Hepatitis C, Cirrhosis, and Portal Hypertension

Hepatitis C can often lead to a domino effect of complications. For example, left untreated, hepatitis C can lead to cirrhosis (severe scarring of the liver). Patients with cirrhosis are at higher risk for associated conditions like liver cancer and/or portal hypertension, varices, ascites, and others. Also, portal hypertension may develop in the liver, regardless of the cause of cirrhosis.

What is portal hypertension?

Portal hypertension is an increase in pressure within the portal vein that carries blood to the liver from your digestive organs. The vein is the vital blood supply to your liver.

Symptoms of portal hypertension

Symptoms include...

• High blood pressure can result from increased blood pressure within the portal veins that supplies blood to the liver from the digestive organs.
• Encephalopathy (brain function affected by toxins in the brain): When liver function is impaired to the point of not being able to filter toxins and ammonia out the body, it can cause confusion or brain fog.
• Edema and Ascites: Portal hypertension can cause increased fluid in the legs (edema) and abdomen (ascites) resulting in swelling.
• Splenomegaly: Enlarged spleen can result from portal hypertension.
• Low levels of white blood cells and platelets can be caused by portal hypertension. (Platelets are cells in the blood responsible for clotting.)
• Internal Bleeding: Problems with blood flow causing small veins to increase in size and become swollen (varices) can occur with portal hypertension. With increased blood pressure, these small veins can rupture and cause bleeding that can be life-threatening. Internal bleeding from portal hypertension can commonly occur in the lower part of the esophagus or stomach.

If internal bleeding occurs, the patient can experience changes in their stool, resulting in black or tarry stool or blood. Vomiting blood can also occur. If the liver can’t make enough platelets, bleeding can be difficult to control.

Treating portal hypertension

Your doctor may recommend...

• Regular exams and tests like blood work, endoscopies, and sonograms will help monitor complications from portal hypertension and will help your liver specialist know how to treat your condition.
• An endoscopy procedure called banding or sclerotherapy helps stop the bleeding in the blood vessels. Banding is the placement of bands to block the unhealthy blood flow to the enlarged veins.
• A procedure called TIPSS (which is a nonsurgical transjugular intrahepatic portal-systemic shunt) can be done to control acute bleeding. This creates new paths for blood to flow from the portal vein to the other blood vessels.
• Medications such as beta-blockers can also help reduce blood pressure and relax the amount of pressure in the veins.
• Other medications can be given to help reduce the risk of high pressure in the veins and reduce bleeding.

Other ways to help

Other options include...

• No Smoking
• No alcohol of any type
• Eating a nutritious diet free high sodium and processed foods
• Maintaining a healthy weight

If you have hepatitis C, seek treatment as early as possible to avoid complications such as cirrhosis. If you have been diagnosed with cirrhosis, have a regular check-up with your liver specialist and be proactive about your condition.