Low Blood Pressure in Patients with Cirrhosis: Understanding the Causes

1. Impaired Gastrointestinal Absorption

One of the primary reasons for low blood pressure in cirrhosis patients is reduced gastrointestinal absorption. Due to liver dysfunction, especially in decompensated cirrhosis, patients often experience poor appetite and malabsorption of essential nutrients. This leads to weight loss and a decrease in overall blood volume, which can result in hypotension. Symptoms such as dizziness and palpitations during physical activity are commonly observed in these patients.

2. Presence of Ascites

Another significant factor is the development of ascites, or fluid accumulation in the abdominal cavity. When cirrhosis is accompanied by significant ascites, it reduces the effective circulating blood volume. As a result, systemic blood pressure drops. This condition may also contribute to feelings of fullness and discomfort in the abdomen.

3. Potential Internal Bleeding

Low blood pressure in cirrhosis patients should also raise concern for possible gastrointestinal bleeding. Even in the absence of visible symptoms like vomiting blood or black stools, internal bleeding can cause blood to pool in the digestive tract. This can lead to upper abdominal discomfort, dizziness, visual disturbances such as "blackouts," cold sweats, cold extremities, and decreased urine output — all signs of severe hypovolemia that require immediate medical attention.

Understanding these contributing factors can help both patients and caregivers recognize when to seek prompt medical evaluation and intervention.