Advances in the treatment of portal hypertension in cirrhosis

Expert Rev Gastroenterol Hepatol. 2016 Aug;10(8):961-9. doi: 10.1586/17474124.2016.1166952. Epub 2016 Mar 28.

Abstract

Non-selective beta-blockers and handling of esophageal varices has been key elements in the treatment of portal hypertension in recent decades. Liver vein catheterization has been essential in diagnosis and monitoring of portal hypertension, but ongoing needs for noninvasive tools has led to research in areas of both biomarkers, and transient elastography, which displays promising results in discerning clinically significant portal hypertension. Novel research into the areas of hepatic stellate cell function and the dynamic components of portal hypertension has revealed promising areas of treatment modalities, targeting intestinal decontamination, angiogenesis, inflammation and oxidative stress. Future studies may reveal if these initiatives lead to developments of new drugs for treatment of portal hypertension.

Keywords: Portal hypertension; cirrhosis; esophageal varices; prevention; treatment.

Publication types

  • Review

MeSH terms

  • Animals
  • Diffusion of Innovation
  • Disease Progression
  • Esophageal and Gastric Varices / diagnosis
  • Esophageal and Gastric Varices / etiology
  • Esophageal and Gastric Varices / physiopathology
  • Esophageal and Gastric Varices / therapy*
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / physiopathology
  • Gastrointestinal Hemorrhage / therapy*
  • Hemostatic Techniques* / adverse effects
  • Humans
  • Hypertension, Portal / diagnosis
  • Hypertension, Portal / etiology
  • Hypertension, Portal / physiopathology
  • Hypertension, Portal / therapy*
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / diagnosis
  • Molecular Targeted Therapy
  • Portal Pressure* / drug effects
  • Predictive Value of Tests
  • Risk Factors
  • Treatment Outcome