Many daily activities cause acute elevations of intra-abdominal pressure (IAP).
In portal hypertensive cirrhotic patients, increased IAP increases absolute portal pressure and azygos blood flow. This suggests that it may have detrimental consequences at the esophageal varices.
In this study, published in the October issue of Hepatology, the research team investigated the effects of increased IAP on variceal pressure, size, and wall tension.
They assessed 14 patients with cirrhosis and esophageal varices.
|Increasing IAP significantly increased variceal pressure and radius.|
The team used endosonography and a noninvasive endoscopic pressure gauge to measure variceal pressure, radius, wall tension, and volume.
Measurements were taken in baseline conditions and after increasing IAP by 10 mm Hg, using an inflatable girdle.
The researchers found that increasing IAP significantly increased variceal pressure and radius. Consequently, wall tension dramatically increased.
In addition, variceal volume increased significantly from 1264 to 2025 mm3.
Dr Angels Escorsell's team concluded, "In portal hypertensive cirrhotic patients, increases in IAP have deleterious effects on variceal hemodynamics, markedly increasing the volume, pressure, and wall tension of the varices".
"Increases in IAP may contribute to the progressive dilatation that precedes the rupture of the varices in portal hypertension".