All you wanted to know about Portal Hypertension

Dr. Manish Joshi is a Consultant Surgical Gastroenterologist, GI Oncologist and Advanced Laparoscopic Surgeon at the BGS Global Hospitals, Bangalore. He had earlier served as Head of Surgical Gastroenterology services at St. John’s Medical College Hospital, Bangalore for almost 3 years. 

What is Portal Hypertension?

Portal hypertension is an increase in the pressure within the portal vein (the vein that carries blood from the digestive organs to the liver). The increase in pressure is caused by a blockage in the blood flow through the liver. Increased pressure in the portal vein causes large veins (varices) to develop across the esophagus and stomach to get around the blockage. The varices become fragile and can bleed easily.

What causes portal hypertension?

The most common cause of portal hypertension is cirrhosis, or scarring of the liver. Cirrhosis results from the healing of a liver injury caused by hepatitis, alcohol abuse or other causes of liver damage. In cirrhosis, the scar tissue blocks the flow of blood through the liver and slows its processing functions. Portal hypertension may also be caused by thrombosis, or a blood clot that develops in the portal vein.

What are the symptoms of portal hypertension?

The onset of portal hypertension may not always be associated with specific symptoms that identify what is happening in the liver. But if you have liver disease that leads to cirrhosis, the chance of developing portal hypertension is high.

How Is Portal Hypertension Diagnosed?

Usually, doctors make the diagnosis of portal hypertension based on the presence of ascites or of dilated veins or varices as seen during a physical exam of the abdomen or the anus. Various lab tests, X-ray tests, and endoscopic exams may also be used.
Before receiving either TIPS or DSRS procedures, you will have the following tests to determine the extent and severity of your portal hypertension:
  • Evaluation of your medical history.
  • A physical examination.
  • Blood tests.
  • Angiogram.
  • Ultrasound.
  • Endoscopy.
Before either the TIPS or DSRS procedure, your physician may ask you to have other pre-operative tests, which may include an electrocardiogram (also called an EKG), chest X-ray, or additional blood tests.

What are the treatment options for portal hypertension?

The effects of portal hypertension can be managed through diet, medications, endoscopic therapy, surgery, or radiology. Once the bleeding episode has been stabilized, treatment options are prescribed based on the severity of the symptoms and on how well your liver is functioning.

Diarrhea

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Fever and fatigue

Abdominal pain and cramping

Blood in your stool

Reduced appetite

Unintended weight loss

Types of Bariatric Surgery

  • Laparoscopic Adjustable Gastric Band
  • Gastric Sleeve Surgery
  • Gastric Bypass
  • Biliopancreatic Diversion

Spigelian Hernia or also known sometimes as “Lateral ventral” hernia is an unconventional type of hernia that develops throughout the Spigelian fascia. While most types of hernia grow below the fatty layers of the human body, Spigelian hernia is different. This type of hernia grows in between the abdominal wall and the muscles. As it is deep under the layers of the human body, this type of hernia usually does not show any obvious symptoms and therefore remains undetected for long durations. 

While most of the hernias are situated at the fat layers of the patient’s body and therefore cause swelling that is noticeable, Spigelian hernia, on the other hand, is situated deep inside and therefore does not show any such symptom. This type of hernia is known as “interparietal hernia” and it develops inside the abdominal walls and muscles. This is why there is no swelling or bulges that could be witnessed externally. Also, the size of this kind of hernia is considerably very small and therefore leaves no chances to identify it externally. However, it can be identified if the patient pays careful attention. Spigelian hernia can cause constant abdominal discomfort and this is what will help you identify it.

A patient starts to feel some amount of pain in the place of hernia after a while. This pain is constant and may come and go in intervals. However, it is still a strong symptom to look out for. Initially, it may not hurt in the immediate area of hernia but after a while, the location becomes clearer as the hernia begins to hurt more specifically. These symptoms are usually for hernias that are small in size and are made up of small lumps of soft tissues. Another symptom of Spigelian hernia is that it causes disturbances in the bowel functioning of the person.

Due to the fact that Spigelian hernia has no as such obvious symptoms, it is hard to diagnose this. Therefore, the doctor needs to go through an extensive examination in order to confirm a diagnosis regarding Spigelian hernia. He/she will check the size of the abdomen and will examine it by touching it gently in order to know if there are any lumps or not. Furthermore, a confirmed diagnosis for Spigelian hernia can also be passed after obtaining the CT scan results.

