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- Title
Upright posture blunts postprandial splanchnic hyperemia in patients with cirrhosis and portal hypertension.
- Authors
Iwao, Tadashi; Oho, Kazuhiko; Nakano, Ryohichi; Yamawaki, Makoto; Sakai, Teruhiro; Sato, Masahiro; Miyamoto, Yasunao; Sakai, Kenji; Sata, Michio; Toyonaga, Atsushi; Iwao, T; Oho, K; Nakano, R; Yamawaki, M; Sakai, T; Sato, M; Miyamoto, Y; Sakai, K; Sata, M; Toyonaga, A
- Abstract
The aim of this study was to compare postprandial hemodynamic changes observed during assumption of the recumbent posture and upright posture in patients with cirrhosis and portal hypertension. Eleven patients with cirrhosis and portal hypertension were studied. Echo-Doppler examinations were performed to measure flow volume in the portal vein (PV), superior mesenteric artery (SMA), and splenic artery (SA) in the fasting condition. Collateral blood flow was indirectly calculated by determining the difference between the sum of SMA, SA, and PV blood flows. After these measurements were done, each patient received a standardized liquid meal and was then randomly assigned to either maintain supine or upright posture, in a crossover design, on 2 different days (recumbent day and upright day). On each study day, the above-mentioned measurements were repeated 30 min and 60 min after the meal. PV blood flow increased significantly after the meal on the recumbent day (P < 0.01) but not on the upright day (P = 0.78). Although there were significant postprandial increases in SMA blood flow on both study days (P < 0.01, P < 0.01), the effect was less pronounced on the upright day than on the recumbent day (P < 0.01). Postprandial SA blood flow showed no change on the recumbent day (P = 0.64), but decreased significantly on the upright day (P < 0.01). The calculated postprandial collateral blood flow increased significantly on the recumbent day (P < 0.05), but showed no change on the upright day (P = 0.53). These results suggest that the upright posture blunts postprandial splanchnic hyperemia in patients with cirrhosis and portal hypertension.
- Subjects
POSTURE; CIRRHOSIS of the liver; HEMODYNAMICS; PORTAL hypertension; PATIENTS
- Publication
Journal of Gastroenterology, 1999, Vol 34, Issue 3, p359
- ISSN
0944-1174
- Publication type
journal article
- DOI
10.1007/s005350050274