What is portal hypertension and how should it be managed?
Mar 18, 2024
Source: Cainiu Health
Dr. Liu Feng
Introduction
Common causes include cirrhosis, portal vein thrombosis, Budd-Chiari syndrome, and heart diseases. Symptomatic treatment under a doctor's guidance may involve medications or surgical interventions. Patients with portal hypertension should receive comprehensive treatment under medical supervision to control disease progression and reduce the occurrence of complications. In daily life, a light and balanced diet is recommended.
Generally, portal hypertension is a clinical condition characterized by increased pressure in the portal venous system due to impaired blood flow. It may be caused by factors such as portal vein thrombosis, liver cirrhosis, heart disease, Budd-Chiari syndrome, or tumor compression. It is recommended to seek medical attention promptly, identify the underlying cause, and receive symptomatic treatment under the guidance of a qualified physician. Specific analyses are as follows:
1. Portal vein thrombosis: This refers to the formation of a blood clot within the extrahepatic portal venous system. Causes include liver cirrhosis, intra-abdominal infections, and oral contraceptive use. Patients may experience symptoms such as fever, chills, abdominal pain, back pain, bloating, and bloody diarrhea. In necessary cases, surgical treatments such as thrombectomy, liver transplantation, or stent placement may be performed under medical supervision.
2. Liver cirrhosis: Cirrhosis is the most common cause of portal hypertension. It typically results from chronic liver diseases such as hepatitis or alcoholic liver disease, leading to liver fibrosis that impairs normal portal blood flow. Medications such as entecavir tablets, sofosbuvir/velpatasvir tablets, and compound glycyrrhizin tablets may be used under medical guidance.
3. Heart disease: Certain cardiac conditions, such as right heart failure or restrictive cardiomyopathy, can obstruct blood return to the liver, contributing to portal hypertension. Treatment may include medications such as furosemide tablets, hydrochlorothiazide tablets, and carvedilol tablets as directed by a physician.
4. Budd-Chiari syndrome: This condition primarily involves impaired hepatic venous outflow due to venous valve abnormalities or heart disease, leading to symptoms such as abdominal pain, bloating, and melena. Treatment may involve anticoagulant medications such as warfarin sodium tablets, low molecular weight heparin calcium for injection, or low molecular weight heparin calcium injection, as prescribed.
5. Tumor compression: When tumors compress blood vessels, they may cause vessel narrowing, impairing normal blood return to the liver and resulting in portal hypertension. Treatment options may include portal devascularization surgery or shunt surgery as directed by a physician.
Patients with portal hypertension should undergo comprehensive management under medical supervision to control disease progression and reduce complications. In daily life, they should maintain a light diet, restrict sodium intake, minimize alcohol consumption, and avoid coarse or rough foods.
