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Last updated: 23-Oct-2026
Portal hypertension treatment · Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Portal hypertension is high pressure in the vein that carries blood from the gut to the liver. The blood backs up into swollen veins, called varices, in the food pipe and stomach, and these can bleed.
The cause decides the treatment. A scarred liver (cirrhosis) is treated very differently from a blocked vein with a liver that still works well, which is common in India.
Most patients are treated with tablets and endoscopy, not surgery. An operation helps a chosen group: young people with a healthy liver who keep bleeding or have a large, troublesome spleen.
The portal vein collects blood from the stomach, bowel and spleen and takes it through the liver. If the liver is scarred, or the vein is blocked, the pressure in this vein rises.
Dr. Jivraj Mehta Hospital. Trained in super-specialty surgical gastroenterology programmes, qualified twice over in the specialty, with 18 years of experience in gastro and liver surgery. Every patient considered for a shunt, a spleen operation or TIPS is discussed with the liver physician and the radiologist before treatment starts.
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Liver & Gastro Surgeon · Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Google rating at Dr. Jivraj Mehta Hospital, Vasna: 4.89 from 216 reviews. At Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad: 4.94 from 18 reviews.
Before any treatment is chosen, the doctor works out which of three groups you are in. The same operation that helps one group can harm another.
| Group | What it looks like | What usually helps |
|---|---|---|
| Cirrhosis (a scarred liver). | Abnormal liver tests, low albumin, a lumpy liver on the scan. | Treating the cause, tablets, banding, TIPS, and a transplant referral when the liver fails. |
| NCPF, also called PSVD. | A liver that works well, a large spleen, varices, an open portal vein, and no cirrhosis on biopsy. | Tablets and banding first; a shunt operation when bleeding keeps coming back. |
| EHPVO (blocked portal vein). | Often a young person, a clotted portal vein with a web of new veins around it, and normal liver tests. | Banding first; a shunt operation in the right anatomy can stop the bleeding for good. |
Western guidelines are written mostly for cirrhosis. In India, the second and third groups are far more common than in the West. These patients have a healthy liver, and surgery still has a real place for them.
Many people first learn of it during a bleed. Others are sent because a blood test shows low platelets, or a scan shows a large spleen.
The tests answer three questions: how well the liver works, where the blockage is, and how large the varices are. No operation is planned on one scan alone.
Most causes of portal hypertension are not cancer. But a clot in the portal vein, or a large spleen, can sometimes come from a growth, so this is checked early.
| What the scan shows | What it can mean | How it is told apart |
|---|---|---|
| A clot in the portal vein with a normal liver. | A plain blood clot, often from a clotting tendency. | The clot does not light up with contrast; blood tests for clotting. |
| A clot in the portal vein with cirrhosis. | A plain clot, or a clot made of liver cancer cells. | A clot that lights up with contrast and a raised AFP point to a tumour. |
| A clot in the splenic vein alone. | Pancreatitis, or rarely a growth in the pancreas. | A CT of the pancreas and, when needed, an endoscopic ultrasound. |
| A large spleen with low counts. | Portal hypertension, or a blood disorder such as lymphoma. | Blood film, and a blood specialist’s opinion when the liver and veins look normal. |
If a growth is found, the plan changes completely, and the cancer team takes over. If the clot is plain, blood thinners are often started after discussion with the liver physician.
Most people with portal hypertension never need an operation. Tablets, banding and treatment of the cause control it for many years.
Treatment moves step by step, from tablets to endoscopy to a radiology procedure or an operation. Not every patient needs every step.
| Step | Who it is for |
|---|---|
| Treating the cause. | Everyone: hepatitis medicines, stopping alcohol, weight and sugar control. |
| Carvedilol tablets. | Varices at risk of bleeding, and after a bleed. |
| Endoscopic banding or glue. | Varices in the food pipe (bands) or stomach (glue), until they are gone. |
| TIPS, a stent placed through the neck vein. | Cirrhosis with bleeding that comes back despite tablets and banding. |
| Shunt operation with spleen removal. | A healthy liver (NCPF or EHPVO) with repeated bleeds or a troublesome spleen. |
| Devascularisation. | Bleeding with veins that cannot be joined. |
| Liver transplant referral. | Cirrhosis with a failing liver. |
A bleed from varices is an emergency. Come to the hospital at once. Treatment starts in the emergency room, before the endoscopy.
The upper GI bleeding page explains the first hours in more detail, including bleeding from ulcers.
After a bleed, or when large varices are found, treatment aims to stop the next bleed. Tablets and banding are used together.
In cirrhosis, the safe way to lower the pressure is usually TIPS, not an open operation. When the liver is failing, a transplant is the answer.
A shunt operation joins a high-pressure vein to a low-pressure one, so blood flows away from the varices. It is meant for people whose liver works well.
