Treatments for Portal Hypertension Liver Disease in Children

As there is no simple cure for portal hypertension, our Center for Childhood Liver Disease takes a multidisciplinary approach to preventing the condition from becoming worse while addressing the risk of gastrointestinal bleeding.

Physicians often prescribe treatment with a medication called a nonselective beta blocker, such as propranolol or nadolol, which can help lower the blood pressure within the portal vein.

Control or prevention of bleeding from varices is a high priority with portal hypertension. To do this, physicians often use an endoscope to tie off varices using a rubber band (a procedure known as “banding”) or to deliver sclerosing therapy. In this kind of therapy, a physician injects a chemical into the varices directly, causing them to clot.

If your child develops significant ascites, our physicians may try to relieve the fluid load with diuretic medications or, if necessary, by draining the fluid from the abdomen with a needle (a non-surgical procedure called abdominal paracentesis).

Should your child experience continued internal bleeding, doctors may create a bypass or shunt between the portal vein and the rest of the bloodstream. Our physicians often use one of two types of shunting procedures, transjugular intrahepatic portal-systemic shunting (TIPSS, a non-surgical procedure involving use of a catheter) or surgical shunting. Both procedures relieve the pressure on the portal vein and redistribute it to the rest of the bloodstream.

Because portal hypertension is an advanced complication of other forms liver disease, such as cirrhosis, it is important to try to manage the conditions that caused damage to the organ in the first place. Should liver function begin to fail, a liver transplant may become necessary.