Treatment of Portal Hypertension in Liver Cirrhosis
Jun 05, 2022
Source: Cainiu Health
Dr. Jin Zhongkui
Introduction
Treatment strategies for sclerosing portal hypertension vary depending on the severity of the condition. First, active management of underlying diseases—such as cirrhosis—is essential, along with appropriate albumin supplementation and correction of metabolic disturbances. Second, symptomatic treatment should be aggressively pursued to prevent bleeding. Vasoconstrictive agents may be used to reduce portal venous pressure. Finally, surgical intervention is indicated.
Portal hypertension is characterized by chronic, progressive splenomegaly, anemia, leukopenia, thrombocytopenia, and gastrointestinal bleeding. In advanced stages, ascites, jaundice, hepatic insufficiency, and cirrhosis may develop. The vast majority of portal hypertension cases result from cirrhosis. Many patients experience symptoms such as fatigue and anorexia. Some individuals have limited understanding of this condition; thus, what are the treatment options for portal hypertension associated with cirrhosis?
Treatment of Portal Hypertension in Cirrhosis
Because the severity of cirrhotic portal hypertension varies, treatment strategies differ accordingly. First, active management of the underlying disease—such as cirrhosis—is essential, along with appropriate albumin supplementation and correction of metabolic disturbances. Second, symptomatic treatment should be prioritized, particularly to prevent bleeding. Vasoconstrictive medications may be used to reduce portal venous pressure. Finally, surgical intervention—including portosystemic shunt procedures—may be indicated to alleviate clinical symptoms.
Portal hypertension secondary to cirrhosis commonly leads to complications including esophageal and gastric variceal rupture and bleeding, ascites, splenomegaly, hypersplenism, hepatorenal syndrome, and hepatopulmonary syndrome. Ascites is the most prominent clinical manifestation during the decompensated phase of cirrhosis. Patients often report abdominal distension; massive ascites causes the abdomen to swell like a frog’s belly and may even promote umbilical hernia formation, resulting in protrusion of the umbilicus. Large-volume ascites can also cause dyspnea and palpitations.
Patients are advised to carefully control their diet—avoiding coarse, hard, or excessively hot foods—because portal hypertension frequently causes esophageal and gastric varices. Consuming overly hard, hot, or coarse foods may trigger upper gastrointestinal bleeding, potentially endangering the patient’s life. We hope this information proves helpful.
