Portal Hypertension

Portal hypertension is elevated blood pressure in the portal vein, which carries blood to the liver. It is caused by a blockage in blood flow to the liver, usually as a result of cirrhosis. This can lead to internal bleeding and other complications.

Key Facts

  • Portal hypertension is most often caused by cirrhosis, which can block the blood flow in the portal vein with scar tissue and raise blood pressure.
  • This increased pressure causes large veins called varices to form in the esophagus and stomach. These are fragile and can bleed easily.
  • Various treatments are available to help reduce blood pressure, control internal bleeding, and prevent any further complications.


The most common cause of portal hypertension is cirrhosis. Cirrhosis is when scar tissue builds up in the liver after repeated damage, such as from alcohol abuse or hepatitis. This scar tissue causes the smooth inner lining of the portal vein to become irregular, which can slow blood flow and increase pressure.

A blood clot in the portal vein can also cause portal hypertension, although this is less common.


The following are some of the most common symptoms of portal hypertension:

  • Black or bloody stools
  • Fluid in the abdomen (ascites)
  • Forgetfulness or mental confusion
  • Gastrointestinal bleeding
  • Jaundice (yellowing of eyes and skin)
  • Reduced levels of platelets or white blood cells
  • Swelling of legs and feet (edema)
  • Vomiting blood


The following are some of the most common ways to diagnose portal hypertension:

  • Physical Examination: Especially in patients with cirrhosis, the presence of a swollen abdomen (ascites) or varices on the abdomen or anus may indicate portal hypertension.
  • Imaging Tests: These form an image of the portal vein so that doctors can better detect signs of hypertension. These tests may include a computerized tomography (CT) scan, an ultrasound, and an x-ray.
  • Elastography: This test measures the elasticity of the liver and its surrounding tissue by pushing against it. Poor elasticity may indicate disease.
  • Endoscopy: This uses a thin, flexible probe with a camera attached so that doctors can examine internal veins and organs.


The main cause of portal hypertension is cirrhosis, which cannot be reversed. Because of this, the primary goal of treatment is to reduce and manage the effects of portal hypertension, such as internal bleeding. The following are the most common ways to do this:

  • Medications: Beta-blockers can help reduce blood pressure, while propranolol and isosorbide can reduce the risk of internal bleeding.
  • Shunting: This uses tiny tubes placed around the liver to help provide sufficient blood flow, reduce portal hypertension, and prevent varices.
  • Endoscopic Therapy: This consists of either banding, which blocks blood vessels from bleeding using rubber bands, or sclerotherapy, which injects a blood-clotting solution into varices to stop bleeding.
  • Liver Transplantation: In severe cases, a liver transplantation may be necessary. This involves surgically removing the diseased liver and replacing it with a healthy donor liver. Learn more about liver transplantations.


While cirrhosis cannot be cured, portal hypertension can be managed. After treatment, patients should schedule regular ultrasounds to monitor the health of their liver. In addition, they should make healthy lifestyle changes, such as limiting alcohol, eating a well-rounded diet, and getting regular exercise.

Next Steps

If you think you may be experiencing any symptoms of portal hypertension, it is important to get diagnosed immediately. We can quickly assess your health and will work with you to develop an appropriate treatment plan that fits your needs.

Call us at (877) LIVER MD/ (877) 548-3763 or use our online form to schedule an appointment.