One consequence of chronic liver disease can be portal hypertension. This is an increase in the blood pressure in the portal vein, which carries the blood from the bowel and spleen to the liver. The pressure in the portal vein may rise because there is a blockage, such as a blood clot, or because the resistance in the liver is increased because of scarring (fibrosis) or cirrhosis. As a result, the pressure in the portal vein rises. This is known as portal hypertension.
What are bleeding oesophageal varices?
As the blood tries to find another way back to the heart, new blood vessels open up. Among these vessels are those that run along the wall under the lining of the upper part of the stomach and the lower end of the oesophagus (gullet). These veins protrude into the gullet and the stomach and can bleed. The dilated veins in the gullet are known as varices. Bleeding may be a gentle ooze in which case anaemia is the commonest symptom. Sometimes there can be a major bleed; a person may have a haemorrhage and either vomits blood or passes blood through their bowels. This blood may appear to be black, since it is often changed as it passes through the body.
Oesophageal varices represent a significant complication of cirrhosis and some other types of liver damage.
There are many causes of cirrhosis, alcohol being the most common. Others include viral hepatitis, autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis and some metabolic diseases.
Portal hypertension may also arise as a result of a parasitic disease, which is common in the Middle East and parts of South America. Other conditions including clotting disorders and pancreatic disease can lead to portal hypertension.