Understanding Portal Hypertension

[Splodge60]

Please can someone explain to me (in a really simple way), what Portal Hypertension is, what are the symptoms and why would I not be informed I have it (by Liver Consultant) when my Diabetic Consultant knows and, once again, nobody has considered it prudent to inform me. Dr Google does not explain this well at all???

[AyrshireK]

BLT website has a page about it at:- britishlivertrust.org.uk/in... If that isn't plain enough i'll post a simpler explanation after my dinner.

Katie

[Splodge60 in reply to AyrshireK]

I can’t download it Katie. Sorry.

[AyrshireK in reply to Splodge60]

It's not a download, that's just a link to the British Liver Trust website. If you want to search for it yourself go to

britishlivertrust.org.uk

From there go down the drop down menu - Information and Support

Under Liver Conditions you've got the A-Z of liver issues and Portal Hypertension page is under P.

Katie

[CarpeDiem11]

Your liver has a vein called the portal vein that carries blood into the liver. This portal vein then carries on into the liver where it has lots of smaller branches of veins. These smaller branches carry the blood. Over time as parts of the liver become damaged (cirrhotic), these little branches cannot carry the blood into the dead/dying part of the liver. However, the blood coming into the liver is still the same amount.

It might help to think of it like this, The portal vein is a motorway carrying 50 cars a minute. Once these cars go into the liver, they divide along the "A" roads. Now each "A" road has, let's say, 10 cars each. Then roadworks appear and one "A" road closes. (Same as the liver becoming cirrhotic). These 10 cars have to go somewhere from the motorway, but the "A" roads are already carrying maximum number of cars. So we get a "tailback".

In the liver this "tailback" causes a builup of blood pressure (portal hypertension). Over time, more and more cars join the "tailback". We've all seen it and the queue gets longer.

In the body, the cars are the blood. The blood gets backed up.

Some people get bored with waiting in the car and try some alternative roads off the motorway. In the body, the blood goes into different veins. These other veins are in the throat (oesophagus) and the stomach.

Of course, these little roads weren't meant to carry this many cars and eventually they become damaged (if the tailbacks keep happening). In the body, the veins in the throat and stomach weren't meant to carry this much blood, they swell up and then eventually burst (variceal bleed).

When you have portal hypertension, then they check regularly to see how swollen these veins in the throat are. If they get too large (stage 3 on endoscopy), they tie them off (banding). It's like putting up a sign on the side roads "No entry".

Symptoms-look for blood in stools. Usually described as black and tarry. What they mean is really sticky (difficult to wipe clean) and black- self-explanatory. Not just slightly darker, obviously blackened (due to blood in the stool). Ther are other symptoms to look out for, but it is best to ask your Consultant, as I know you have a lot of other conditons that might impact on how you feel.

Sorry such a long post, but it needs a lot of explanation. Hope that helped.

[Hidden in reply to CarpeDiem11]

Excellent explanation! Trust10 😃

[CarpeDiem11 in reply to Hidden]

Aw thanks!!

[purple64 in reply to CarpeDiem11]

That was such a good explanation thank you 😊

[CarpeDiem11 in reply to purple64]

Glad it helped and you're welcome

[Splodge60 in reply to CarpeDiem11]

Thank you. That makes it very much better to understand. 🩸🩸🩸🩸🩸

[CarpeDiem11 in reply to Splodge60]

Good to know- especially since you were the one who asked the question I do hope that things are getting better for you, since you seem to have had a lot of difficult times. Sending you best wishes

[Splodge60 in reply to CarpeDiem11]

I’ve done an update but I can’t find it anywhere xxxxx

[deanw41 in reply to CarpeDiem11]

I’m travelling by air...

[CarpeDiem11 in reply to deanw41]

There's always one......... 🤣🤣You'll have to make up your own analogies.

[deanw41 in reply to CarpeDiem11]

I know, I had too😅🤦‍♂️

[degenx_365 in reply to CarpeDiem11]

What an explanation, thanks a ton for that. One question, are only internal stomach and oesophagus veins impacted or veins visible on stomach can be impacted as well ?

[CarpeDiem11 in reply to degenx_365]

I'm afraid I have no idea on that one- I would just be guessing. I don't actually know how the veins on the stomach are connected to the portal vein system. If they are connected to this system, then it would be fair to assume they would be affected in the same way. If they are not connected to this veinous system, then it would be fair to assume they are not affected. I can only say that in all the years I have been reading and commenting on this board, I don't recall anyone saying that these veins had caused a bleed. I don't have any of these veins, so I have no experience of them. Sorry can't be more help.

[AyrshireK in reply to degenx_365]

There are veins on the stomach that can enlarge when you have portal hypertension though they are unlikely to bleed - they are known as caput medusae. P/H causes blood to back up and it tries to divert round the liver or find alternate routes often into vessels that arn't designed for that degree of volume - hence the reason the vein walls bulge out or become dilated/enlarged.

My hubby has one right in the centre of his rib cage and we were told "It's just part of you having portal hypertension!"

Katie

[degenx_365 in reply to AyrshireK]

Thank you both for your answers. I am just a bit worried because have fatty liver and observed visible veins (not bulging like in caput medusa, nor coming out of belly button, just can see green vein inside skin) at the side of my abdomen with a small spider vein branching out (only 1 streak around 1 cm). Know spider veins are quite common in legs but visible veins at right side of my stomach and that tiny spider vein is scaring me a bit, my doc said not to worry but just wondering what else could be the reason, pressure due to obesity, exercise or something else

[AyrshireK in reply to degenx_365]

Spider veins are entirely common and probably are caused by what your doctor is saying rather than anything to do with portal hypertension. Caput medusae due to portal hypertension are completely different they are like giant varicose veins on your abdomen (portal hypertension is a side effect of more advanced liver disease rather than just fatty liver).

[CarpeDiem11 in reply to degenx_365]

Veins that could erupt due to portal hypertension can occur in numerous places that you can't see. I have one near my liver, which caused worry for surgeons before an op I had. However, the surgeon who carried out the op said "he pushed it to one side" and it didn't affect anything. No doubt he softened the blow of what might have been, but nevertheless due to his skills and my body co-operating, I got through. Spider veins can occur due to a number of reasons (apparently they can be hereditary amongst other things), but shouldn't cause you any real problems. If you are concerned speak to the Helpline or a different GP to reassure as clearly it is bothering you. I hope someone is able to reassure you that you don't need to be scared, even though worrying is a natural part of this liver journey unfortunately. Wishing you a restful weekend

[redpoint72]

what a great way of explaining portal hypertension....we'll done. chris

[CarpeDiem11 in reply to redpoint72]

Cheers! It's what works for me I guess, so hopefully works for others

[Hidden in reply to CarpeDiem11]

⭐⭐⭐⭐⭐ go to the top of the class !

[CarpeDiem11 in reply to Hidden]

That made me laugh

[KulG20]

The liver has a pretty diffuse blood supply and little or no nerve supply When it can’t filter toxins Thea kind of back up and if it affects the kidneys ban build up to cause varices in the GI tract and can’t

The varices then burst and if you are asleep the chances of survival are low

Mine happened when sitting on the loo

Luckily my wife was rained in CPR and my brother is GP

We are all now deaing with PTSD related to that night but seeing the football yesterday and what happened to Eriksen when push comes to shove emergency training kicks in

To have your doctor brother help to squeeze for units of blood into your body

Words can’t describe it

My PTSD is related to the time spent in an induced coma

A man of my intellect who can account for los days is diificult to understand