carvedilol and portal hypertension

Hi. Thank you for writing. Note that a beta-blocker treatment will not stop or prevent varices. Varices are a complication of cirrhosis and can only be "cured" when a person no longer has cirrhosis. The good news is that varices and the portal hypertension can usually be controlled (reducing the blood flow and pressure) with use of a beta-blocker.

I find so much info on treatment and cirrhosis but cannot find anything on spleen or portal hypertension. I hope it helps and hope your uncle continues to do well!

Do you take any medication? Have you seen a doctor? If yes, do you have any diagnosis : heart or something else?

So you are already taking 10mg of propranolol for your portal hypertension caused by your portal vein thrombosis (PVT). Propranolol is the most commonly used drug for portal vein obstruction. Combined with endoscopic banding treatment they are the standard first line of treatment. Do you know why she don't just increase the dosage? Now she wants to add another beta blocker in addition to propranolol? Has your doc talked to you about anticoagulation therapy?

how bad is portal hypertension,and how long does it take to become a very nasty problem

I have recently been prescribed Amlodipine-Benaz 5/10 MG capsules for treatment of hypertension. However, my resting pulse rate has consistently been in the 90's and increasing into the 100's at time, so I have been prescribed Carvedilol to help control the heart rate. My question is, doesn't Carvedilol control hypertension as well...Why should I be taking carvedilol in addition to amliodipine?

TIPS is the only way to mdecrease portal hypertension appreciably. There is still some hope that there can be some interval improvment but more likely not.

HCC is primary liver cancer, which cirrhosis predisposes to. the portal hypertension will lessen and hopefully resolves over time but the sdcarring in the liver takes a much time to regress and that is what places the individual at risk. I do not think that you reached the point of no return so keep doing what you're doing.

Scar tissue in the liver (caused by scaring of the liver/cirrhosis) can interfere with that blood flow...... causing pressure to build up in the portal vein (portal hypertension), and the spleen to enlarge (splenomegaly). As the spleen enlarges, it traps platelets. (The amount of platelets in the bloodstream is reduced.) So usually--- people with cirrhosis end up having a problem with portal hypertension and an enlarged spleen, and a reduced platelet count in the bloodstream.

I am assuming you have esophageal varicies due to your portal hypertension and that is why you are taking the beta blocker propranolol to treat your portal hypertension is that correct?

Lisinopril and Metoprolol when I left the hospital, now Lisinopril and carvedilol (coreg). seems like a relatively common combination.

The portal vein supplies the majority of blood to the liver. That blood comes from the GI tract and the spleen. When scar tissue in the liver (cirrhosis) interferes with that blood flow (some patient with stage 3 can begin to have spleen enlargement (splenomegaly)--- pressure can build in the portal vein ("portal hypertension"). Portal Hypertension can cause the spleen to enlarge and varices to form in the GI tract.

If so an enlarged spleen is a complication that occurs because of the cirrhosis and the resulting portal hypertension. It is a condition that is the result of the cirrhosis and portal hypertension and not a condition of the spleen itself. There is no treatment for an enlarge spleen resulting from cirrhosis. Only when the cirrhosis is reversed can the enlargement of the spleen be resolved.

If you had a liver transplant, you would no longer have portal hypertension. And as long as the portal hypertension is the only cause for the pulmonary hypertension, then you would theoretically be cured.

Whether celiac disease can cause portal hypertention in some way I do not know. But I can explain cirrhosis and portal hypertension and their relationship in typical liver disease caused by most causes of liver disease such as alcoholic liver disease, hepatitis B and C infection, fatty liver disease etc. Typically cirrhosis of the liver is easy to diagnose. With a one minute physical exam a doctor should be able to detect if someone has cirrhosis.

Once your liver has become fibrotic enough to cause portal hypertension, then your collateral vessels will be affected (if linked to the portal venous system). But these are mostly internal as in: gastric varices, esophageal varices or other upper and lower GI collaterals. Your outer surface stomach region may show some strange vein issues due to the recanalisation of the paraumbilical vein, but these are quite pronounced (scary looking too, called "caput medusae").

although it is possible he does not have cirrhosis and only alcoholic hepatitis this in itself is a life threatening condition as are all the other complications of portal hypertension. Although many of these things can be reversible eventually people reach the point of no return. He needs to enter a structured relapse prevention program ASAP if at all possible.

The preferred, albeit indirect, method for assessing portal pressure is the wedged hepatic venous pressure (WHVP) measurement, which is obtained by placing a catheter in the hepatic vein and wedging it into a small branch or, better still, by inﬂating a balloon and occluding a larger branch of the hepatic vein. This is rarely done as the exact pressure is not needed and what is important is to stop the resulting complications such as life-threatening variceal bleeds. Also .

It sounds like you have significant liver disease, and certain beta-blockers (like nadolol) can help lessen portal hypertension and reduce the risk of esophageal varices, which can be a dangerous complication for cirrhotics. Hope that helps.

Festi explained that the prognosis of compensated cirrhotic patients is strongly associated with the development of portal hypertension, and the gold standard for evaluating portal hypertension is the hepatic venous pressure gradient. However, it is an invasive technique that should be performed only by highly experienced operators. Potential complications include bleeding and supraventricular arrhythmias.

Granted I did work all week and pushed myself a bit too far this week, but do not really understand what life with no virus but cirrhotic liver and portal hypertension entail? Many of you have helped me along the way, but this is something new? Am I to expect the payback of a hard week at work equals liver pain? I do not yet know the symptoms to be on guard for the portal hypertension. . . My endoscopy this past Feb did not indicate the need for banding yet.

I had a colonoscopy and endoscopy today. I thought I was going to get good news or at least hoped for it. Well the colonoscopy revealed some small valleys in the colon (diverticulosis) hemmeroids, IBS, etc etc. NOW when he did the esophogus that was a different story all together. He noticed bulging veins in my esophogus!!!!! I am sooooooooo frightened. He said he took a biopsy of the tissue to look for inflammation..............

Carvedilol and portal hypertension

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