Skip to content 
Treatment
Treating portal hypertension consists of:
- Controlling and treating portal hypertension
- Managing the original condition that caused it
Managing portal hypertension and its complications consists of managing some milder symptoms such as slow continuous bleeding from the gastrointestinal symptoms and ascites to managing severe life-threatening hemorrhage.
Managing continuous bleeding occurs after performing endoscopy to assess the number and severity of esophageal varices as well as their likelihood of bleeding. This is followed by optimizing your care to prevent them from bleeding or rebleeding and this includes:
- Using beta-blockers, especially in those with varices which have not bled before. Beta-blockers act by decreasing the size of such varices, decreasing the likelihood of their bleeding.
- Performing endoscopic band ligation: Endoscopic band ligation is a procedure done to control bleeding from large varices. It includes the application of a rubber band around the large varices to cut off blood supply coming to them and cause them to shed and fall off. This causes a small wound in their place which, then, heals.
- Performing endoscopic sclerotherapy: Endoscopic sclerotherapy includes the injection of a material that glues the walls of the varices together. This technique is, however, not effective in esophageal varices but in gastric ones.
Controlling portal hypertension can be done using some medications if the condition is mild, but if the condition is severe, then shunting procedures may need to be done including TIPS (Transjugular intraperitoneal portosystemic shunt) which is a direct connection between the veins of the portal and systemic circulation. This helps reduce the pressure within the portal system but can accelerate some side effects such as hepatic encephalopathy.
