education for patient with portal hypertension

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Portal hypertension is an increase in the pressure within the portal vein (the vein that carries blood from the digestive organs to the liver). The increase in pressure is caused by a blockage in the blood flow through the liver. Increased pressure in the portal vein causes large veins to develop across the esophagus and stomach to get around the blockage. The varices become …

What is the purpose of the patient portal?

Portal hypertension is a term used to describe elevated pressures in the portal venous system (a major vein that leads to the liver). Portal hypertension may be caused by intrinsic liver disease, obstruction, or structural changes that result in increased portal …

How serious is portal hypertension?

Jan 21, 2022 · Liver Int. 2015 Nov. 35 (11):2416-24. [Medline]. Salzl P, Reiberger T, Ferlitsch M, et al. Evaluation of portal hypertension and varices by …

How to evaluation of portal hypertension?

Dec 18, 2021 · Portal hypertension is increased pressure within the portal venous system. It is determined by the increased portal pressure gradient (the difference in pressures between the portal venous pressure and the pressure within the inferior vena cava or the hepatic vein. This pressure gradient is normally less than or equal to 5 mmHg. A pressure gradient of 6 mmHg or …

What is patient teaching for hypertension?

Portal hypertension is high blood pressure in the portal vein. The portal vein is located in your belly (abdomen). It gets blood from your digestive organs (large and small intestines, stomach, pancreas, spleen) and carries it to the liver. The liver cleans and filters waste from the blood. The blood then travels to the heart and into general circulation for your body to use.

How do you manage portal hypertension?

The effects of portal hypertension can be managed through diet, medications, endoscopic therapy, surgery, or radiology. Once the bleeding episode has been stabilized, treatment options are prescribed based on the severity of the symptoms and on how well your liver is functioning.Nov 16, 2017

Which intervention is most appropriate for a person with portal hypertension?

Liver transplantation is the ultimate shunt, because it relieves portal hypertension, prevents variceal rebleeding, and manages ascites and encephalopathy by restoring liver function.Nov 30, 2017

Can you exercise with portal hypertension?

Conclusions: The present study shows that moderate exercise increases portal pressure and may therefore increase the risk of variceal bleeding in patients with esophageal varices. These findings suggest that cirrhotic patients with portal hypertension should be advised of potential risks during exercise.

What foods are good for portal hypertension?

What to EatFruits and vegetables (raw or cooked without butter, oil, or salt)Eggs, egg whites.Cooked fish (salmon, tuna)Lean chicken or turkey (without the skin)Low-fat Greek yogurt.Cream cheese, ricotta.Hard cheeses (cheddar, mozzarella)Nuts and seeds (unsalted)More items...•Sep 30, 2021

What is a TIPS procedure for?

A TIPS is used to treat the complications of portal hypertension, including: variceal bleeding, bleeding from any of the veins that normally drain the stomach, esophagus, or intestines into the liver. portal gastropathy, an engorgement of the veins in the wall of the stomach, which can cause severe bleeding.

What does portal hypertension treatment aim to reduce?

Treatment. Medical treatment of portal hypertension includes betablockers, which are known to many as drugs to improve blood pressure and heart function. This class of drugs helps to decrease blood flow into the portal-vein system, decreases pressure and reduces the risk of bleeding from varices.

Which exercise is good for liver?

Regular exercise and have an active lifestyle Exercise decreases stress on the liver, increases energy levels and helps to prevent obesity – a risk factor for liver disease. Aim for a total of 150 minutes of exercise, such as brisk walking or swimming per week.

What exercise is good for liver cirrhosis?

The American College of Sports Medicine and their Exercise Is Medicine program suggest that patients with chronic liver disease engage in moderate-intensity aerobic activity, (e.g., walking at a pace where you can maintain a conversation with the person next to you), for at least 150 minutes per week.Jun 1, 2021

How do you monitor portal hypertension?

How Is Portal Hypertension Diagnosed? Usually, doctors make the diagnosis of portal hypertension based on the presence of ascites or of dilated veins or varices as seen during a physical exam of the abdomen or the anus. Various lab tests, X-ray tests, and endoscopic exams may also be used.Dec 7, 2020

What is the most common complication of portal hypertension?