Spigelian hernia is very consistent with strangulation. This means that it can cause the congestion and cause the blood supply to be cut. Like most other hernia types, Spigelia hernia is also operated using a laparoscopic procedure. Incisions are made at the location of the hernia to extract it out and misplaced tissues are placed in their appropriate positions. The abdominal wall that is damaged due to the hernia is fixed by the help of a surgical mesh. This is to avoid any further chances of the hernia returning.

The recovery depends solely on the type of surgical procedure used, the expertise of the physician, the willpower of the patient and the severity of the hernia. However, the recovery time is usually around two weeks and if the laparoscopic method is used, the chances for recovery are faster.

Disclaimer: Information provided in this article is for general knowledge purposes only. It is, in no means, a replacement for your doctor’s advice. Please consult your doctor and surgeon with your particular case for effective treatment and recovery of your condition.

The recovery depends solely on the type of surgical procedure used, the expertise of the physician, the willpower of the patient and the severity of the hernia. However, the recovery time is usually around two weeks and if the laparoscopic method is used, the chances for recovery are faster.

Disclaimer: Information provided in this article is for general knowledge purposes only. It is, in no means, a replacement for your doctor’s advice. Please consult your doctor and surgeon with your particular case for effective treatment and recovery of your condition.

Spigelian Hernia or also known sometimes as “Lateral ventral” hernia is an unconventional type of hernia that develops throughout the Spigelian fascia. While most types of hernia grow below the fatty layers of the human body, Spigelian hernia is different. This type of hernia grows in between the abdominal wall and the muscles. As it is deep under the layers of the human body, this type of hernia usually does not show any obvious symptoms and therefore remains undetected for long durations. 

While most of the hernias are situated at the fat layers of the patient’s body and therefore cause swelling that is noticeable, Spigelian hernia, on the other hand, is situated deep inside and therefore does not show any such symptom. This type of hernia is known as “interparietal hernia” and it develops inside the abdominal walls and muscles. This is why there is no swelling or bulges that could be witnessed externally. Also, the size of this kind of hernia is considerably very small and therefore leaves no chances to identify it externally. However, it can be identified if the patient pays careful attention. Spigelian hernia can cause constant abdominal discomfort and this is what will help you identify it.

A patient starts to feel some amount of pain in the place of hernia after a while. This pain is constant and may come and go in intervals. However, it is still a strong symptom to look out for. Initially, it may not hurt in the immediate area of hernia but after a while, the location becomes clearer as the hernia begins to hurt more specifically. These symptoms are usually for hernias that are small in size and are made up of small lumps of soft tissues. Another symptom of Spigelian hernia is that it causes disturbances in the bowel functioning of the person.

Due to the fact that Spigelian hernia has no as such obvious symptoms, it is hard to diagnose this. Therefore, the doctor needs to go through an extensive examination in order to confirm a diagnosis regarding Spigelian hernia. He/she will check the size of the abdomen and will examine it by touching it gently in order to know if there are any lumps or not. Furthermore, a confirmed diagnosis for Spigelian hernia can also be passed after obtaining the CT scan results.

Spigelian Hernia or also known sometimes as “Lateral ventral” hernia is an unconventional type of hernia that develops throughout the Spigelian fascia. While most types of hernia grow below the fatty layers of the human body, Spigelian hernia is different. This type of hernia grows in between the abdominal wall and the muscles. As it is deep under the layers of the human body, this type of hernia usually does not show any obvious symptoms and therefore remains undetected for long durations. 

While most of the hernias are situated at the fat layers of the patient’s body and therefore cause swelling that is noticeable, Spigelian hernia, on the other hand, is situated deep inside and therefore does not show any such symptom. This type of hernia is known as “interparietal hernia” and it develops inside the abdominal walls and muscles. This is why there is no swelling or bulges that could be witnessed externally. Also, the size of this kind of hernia is considerably very small and therefore leaves no chances to identify it externally. However, it can be identified if the patient pays careful attention. Spigelian hernia can cause constant abdominal discomfort and this is what will help you identify it.

A patient starts to feel some amount of pain in the place of hernia after a while. This pain is constant and may come and go in intervals. However, it is still a strong symptom to look out for. Initially, it may not hurt in the immediate area of hernia but after a while, the location becomes clearer as the hernia begins to hurt more specifically. These symptoms are usually for hernias that are small in size and are made up of small lumps of soft tissues. Another symptom of Spigelian hernia is that it causes disturbances in the bowel functioning of the person.

