There is no specific symptom associated with portal hypertension. The chances of developing this disease increase with diseases of the liver such as cirrhosis. The complications or symptoms associated with portal hypertension are:
Treatment of portal hypertension is focused on the prevention and management of the complications associated with the disease, especially bleeding. The severity of the disease is dependent on the extent of liver function. Modification in diet, medications, surgery and endoscopic procedure can help combat the complications of portal hypertension.
Higher mortality and morbidity rates are reported in patients with severe and persistent gastrointestinal hemorrhage. 90% of complicated cases (due to cirrhosis) of portal hypertension cause variceal hemorrhage.
The mortality rate of the patients who show the first episode of variceal hemorrhage is around 50%, while that with known diagnosis of esophageal varices is 30%.
Patients who report at least one episode of bleeding from the esophageal varices have 80% chances of re-bleeding within 1 year. In patients with esophageal varices, complications arising from immune, cardiovascular, pulmonary, cardiovascular systems contribute to around 20-65% of the deaths .
Cirrhosis of the liver is the most important cause of portal hypertension. Cirrhosis is the aftermath (healing) of the liver injury which is caused by hepatitis, or excessive alcohol consumption. The scar in the liver, which is caused due to cirrhosis, blocks the flow of blood through this organ affecting its function.
There are some other causes of portal hypertension namely:
Portal hypertension is the most common manifestation of the liver. In the United States, the deaths associated with the liver cirrhosis (of which portal hypertension is a manifestation) is around 30,000. The international data for portal hypertension is not known, though 30% and 70% of patients with compensated and decompensated cirrhosis respectively suffer from portal hypertension at the time of diagnosis.
In Sub-Saharan Africa, Sudan and Egypt, the most common cause of portal hypertension is Schistosomiasis, while in South America, the Far-East and Southeast Asia, hepatitis B contribute to this condition.
More than 60% of the patients with cirrhosis (which eventually causes portal hypertension) are men; hence gender plays a significant important role in the etiology of the disease. Among children, portal vein thrombosis and secondary biliary cirrhosis contribute to esophageal varices  .
Portal vein carries the blood from the large and small intestine, stomach and spleen to the liver. Any obstruction of this vein can cause complications leading to portal hypertension.
This change causes an increase in the venous pressure, leading to development of collateral circulation which diverts the blood to the systemic veins. High portal pressure is responsible for the development of the portosystemic collaterals, including esophageal varices   .
When there is an increase in blood pressure in the system of veins referred to as a portal system, it is called portal hypertension.
Normal portal pressure ranges between 5 mmHg and 10 mmHg. Generally a portal blood pressure of greater than 12 mmHg causes complications such as ascites and varices. Two factors that contribute to the development of portal hypertension are vascular resistance and blood flow .
Obstruction in the portal vein (the blood vessel that carries blood from the intestines, stomach and spleen to the liver) leads to the development of collateral circulation, causing portal hypertension.
Though there are no specific symptoms of the disease, blood in the stool or in vomit can be considered as reason enough to visit the doctor. Some of the other symptoms of portal hypertension are
Though the treatment of the disease remains a challenge, management strategy of disease is focused on the prevention of the complications. Beta-blockers and lactulose are some medications which are prescribed to patients with portal hypertension. Treatment with endoscopic therapy has been proved to be most effective.