consists of either sclerotherapy or banding. In the sclerotherapy procedure, the gastroenterologist will inject a solution into the bleeding varices to limit or control the bleeding. In the banding procedure, the gastroenterologist utilizes rubber bands to restrict the blood supply to each varix.

Medications will be prescribed alone or blended with endoscopic therapy so that pressure in your varices are reduced, which would help in reducing the risk of bleeding.

The second level of treatment

You may be required one of the following decompression procedures to lessen the pressure in the veins if the first level of treatment does not successfully control your variceal bleeding.

• Transjugular intrahepatic portosystemic shunt (TIPS): In this procedure, the radiologists insert a stent (a tubular device) in the middle of the liver. This procedure helps in rerouting the blood flow in the liver and reducing the pressure in all abnormal veins. This procedure helps in controlling the bleeding immediately.
• Distal splenorenal shunt (DSRS): In this procedure, the surgeon connects the splenic vein to the left kidney in order to weaken the pressure in your varices and in controlling the bleeding. The DSRS procedure helps in long-term control of bleeding.
• Liver transplant is performed by our doctors in cases of end-stage liver disease.
• Devascularization: In this procedure, bleeding varices are removed.
• Paracentesis: Here, the accumulated fluid is directly removed from the abdomen.