Variceal hemorrhage is the most common complication associated with portal hypertension. Almost 90% of patients with cirrhosis develop varices, and approximately 30% of varices bleed.Nov 30, 2017

Which fruit is best for liver?

Fill your fruit basket with apples, grapes and citrus fruits like oranges and lemons, which are proven to be liver-friendly fruits. Consume grapes as it is, in the form of a grape juice or supplement your diet with grape seed extracts to increase antioxidant levels in your body and protect your liver from toxins.Jul 30, 2019

Is coffee good for liver?

Coffee also lowers the risk of other liver conditions including fibrosis (scar tissue that builds up within the liver) and cirrhosis. Drinking coffee can slow the progression of liver disease in some patients. Beneficial effects have been found however the coffee is prepared – filtered, instant and espresso.

Fact Sheets About Hypertension and Related Conditions and Behaviors

Facts About Hypertension: Stay up to date on the latest facts about hypertension from the CDC.

Resources from Other Organizations

The following web sites include patient-friendly links and resources about hypertension (high blood pressure):

Tools for Community Health Workers (CHWs)

Hispanic populations have low control rates for hypertension, a major risk factor for heart disease and stroke. Also, they have high prevalence of high blood cholesterol, and their diets are often high in salt and saturated fats. Reaching these audiences with effective messages about prevention can be challenging.

What is portal hypertension?

Portal hypertension is a pressurein the portal venous system that is at least 5 mm Hg higher than the pressure in the inferior vena cava. This increased pressureresults from a functional obstruction to blood flow from any point in the portal system's origin (in the splanchnic bed) through thehepatic veins (exit into the systemic circulation) or from an increase in blood flow in the system.

What is the most common cause of portal hypertension?

Cirrhosis is the most common cause of portal hypertension, and chronic viral hepatitis C is the most common cause of cirrhosis in the United States. Alcohol-inducedliver disease and cholestatic liver diseases are other common causes of cirrhosis. Less common causes include hemochromatosis, alpha 1-antitrypsin deficiency,drug-induced liver disease, and (in Eastern countries) hepatitis B. Portal hypertension is considered an advanced complication of cirrhosis. Once it has developed, theterm "decompensated cirrhosis" is used (Figure 5).

What is the normal portal vein pressure?

Venous pressure morethan 5 mm Hg greater than the inferior vena cava pressure is defined as portal hypertension. Clinically it may be difficult to detect portal hypertension until pressuresare much higher. There are many causes of portal hypertension including etiologies above the liver, within the liver, and below the liver.

Can gastric mucosa cause bleeding?

Bleeding can also occur from the gastric mucosa. Due to blood flow changes in mucosa, the integrity is often compromised and very friable. This is called portalhypertensive gastropathy. There is no effective management except relief of portal hypertension.

Is splenomegaly a portal hypertension?

Enlargement of the spleen, or splenomegaly, is a common occurrence with portal hypertension (Figure 21). There is little correlation between the size of the spleenand the severity of portal hypertension. Hypersplenism with sequestration of platelets and leukocytes is a common phenomenon. Generally, there is no indication forplatelet transfusions unless an invasive procedure is planned, and splenectomy is not indicated. Both hypersplenism and splenomegaly resolve (though not alwayscompletely) with decompression of portal hypertension.

What is the purpose of shunting in portal hypertension?

The aim of surgical shunting in portal hypertension is threefold: 1) to reduce portal venous pressure, 2) to maintain hepatic and portal blood flow, and 3) to try toreduce or not complicate hepatic encephalopathy ( Figure 16). Currently, there is no procedure that reliably and consistently fulfills all of these criteria.

What is the standard diagnostic approach in patients with acute gastrointestinal hemorrhage after initial resuscitation

Endoscopy is the standard diagnostic approach in patients with acute gastrointestinal hemorrhage after initial resuscitation. In most patients with cirrhosis (60–80%)bleeding is related to esophageal varices. In addition to making a definitive diagnosis, endoscopic therapy may be indicated for bleeding. Endoscopic examinationmay require endotracheal intubation in patients who have significant alteration in mental status as a result of severe hepatic decompensation.

