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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment To Reduce Portal Hypertension

I am Prabhakaran.My uncle(Aged 62) has been diagnosed with acute liver cirrhosis 5months ago.He has been suffering from regular acites ever since he has been diagnosed. He also has kidney problems. He also has edema formation in his legs and scrotum. Now few days back he had black stool indicating an internal bleeding due to increased portal hypertension. He has been immediately hospitalized and treated in ICU and was given octreotide and vitamin K. Doctors say that the liver damage he sustains is irreversible. So they say that only option for us now is to live with medications and with some lifestyle modifications or transplantation(which is not affordable at the moment). absolutely its fine for us to live with medications life long but only if they work properly(.He has been prescribed to take aldactone to reduce portal pressure and some laxative and urilizer regularly). By now this is obvious that the drug given to reduce the portal pressure doesn t work,because he never had a relief from acites and edema. My question is what can we do in case of drug doesn t work? is there any better medication to treat portal hypertension? or is there any alternative treatment to reduce the portal hypertension? it seems only if we were able to reduce the portal hypertension my uncle can live with this disease without much complications. Please Help me find some better treatment for this. Thank you in advance.
Tue, 30 Dec 2014
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Pain Medicine & Palliative Care Specialist 's  Response
hi
portal hypertension can lead to these bleeding episodes either orally or rectally due to the related varices involving the whole gastrointestinal, hepato-renal system,
most of the problems occur due to decreased albumin & bleeding.
emergency treatment for bleeding remains either with fresh frozen plasma,octreotide, somatostatin,vitamin k, if uncontrolled, banding can be done, that too involved with high risk
.
aldactone & laxatives (lactulose or glycerol) are the standard drugs to maintain the portal hypertension and many complications related to the toxicity of liver enzymes.

allthough the gold standard treatment of choice is liver transplantation, which has many other considerations.

change in lifestyle, food, increased and monitored dose of aldactone,dietary albumin,avoiding hepatotoxic drugs & foods can help

all the best
take care
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Suggest Treatment To Reduce Portal Hypertension

hi portal hypertension can lead to these bleeding episodes either orally or rectally due to the related varices involving the whole gastrointestinal, hepato-renal system, most of the problems occur due to decreased albumin & bleeding. emergency treatment for bleeding remains either with fresh frozen plasma,octreotide, somatostatin,vitamin k, if uncontrolled, banding can be done, that too involved with high risk . aldactone & laxatives (lactulose or glycerol) are the standard drugs to maintain the portal hypertension and many complications related to the toxicity of liver enzymes. allthough the gold standard treatment of choice is liver transplantation, which has many other considerations. change in lifestyle, food, increased and monitored dose of aldactone,dietary albumin,avoiding hepatotoxic drugs & foods can help all the best take care