How to treat portal hypertension

  The vast majority of portal hypertension is caused by cirrhosis after viral hepatitis. Many patients have symptoms such as weakness and loss of appetite, but the most typical clinical symptoms include splenomegaly, anemia, leukopenia and thrombocytopenia, vomiting blood and passing black stools, and abdominal distention. Gastrointestinal bleeding is a common cause of death in cirrhotic portal hypertension. The development of portal hypertension in patients with cirrhosis is inevitable and progressively aggravated. The progression of portal hypertension can be delayed with good out-of-hospital management and regular in-hospital screening and timely treatment of viral hepatitis. Good out-of-hospital management includes the following aspects: (1) Rest: Patients with portal hypertension generally do not emphasize bed rest during the period of liver function compensation, and those with mild disease can participate in general work appropriately but should reduce the working hours and labor intensity, pay attention to the combination of work and rest, in order not to feel fatigue. Those who are more seriously ill or have recently had complications such as gastrointestinal hemorrhage should stop working to ensure sufficient bed rest and sleep time to prevent fatigue, rest can facilitate the improvement of liver microcirculation to promote liver cell regeneration and repair to reduce liver damage.  (2) Diet: Since the entire gastrointestinal function of the patient is affected, high-calorie, easy-to-digest soft food should be given. For patients with chronic liver disease, a proper diet can supplement nutrition, improve liver metabolism, enhance body resistance, promote liver cell regeneration and repair, and prevent various complications from occurring. In principle, it is advisable to give foods with sufficient calories and rich in various vitamins, which contain not only high sugar, high protein (protein intake should be limited for those with hepatic encephalopathy), appropriate fat and vitamins, but also various inorganic salts and trace elements. Food is mainly soft food, should avoid the risk of bleeding caused by mechanical damage to the esophagogastric mucosa caused by hard and rough food, try to control spicy and irritating food, alcohol is strictly prohibited.  (3) Treatment of ascites: the appearance of ascites is a manifestation of impaired liver function to a certain degree, the worse the liver function ascites is more difficult to eliminate, so the treatment of ascites focuses on correcting and restoring liver function. Limit water consumption, less salt diet is basic. If the patient has more ascites, it is necessary to give supplemental albumin with diuretic drugs to increase the discharge of water, stubborn ascites can sometimes only be released by abdominal puncture to reduce the patient’s discomfort.