More on portal hypertension and bleeds

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What is portal hypertension and what causes it?

Normally, blood is carried to the liver by a major blood vessel called the

portal vein. If blood can’t flow easily through the liver because of cirrhosis,

the blood gets slowed down in this vein and the pressure inside the vein

increases. This higher blood pressure in the portal vein is called portal

hypertension.

If blood can’t flow normally through the portal vein, it must return to the

heart using other blood vessels. These vessels become swollen because of the

increased amount of blood flowing through them. They are called varices. Varices

have thin walls and can easily break open because they aren’t meant to handle

such high-pressure blood flow. Bleeding from a broken blood vessel is serious

and can even be fatal.

What are the treatments for cirrhosis and portal hypertension?

Once liver cells have been damaged, nothing can be done to repair the liver or

cure cirrhosis. Treatment is aimed at avoiding further damage to the liver, and

preventing and treating complications such as bleeding from broken blood

vessels. Your doctor may prescribe a medicine to help prevent your blood vessels

from breaking open. Drugs that prevent broken blood vessels have some side

effects. Not everyone can take them.

If medicine isn’t enough, surgery may help stop the bleeding from broken blood

vessels. One option is to interrupt the flow of blood to swollen varices in the

area where the esophagus (the tube leading to the stomach) attaches to the

stomach. A long lighted tube is passed through the mouth to the stomach. Then

rubber bands or hardening chemicals are placed on the swollen blood vessels to

block them off.

If this procedure isn’t successful, a person with portal hypertension may need

to have a surgeon connect the blood vessels in such a way that the blood doesn’t

flow through the liver. Another kind of procedure, called TIPS (transjugular

intrahepatic portosystemic shunt), may be done in some cases.