Due to the fact that Spigelian hernia has no as such obvious symptoms, it is hard to diagnose this. Therefore, the doctor needs to go through an extensive examination in order to confirm a diagnosis regarding Spigelian hernia. He/she will check the size of the abdomen and will examine it by touching it gently in order to know if there are any lumps or not. Furthermore, a confirmed diagnosis for Spigelian hernia can also be passed after obtaining the CT scan results.

Spigelian Hernia or also known sometimes as “Lateral ventral” hernia is an unconventional type of hernia that develops throughout the Spigelian fascia. While most types of hernia grow below the fatty layers of the human body, Spigelian hernia is different. This type of hernia grows in between the abdominal wall and the muscles. As it is deep under the layers of the human body, this type of hernia usually does not show any obvious symptoms and therefore remains undetected for long durations. 

While most of the hernias are situated at the fat layers of the patient’s body and therefore cause swelling that is noticeable, Spigelian hernia, on the other hand, is situated deep inside and therefore does not show any such symptom. This type of hernia is known as “interparietal hernia” and it develops inside the abdominal walls and muscles. This is why there is no swelling or bulges that could be witnessed externally. Also, the size of this kind of hernia is considerably very small and therefore leaves no chances to identify it externally. However, it can be identified if the patient pays careful attention. Spigelian hernia can cause constant abdominal discomfort and this is what will help you identify it.

A patient starts to feel some amount of pain in the place of hernia after a while. This pain is constant and may come and go in intervals. However, it is still a strong symptom to look out for. Initially, it may not hurt in the immediate area of hernia but after a while, the location becomes clearer as the hernia begins to hurt more specifically. These symptoms are usually for hernias that are small in size and are made up of small lumps of soft tissues. Another symptom of Spigelian hernia is that it causes disturbances in the bowel functioning of the person.

Due to the fact that Spigelian hernia has no as such obvious symptoms, it is hard to diagnose this. Therefore, the doctor needs to go through an extensive examination in order to confirm a diagnosis regarding Spigelian hernia. He/she will check the size of the abdomen and will examine it by touching it gently in order to know if there are any lumps or not. Furthermore, a confirmed diagnosis for Spigelian hernia can also be passed after obtaining the CT scan results.

Portal Hypertension FAQ's

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Ask the Doctor

PreOp-Instructions

  • ON THE DAY BEFORE SURGERY
    Proceed with normal activities, normal diet & Shower
  • AFTER MIDNIGHT BEFORE THE DAY OF SURGERY
    Do not eat or drink anything, including water, candy, gum, mints, Brushing teeth is okay
  • ON THE DAY OF SURGERY
    Do not eat or drink anything Brushing teeth is okay Shower if you did not shower the night before
  • These are typical instructions. Your instructions by your surgeon or doctor may vary.

These are typical instructions. Your instructions by your surgeon or doctor may vary.

PostOp-Instructions

  • ON THE DAY BEFORE SURGERY
    Proceed with normal activities, normal diet & Shower
  • AFTER MIDNIGHT BEFORE THE DAY OF SURGERY
    Do not eat or drink anything, including water, candy, gum, mints, Brushing teeth is okay
  • ON THE DAY OF SURGERY
    Do not eat or drink anything Brushing teeth is okay Shower if you did not shower the night before
  • These are typical instructions. Your instructions by your surgeon or doctor may vary.

These are typical instructions. Your instructions by your surgeon or doctor may vary.

Key Benefits of Laparoscopic / Robotics Surgery

Key Hole Surgery

No Bigger Cuts

Shorter Hospital Stay

Safe & Stress Free Surgery

Short Stay Surgery

Dedicated Doctors

Best-in-Class Process for Best-in-Class Patient Experience

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Consulting

Pre-Surgery Counselling

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Post-Surgery Counselling

Discharge & Follow-Up

With Dr. Manish Joshi - You Are In Trusted Hands

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Dr. Manish Joshi is the Best Gastrointestinal surgeon in Bangalore & India. He is an expert in Advanced Laparoscopic & Robotic Surgical Techniques. His motto is ‘Patient comes first” View Profile.

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Dr Manish Joshi conducts consultation at below locations

BGS Gleneagles Global Hospitals

Apollo Clinic

  • Consulting : 06:00 PM – 07:00 PM (Tues/Thur/Sat)
  • 673/A, Opp. Shriram Samruddhi , Varthur Road, Kundalahalli gate signal, Bengaluru, Karnataka 560066
  • www.apolloclinic.com

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