Thanks for asking at healthcare magic. I read your question and i understand your concern. Portal Hypertension per say neither need Shot nor rubber band. It is sequele in the form of variceal bleeding (mostly esophageal) that needs one of the two procedures. Both procedures has their own merits and demerits. Shot stop bleeding immediately once applied but there is risk of rebleeding as well as slippage of shooters. Rubber band can also stop bleeding but there is risk of normal mucosa infarction and necrosis leading to perforation. I would suggest shot. For prevention of portal hypertension patient should be started on betablockers preferably combine alfa betablockers like carvedilol 3. 125mg BD increase up to 6.25 mg BD depends Upon patient tolerance. Best therapy is Transjugular intrahepatic shunt. Last but not the least cause should be digged out Like chronic liver disease due to hepatitis B, C Autoimmune, hemochromatosis, cryptogenic etc or non cirrhotic portal hypertension like portal or inferior vena cava thrombosis. Hope it helps best Take your best care Don t forget to rate this answer and close the discussion at healthcare magic. Regards Dr Ejaz