Portal hypertension

[PiperAlfie]

Hi, I’m new.

5 years ago I developed sepsis due to infected gallbladder. I had developed clots in my portal,mesenteric and splenic veins. Saw vascular specialist and put on blood thinners for 2 months. 6 months after sepsis got my gallbladder removed. During surgery varix was cut and I required a plasma transfusion. No one connected the clots and the varicies..

I have felt poorly since and in feb 2020 went for endoscopy. Discovered varicies in stomach too. I was referred to stomach specialist but seemed to slip through the net. After chasing hospital, I was informed, in September, I have portal hypertension and was prescribed beta blockers. Nothing has happened since apart from moving health authorities and have to be referred all over again . I have no idea how long this will take. I want to be prepared , I would like to know what tests/scans should be done, although I do have an idea. Any information would be helpful

[JennerLayne]

Hello and welcome,

When you had your endoscopy, did the doctor collect specimens for pathology? I too had an endoscopy earlier this year and stomach bleeding was found. The pathology reports came back with the DX of atrophic gastritis and GAVE Disease (Gastric Antral Vascular Ectasia) aka 'Watermelon Stomach'. Apparently, due to Portal Hypertension and cirrhosis, the stomach vessels are dilating and causing severe bleeding.

Bloodwork confirmed that my Iron was really low at a saturation of 5. To improve the iron from blood loss, I also tried iron pills for restoration (too slow) and recently was given to iron infusions which restored my iron sat to normal levels (31). In addition, my doctor prescribed taking B12 tablets daily which also restored me to normal range. I'd ask your doctor to check bloodwork for factors such as these.

In addition, a visit to the emergency room when I was having a low blood pressure episode and confusion (possibly HE), a fecal culture revealed 'positive for blood'. I was encouraged to go off my Beta Blocker (Nadalol) which had already been cut to 1/2 pill or dose daily due to a drop in BP. How's your BP? Do you know if the varices in your stomach are bleeding? Perhaps another endoscopy or fecal culture if iron is low?

Earlier this week, I had the camera pill procedure and am awaiting results. The camera was monitored for 8 hours as it went through my esophagus, stomach and intestines to monitor for additional issues.

Next Tuesday, I am having another endoscopy with the purpose of accomplishing 3 tasks: 1) a liver biopsy, 2) measuring the portal vein pressure and 3) repairing the GAVE. This will be done using one of two methods based on what the camera pill results say and what they are seeing when in there. They can use argon plasma coagulation and electrocautery or radio frequency ablation (RFA). You'd have to look those methods up.

Stay persistent with your doctors. They weren't listening to me so I had my sister call and report that I was lethargic, sleeping way too much and confused. They listened to her and immediately set up a doctor appointment, lab visit and the first iron infusion. I feel so much better just three weeks later! Keep u posted PiperAlfie.