Advice re: ‘widespread portal hypertensive gastropathy’ following gastroscopy.

[OfftowalktheCamino]

Hi all

My husband recently saw a Gastroenterologist following result of an ultrasound which showed enlarged liver & spleen. He also had high liver enzyme results following blood tests. Was referred for CT scan of stomach/pelvis & gastroscopy. He has also been referred for a Fibro Scan due to concerns that he has cirrhosis with advanced fibrosis. Still waiting for a date for that. He has been a heavy drinker for years, but has been abstinent now for several weeks due to concerns about his health - it has really scared him!

The results of the procedure showed ‘widespread portal hypertensive gastropathy’ - but no varices. He is going to have his omeprazole increased and needs to have another scan in 8 weeks.

Sorry for the long post - my question is does anyone know if this damage can be reversed? Does it usually lead to varices? He has an appt for a follow up to explain results of CT scan and gastroscopy - but this isn’t for another 6 weeks.

Thank you for taking time to read this post. I would be grateful for any thoughts.

[BritishLiverTrust3 Administrator British Liver Trust]

Dear OfftowalktheCamino,

If you would find it useful to talk things over, our nurse-led helpline is open Monday to Friday from 9am to 3pm on 0800 652 7330 (excluding bank holidays)

Best wishes

British Liver Trust

[Kristian]

It's difficult to say if the portal hypertension could be reversed as its not clear how advanced any liver disease is. However, if the cause is alcohol and he has abstained from that, and continues to do so, then there is a very good chance that any further damage can be halted and further progression can be very much reduced or even stopped. There may also be some improvements seen too.

I'm guessing some follow up will be arranged to discuss all the test results once they are available and that would be a good chance to ask this very question of your gp, or hospital specialist. They will be happy to give you a clearer picture on the possibilities. However, there are many stories on this forum of folks that have seen an improvement once they've abstained from alcohol. So there can still be positive outcomes even if the diagnosis isn't ideal.

[DB50 in reply to Kristian]

The varices ‘can’ resolve. Endoscopy found one low-risk oesophageal varix, and one low-risk gastric varix, in 2021, two years after I was diagnosed with cirrhosis in 2019.

In 2023 the oesophageal varix had disappeared and the gastric one unchanged.

I stopped drinking alcohol completely in 2019. There have been signs of portal hypertension continuously since, although no pressure readings to confirm extent.

The main thing is to stay off booze, if at all possible. I’m so much happier without it, which I simply wouldn’t have believed five years ago.

Good luck,

Richard

[OfftowalktheCamino in reply to DB50]

Thanks Richard. That sounds very positive and what an achievement to have given up alcohol in 2019. Early days yet for my husband, but he seems determined not to drink again. It’s all a bit scary, but there are lots of positive comments on this forum from people who have cirrhosis and are doing well.

[OfftowalktheCamino in reply to Kristian]

Thanks for your reply Kristian. Follow up appt is in 6 weeks. So will hopefully have more information then.

[Kristian in reply to OfftowalktheCamino]

Yeah, that'll be a food time to ask all those questions you may have.

[Chick_atee in reply to Kristian]

Hi,

I take carvedilol 2 x daily to control portal hypertension. I am due an Ultrasound with doppler next week to check the pressure and flow. Hopefully there will be a change as I’m considered for the most part re compensated. This is how it’s checked. I’ll post here if I get any more info. There is a chance that one may be able to stop the meds after 5 years or so if all is well. I asked and that is what I was told.

[Aotea2012]

I was in a similar position in March 21. I had 2 minor varices and PHG. I’m pleased to say both have now gone. They were caused by alcohol and I haven’t drunk anything in 3 years. So with abstinence it is possible for your health to recover. My consultant says that the liver is notoriously unpredictable so it was very difficult to give me an accurate prognosis when I was first diagnosed. His advice was to abstain and follow my dietician’s advice and then give my liver a chance. It worked. I feel very well. I take no meds and whilst I have cirrhosis, it doesn’t really cause any symptoms.

[OfftowalktheCamino in reply to Aotea2012]

Thank you for replying. It gives me hope to hear that you are doing well. It just shows how making the right positive changes can have a beneficial impact.