Portal hypertension is a serious condition caused by an increase in blood pressure within the portal venous system. There are veins that come in from the spleen, intestines, stomach, and pancreas and form the portal vein, which then branches off and travels through the liver. When the liver is damaged, the blood cannot flow through, and high pressure develops. Without proper treatment, a patient can suffer from complications, some of them very severe. There are several ways to treat and even prevent portal hypertension.
Medications can be used by themselves or in conjunction with endoscopic therapy. The goal is to reduce the risk of bleeding by reducing the varices’ pressure, which is caused by the liver not being able to handle the blood flow sent to it through the portal vein. When this happens, the blood causes pressure on various blood vessels, including in the esophagus. If a doctor feels the varices may be at risk for bleeding, they may recommend beta-blockers, which are used to help reduce blood pressure. Beta blockers work by reducing the heart’s beating, which in turn reduces blood pressure. There is also a medication, known as lactulose, that can help treat confusion and changes in mental status due to encephalopathy.