Portal hypertension (high pressure in the liver veins)

Overview

High pressure pushes blood into veins in the esophagus and stomach, which can bleed.

It also causes fluid in the belly and an enlarged spleen.

Symptoms

Common signs:

• Swollen belly

Less common

• Vomiting blood

When to get medical care

Causes

Cirrhosis.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• Cirrhosis

Possible complications

• Esophageal varices: Swollen veins that can bleed
• Fluid in the belly (ascites): Common

Diagnosis

A clinician asks about your symptoms and may order tests.

The exam

A physical exam.

Tests

Tests, if needed:

• Endoscopy:
• Ultrasound:

Treatment

Treatment depends on the cause and how severe it is.

Self-care

• No alcohol
• Low salt

Prevention

To lower your risk or prevent problems:

• Avoid alcohol
• Hepatitis vaccines

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a hepatologist (liver doctor).

Living with it

• Check your blood pressure at home and write it down.
• Eat less salt and more fruits and vegetables.
• Take your medicine every day, even when you feel fine.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Support groups and helplines

• American Heart Association: Plain-language heart information and a support network for patients.
• American Liver Foundation: Helpline and support groups for liver disease.

Back to school, work, or sports

• Most people can keep working or going to school.
• Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.

Children, pregnancy, and older adults

• People with cirrhosis: Highest risk.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• This condition needs closer checkups during pregnancy. Plan ahead with your doctor.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Take breaks and ask for help. Caregivers need care too.

Outlook

Medicines and procedures lower bleeding risk.

Treatment lowers bleeding risk.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

• A list of your medicines and supplements
• Notes on when symptoms started and what makes them better or worse

Questions to ask

• What's causing this?
• What treatment do you recommend?
• Do I need a scope for varices?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Portal hypertension (high pressure in the liver veins)