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Portal Hypertension

At GastroDoxs in Houston, Dr. Bharat Pothuri specializes in diagnosing and managing portal hypertension with personalized, advanced care. Board-certified in liver and digestive diseases, he offers compassionate, expert treatments-from medical therapies to procedures-ensuring optimal outcomes and improved quality of life.

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Difficulty Swallowing

American Society for Gastrointestinal Endoscopy

About the Expert

Dr. Bharat Pothuri is a board-certified gastroenterologist and the founder of GastroDoxs. With extensive experience in digestive health, he specializes in advanced endoscopic procedures, chronic GI disorder management, and preventive care. Dr. Pothuri is dedicated to providing expert, patient-focused insights to help improve gut health and overall well-being.

Common Causes and Risk Factors

Cirrhosis (scarring of the liver)
Blood clots in the portal vein
Schistosomiasis (parasite infection)
Certain heart conditions causing back-pressure
Hepatitis B or C infections
Nonalcoholic fatty liver disease
Heavy alcohol use
Family history of liver disease

Signs and Symptoms

Often none in early stages
Abdominal swelling (ascites)
Enlarged spleen
Bleeding in the digestive tract (variceal bleeding)
Visible veins on the abdomen (-caput medusae-)
Jaundice (yellowing of skin or eyes)
Confusion or altered mental state (hepatic encephalopathy)

Expert Treatment for Portal Hypertension by Dr. Bharat Pothuri

Dr. Pothuri uses a step-by-step approach:

Medical History and Physical Exam

He reviews your symptoms-such as epigastric pain, bloating or bleeding-along with past liver disease, alcohol use, and family history.

Blood Tests

We check liver enzymes, complete blood count, coagulation panels and viral hepatitis markers to assess liver function and rule out other causes.

Imaging Studies

Abdominal Doppler Ultrasound evaluates portal vein flow, spleen size and checks for ascites.
CT Scan or MRI offers detailed views of liver structure, varices and collateral vessels.

Endoscopy

An upper GI endoscopy looks for enlarged veins (varices) in your esophagus or stomach that may bleed.

Hepatic Venous Pressure Gradient (HVPG)

This catheter-based test directly measures the pressure in your portal vein to confirm and grade the severity of portal hypertension.

Treatment

Our Team offers a full range of care for portal hypertension.

1. Healthy Lifestyle and Supportive Care

Low-salt diet to minimize fluid retention
Complete abstinence from alcohol
Light, doctor-approved physical activity to maintain strength

2. Medications

Non-selective beta-blockers to reduce portal vein pressure
Diuretics (water pills) to control ascites
Lactulose or rifaximin to prevent or treat hepatic encephalopathy

3. Endoscopic and Interventional Procedures

Endoscopic variceal ligation (banding) to stop or prevent variceal bleeding
Transjugular Intrahepatic Portosystemic Shunt (TIPS) for refractory portal hypertension
Liver transplantation evaluation for patients with decompensated cirrhosis

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1.5K

Patients Treated

Dr. Pothuri has treated more than 1.5K patients, helping individuals improve their digestive health and overall well-being through expert, personalized care.

20Y

Years of Experience

With over 20 years of experience, GastroDoxs has been a trusted provider of gastroenterology care, focusing on delivering the best outcomes for patients

About the Author

Dr. Bharat Pothuri is a Board-Certified Gastroenterologist and Hepatologist. With extensive experience in digestive health, he specializes in advanced endoscopic procedures, chronic GI disorder management, and preventive care. Dr. Pothuri is dedicated to providing expert, patient-focused insights to help improve gut health and overall well-being.

Frequently Asked Questions

What is portal hypertension?

Portal hypertension is high blood pressure in the portal venous system, usually from cirrhosis, leading to varices and ascites.

What symptoms occur?

Symptoms include enlarged spleen, variceal bleeding, ascites (fluid in the belly), and hepatic encephalopathy.

How is it diagnosed?

Diagnosis combines imaging (ultrasound Doppler), endoscopy for varices, and measurement of hepatic venous pressure gradient (HVPG).

What treatments are available?

Treatments include nonselective beta?blockers, endoscopic banding of varices, diuretics for ascites, TIPS procedure, and liver transplant when needed.

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