Syndrome of portal hypertension: signs, methods of treatment
Portal hypertension syndrome is a condition that most often occurs as a result of cirrhosis of the liver (HC). Due to the fact that the connective tissue in the liver begins to replace normal cells, the smallest elements of the circulatory system - capillaries, called sinusoids - are shut off from the intrahepatic blood flow. Blood begins to flow through bypasses, pressure increases in the portal vein, which carries blood to the liver, and this manifests itself in certain signs.
Symptoms of portal hypertension
Doctors distinguish several signs of this pathology:
- varicose dilation of special localization;
- ascites;
- enlargement of the spleen - splenomegaly;
- gastropathy.
The first sign is most often revealed only when one of the dilated veins bursts and bleeding begins. Varicose nodes are usually located in the area of the lower third of the esophagus, and much less often - in the stomach and around the rectum. Bleeding can be profuse and accompanied by heavy blood loss up to hemorrhagic shock.
Ascites is associated with the fact that the surface of the damaged liver ceases to be dense. Resembling a sponge, it begins to pass through itself a liquid rich in protein. Because of this, by the way, patients with liver cirrhosis lose weight intensively.
Splenomegaly and accompanying hypersplenism is manifested by a decrease in the production of some cellular elements of the blood - erythrocytes, platelets. As a result, anemia and thrombocytopenia occur, accompanied by the appearance of small and large hemorrhages on the skin. This is a bad prognostic sign, a sign that an adverse outcome is imminent.
Gastropathy most often occurs after manipulations on the veins of the esophagus, called "sclerotherapy" (introduction of special solutions into the veins, after which the vessels are completely closed).
Treatment of portal hypertension
Because liver cirrhosis is an irreversible condition, its ideal treatment is a liver transplant. Unfortunately, not every patient is "lucky enough" to wait for a donor organ, so while a person is on the waiting list, they are treated medically, applying two principles: ensuring the liver's functional rest and correcting its vascular network.
To achieve the first goal, the patient is prescribed diet No. 5, excluding fatty, fried, spicy foods, herbal bitters, alcohol, coffee, tea, marinades and smoked meats, and fresh bread.
To reduce the production and absorption of toxic products of food digestion from the intestine, lactulose preparations are prescribed - Dufalak, Lactovit, Normase. To improve the microbial composition of the intestines and effective absorption of food, it is recommended to take pro- and prebiotics. This group of drugs helps the body synthesize vitamins and amino acids that the damaged liver is no longer able to produce. In addition, microbial preparations have detoxifying properties.
Ursodeoxycholic acid drugs help reduce the load on liver cells by improving bile metabolism. Also, in case of portal hypertension, the introduction of glucose, amino acid and fat mixtures adapted to the needs of patients with liver diseases, and vitamins is recommended.
To improve microcirculation in the liver, drugs from the statin group are used, which cause expansion of intrahepatic vessels - sinusoids. Nitrates (sodium nitroprusside) are also prescribed for this purpose, however, with long-term use, these drugs can cause the opposite effect.
Pentoxifylline and antioxidants in general improve the viability of liver cells, reduce the frequency of serious complications of cirrhosis.
The basis of the treatment of portal hypertension is the use of drugs that narrow the vessels of the liver and reduce the pressure in the portal vein. Such drugs include terlipressin, midodrine, norepinephrine, propranolol, carvedilol. Also indicated is the administration of albumin, which helps to preserve fluid in the bloodstream, preventing ascites, and normalizing the pressure in the portal vein system.
Portal hypertension is a condition that requires constant treatment. The site dobrobut.com recommends carefully following the doctor's instructions in order to prolong the patient's life and improve its quality as much as possible.
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