Where is portal hypertension located?

What is portal hypertension? Portal hypertension is high blood pressure in the portal vein. The portal vein is located in your belly (abdomen). It gets blood from your digestive organs (large and small intestines, stomach, pancreas, spleen) and carries it to the liver.

What are the symptoms of portal hypertension?

Call your healthcare provider right away if you notice any of these symptoms: Yellowing of the skin. Abnormally swollen belly. Unexpected weight loss. Vomiting of blood or what looks like coffee grounds.

How does liver disease affect blood flow?

The blood then travels to the heart and into general circulation for your body to use. With liver disease, blood flow can be blocked through the liver. This raises the pressure in the portal vein. When you have portal hypertension, this increased pressure makes it harder for blood ...

What tests are needed for cirrhosis?

If you are at risk for or already have cirrhosis, you may need several tests: Lab tests. You may have various blood tests. A low platelet count is the most common sign of portal hypertension. Imaging tests. These give your provider pictures of the liver or blood flow in the liver.

What to do if you have internal bleeding?

If you have internal bleeding because of portal hypertension, your healthcare provider might inject medicine into the vein to help stop the bleeding. Or they may place bands around veins to stop the bleeding. Shunting. If you have a severe case, you may need shunting.

What is a varices in the esophagus?

Esophageal varices are enlarged veins at the lower end of the esophagus. With portal hypertension, blood backs up in nearby veins in the esophagus and stomach, causing varices. Varices are a serious problem. They can burst and cause internal bleeding. This often happens where the esophagus and stomach meet.

What is the scarring of the liver called?

Scarring of the liver (called cirrhosis) Clotting of the portal vein. Clotting of the veins in the liver. In developing countries, one of the most common reasons is an infection called schistosomiasis.

How to treat ascites?

To treat ascites, healthcare providers prescribe medications called diuretics, which help the body excrete excess fluid. They also recommend that people with the condition reduce the amount of sodium they consume. (See "Patient education: Low-sodium diet (Beyond the Basics)" .)

What are the symptoms of cirrhosis?

When these organs are affected, people can have fatigue, trouble breathing, chest pain, and other symptoms. Liver cancer — People with cirrhosis have an increased risk of developing liver cancer, especially if their cirrhosis was caused by hepatitis B, hepatitis C, nonalcoholic steatohepatitis, or hemochromatosis.

Why does my abdomen swell?

Ascites (abdominal swelling) — For reasons that are not entirely understood, people with cirrhosis sometimes accumulate fluid in the abdomen. This condition, called ascites, causes the abdomen to swell. Ascites can also cause a person to feel short of breath or full.

What causes cirrhosis in the liver?

The most common causes of cirrhosis include alcohol abuse, chronic hepatitis B or C (viral infections that affect the liver), and fatty liver disease (often seen in people with obesity or diabetes).

Where is the liver located?

CIRRHOSIS CAUSES. The liver is a large organ (weighing about three pounds) that is located in the right upper abdomen beneath the rib cage ( figure 1 ). It performs many functions that are essential to life. The liver is able to repair itself when it has been injured.

Why is the liver not working?

That's because one of the jobs of the liver is to break down medications and clear them out of the blood. When the liver is not working well, those medications can build up in the body and become toxic. Separately, some medications can have side effects that worsen the complications of cirrhosis.

What causes redness in the fingers?

As the pressure builds up, blood backs up into nearby blood vessels, primarily in and around the esophagus and intestines. Changes in the hands — Cirrhosis can affect the hands, causing the palms to redden, the nails to whiten or develop white stripes, and the tips of the fingers to widen.

What is the management of portal hypertension?

