Hi Bob,

So you can find more than you ever wanted to know about portal hypertension here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309905/

The reason we use a very old NSBB (Non Selective Beta Blocker) is complex but is explained in this article. Other things have been tried, but nothing else seems proven to be better.

If you neglected to mention to your doctor you had stopped taking the Inderal 40 they probably had a look and went, hmm, not much change, Bob’s on the lower dose and not complaining, so let’s give him more!

Yes, you should take them and yes they do help. Consider blowing up a balloon. You know how it’s hard to do at the start and then gets easier? Your portal veins are like that. It’s hard to get them to blow up, but the more they blow up the easier it is to blow them up. If you can shrink them down a bit that actually makes them stronger and more resistant to being blown up.

Technically that is called Laplace’s law and here are a couple of explanations: http://www.tiem.utk.edu/~gross/bioed/webmodules/tensionblood.htm

http://medicineconspectus.blogspot.com.au/2013/11/laplaces-law-wall-tension-radius-and.html

We do expect some improvement over time, but on the bright news front, if you ain’t dead already then you’ll probably live long enough to succumb to something else!

Life is a terminal disease, and sexually transmitted at that. None of us get out alive but chances are it won’t be your liver that marks the final chapter.