Three things must be in place before a shunt: normal liver tests, no cirrhosis, and veins wide enough on the CT map. If any is missing, a shunt is not offered.
The operation is done open, under general anaesthesia, with blood ready. You spend the first night in intensive care. A Doppler scan checks every day that the shunt is flowing. Most people go home in seven to ten days.
Some patients bleed, but their veins are too clotted or too narrow to join. For them, an operation called devascularisation is used.
The spleen is removed when it is very large and painful, or when it traps so many cells that counts are dangerously low. On its own, it does not treat varices.
If you need a hernia repair, a gallbladder operation or any other abdominal surgery, the portal pressure adds risk. That risk is measured first.
Every treatment carries risk, and the liver’s strength decides how much. These are the main ones; your own risks are discussed in person before you agree.
A few signs need the hospital the same day. Patients and families are told these before they go home.
Portal hypertension needs follow-up for years, often for life. Young patients with a healthy liver have decades ahead, so the follow-up is planned with that in mind.
| When | What is done |
|---|---|
| Two to six weeks after surgery. | Wound check, Doppler of the shunt, blood count and liver tests. |
| Three months. | Endoscopy to check the varices, and a Doppler scan. |
| Every six to twelve months. | Endoscopy as needed, Doppler and liver tests. |
| Every six months, in cirrhosis. | An ultrasound, with an AFP blood test, to look for early changes in the liver. |
| After spleen removal. | Vaccine boosters on schedule, and a yearly check of the infection card. |
Long-standing EHPVO can narrow the bile duct (portal biliopathy). Jaundice or itching should be reported, even years later.
★★★★★
“I must say Dr harsh shah is very calm and humble in nature towards there patient.My wife had been operated by him.Thank you so much sir.Dr harsh shah is expert Gastro surgeon.”
Ashokbhai Brahmbhatt · Google review
★★★★★
“We consulted Dr Harsh shah for my Husband as having cyst . surgery was done by Doctor very successfully. today we got discharged. our experience with sir was very good . he is very cooperative, explained about diagnosis very calmly. well Experienced, good Doctor . also thanks to Roshani maam for good cooperation. Thanks sir Dr Priyanka Prajapati”
Priyanka Prajapati · Google review
★★★★★
“My father has chronic pancreatic he has Savior pain. Many Dr. Said operation needed but Dr. Harsh shah doing his treatment without an operation. Flexibility, friendly staff over visiting hospital as well.”
Rhythm Christian · Google review
Quoted exactly as written on Google. These patients describe abdominal surgery with Dr Harsh Shah. No review yet names portal hypertension.
The cost depends on the path you need. Tablets and banding cost far less than a shunt operation with an intensive care stay, so a written estimate is given first.
What moves the estimate is the number of endoscopies, whether TIPS or surgery is needed, the blood products used, and the days in intensive care and on the ward. Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad works with the main insurers and cashless schemes, and its desk handles pre-authorisation for any admission. Please bring every scan and report, your medicine list, your insurance card and an ID. For questions before booking, call +91-63555-64601.
It is high pressure in the portal vein. It is caused by a scarred liver in some people, and by a blocked vein with a healthy liver in others. The cause decides the treatment.
Most people do not. Tablets and banding control the varices in most patients. An operation is offered mainly to people with a healthy liver who keep bleeding or have a troublesome spleen.
It joins a high-pressure vein to a low-pressure one, usually the spleen vein to the left kidney vein, so blood flows away from the varices. It is done only when the liver works well.
A scarred liver copes poorly with a major operation, and the risk of confusion and liver failure is high. TIPS, placed by a radiologist, or a transplant is the safer path.
Yes, with care. You need vaccines before the operation, a card to carry, and an antibiotic and a doctor the same day for any fever, for life.
Usually not. Most are plain blood clots. In a scarred liver, a clot that lights up on a contrast scan, with a raised AFP, is checked for liver cancer.
They can. That is why endoscopy and Doppler scans continue after banding, TIPS or surgery, on a written schedule.
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr. Jivraj Mehta Hospital, Dr Jivraj Mehta Marg, Vasna, Ahmedabad 380007.
Endoscopy and banding, interventional radiology, shunt and spleen surgery, intensive care and inpatient care.
Google: Dr Harsh Shah · 4.94 · 18 reviews
Directions to Dr. Jivraj Mehta Hospital, Vasna · WhatsApp +91-63555-64601
Patients come to Ahmedabad from across Gujarat, southern Rajasthan and western Madhya Pradesh.
Told you have varices, a large spleen or portal hypertension? Your endoscopy report, Doppler or CT report, and blood tests can be sent ahead, so the consultation starts with them already read. The treatment plan is decided at the consultation, together with the liver physician and the radiologist. Call +91-63555-64601 · Bring the reports to the visit
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