For this reason, the management is multidisciplinary with an interprofessional team of healthcare professionals required including a nurse, nurse practi tioner, pharmacist, primary care physician, gastroenterologist, a hepatologist and a transplant team with the possible need of a cardiologist and a pulmonologist, depending on the severity of the disease. All healthcare workers should follow these patients and monitor them. Pharmacists should ensure that they are on the correct medications and are taking them correctly and are medication compliant, reporting any issues to the clinicians. Nurses will take care of these patients during their visits to the clinic or at the hospital if they get admitted. They will check their vitals, diet, and are the first to notice any changes in their mental status or hemodynamics. Clinicians should follow up with these patients on regular bases and make sure they are up to date on their immunizations, appropriate screening such as for esophageal varices and hepatocellular carcinoma, diet, medications, functional status, and mental health. Without proper management from an interprofessional team, the morbidity and mortality from portal hypertension are high. [Level 5]

What is portal hypertension?

Portal hypertension is increased pressure within the portal venous system. It is determined by increased portal pressure gradient (the difference in pressures between the portal venous pressure and the pressure within the inferior vena cava or the hepatic vein. This pressure gradient is normally less than or equal 5 mmHg. A pressure gradient of 6 mmHg or more between the portal and hepatic veins (or inferior vena cava) suggests the presence of portal hypertension in most cases. Portal hypertension is the most frequent cause of hospitalization, variceal bleed, liver transplantation, and death in patients with cirrhosis. This activity illustrates the evaluation and management of portal hypertension and highlights the role of the interprofessional team in improving care for the patient with this condition.

Why does portal hypertension increase blood flow?

This increased blood flow is due to the increased release of splanchnic vasodilators because of increased shear stress and reduced effective arterial volume. Thus portal hypertension is a result of both increased resistance to portal venous flow and increased portal blood flow due to splanchnic vasodilation.

How to determine portal hypertension?

Portal hypertension is increased pressure within the portal venous system. It is determined by the increased portal pressure gradient (the difference in pressures between the portal venous pressure and the pressure within the inferior vena cava or the hepatic vein. This pressure gradient is normally less than or equal to 5 mmHg. A pressure gradient of 6 mmHg or more between the portal and hepatic veins (or inferior vena cava) suggests the presence of portal hypertension in most cases. [1] When the pressure gradient is greater than 10 mmHg, portal hypertension becomes clinically significant. A pressure gradient between 5 to 9 mmHg usually reflects subclinical disease. This gradient is measured by determination of the hepatic venous pressure gradient (HVPG). [1] Portal hypertension develops when resistance to portal blood flow increases. This resistance often occurs within the liver, as in cirrhosis. It can also be outside of the liver, such as prehepatic in portal vein thrombosis or posthepatic in the case of constrictive pericarditis or Budd-Chiari syndrome. Identification of the level of resistance to portal blood flow allows the determination of the cause of portal hypertension. This condition is the most frequent cause of hospitalization, variceal bleed, liver transplantation, and death in patients with cirrhosis. Gilbert and Carnot coined the term "portal hypertension" in 1902.

What is the most common cause of portal hypertension in the Western world?

Cirrhosis of the liver is the most prevalent cause of portal hypertension in the Western world. However, schistosomiasis is the most frequent cause in the African continent where schistosomiasis is endemic. [1]

Is portal hypertension reversible?

Management of portal hypertension depends on its cause. If there are reversible causes, the clinician should attempt to correct them. For example, if there is thrombosis in the portal vein or the inferior vena cava due to a hypercoagulable state, it needs anticoagulation.

What is the portal vein?

The superior mesenteric vein and splenic vein join to form the portal vein. It drains into the liver before dividing into the right and left portal veins into both lobes, respectively. It supplies two-thirds of the blood to the liver. The portal vein pressure is typically between 1 to 4 millimeters of mercury more than the hepatic vein pressure. This pressure differential enables blood to flow through the liver into the systemic circulation. The veins do not have valves. If there is resistance to the flow of blood in the portal venous tract, it leads to elevated portal venous pressure, as seen in portal hypertension. The resistance occurs more commonly within the liver, as seen in cirrhosis, but it can also be pre-hepatic or post-hepatic.

Fact Sheets About Hypertension and Related Conditions and Behaviors

See more on cdc.gov

Resources from Other Organizations

Tools For Community Health Workers