Treatments for Portal Hypertension

The goals of portal hypertension treatment are to reduce further damage to the liver and treat or prevent bleeding from broken blood vessels in the abdomen or esophagus. Minor damage or bleeding may be controlled by medication or a process called banding. In more serious cases, surgical intervention may be needed.

Diet and Lifestyle

• The goal of this treatment is to help the liver function effectively by maintaining a good diet and healthy lifestyle. A physician or dietitian may give the patient a low-salt, low-fat diet to follow. A daily exercise routine helps to maintain a healthy body weight. Do not use alcohol or drugs. Some over-the-counter medications may worsen liver disease and should not be taken without consulting a doctor.

Medication

• Medications to treat portal hypertension include beta blockers, nitrates, propranolol and isosorbide. They reduce the blood pressure and reduce the risk of bleeding. A class of medications called antihypertensives include alpha blockers, calcium channel blockers, diuretics and angiotensin-converting enzyme inhibitors (ACE). These medications are are usually given to the patient in combination with other portal hypertension treatments to control high blood pressure.

Endoscopic Variceal Banding

• The physician uses an endoscope which is threaded down into the throat. He will then place small rings made of rubber inside the esophagus to stop bleeding. The EVB procedure is used in with medications such as beta-blockers and vasoconstrictors to prevent future bleeding and decrease pressure in the portal vein.

Transjugular Intrahepatic Portasystem Shunt

• Transjugular intrahepatic portasystem shunt (TIPS) is a surgical procedure done in a hospital under general anesthesia. The surgeon places a metal shunt in the middle of the liver to allow blood to flow properly and bypass the liver. The shunt prevents blood flowing backward into the abdomen and esophagus preventing future bleeding.

Endoscopic Variceal Sclerotherapy

• The EVS procedure is used for people who cannot have the endoscopic variceal banding (EVB) done. For this procedure the physician threads an endoscope through the mouth into the throat and injects a solution into the esophagus tissue to stop bleeding. The solution stops the bleeding by causing the sites to develop scar tissue.