Colonic Mucosal Changes in Egyptian Patients with Liver Cirrhosis and Portal Hypertension

Background and Aims: In liver cirrhosis with portal hypertension, Portal Hypertensive Colopathy (PHC) is thought to be an important cause of lower gastrointestinal bleeding. This study aimed at evaluating the prevalence and clinical significance of colonic mucosal changes in Egyptian patients with cirrhotic and Portal Hypertension (PHT). Patients and Methods: A prospective study done on 35 patients with liver cirrhosis and portal hypertension (proved by upper endoscopy and/or abdominal US). They were evaluated using full colonoscopy to detect changes in colonic mucosa and gastroscopy for presence of gastro-esophageal varices, and Portal Hypertensive Gastropathy (PHG) as well. Results: Colonic lesions were found in 27 patients (77.1%), including hemorrhoids in 20 patients (57.1%), diffuse hyperaemic mucosa in 16 patients (45.7%), angiodysplastic lesions in 12 patients (34.3%) and rectal varices in 5 (14.3%). Bleeding per rectum was detected in 7 patients (20%), and it significantly correlated with the presence of hemorrhoids (P: 0.02). The prevalence of PHC and the presence of hemorrhoids increased with worsening Child-Pugh class (P: 0.01 and 0.02 successively). Conclusion: The prevalence of PHC and haemorrhoids increases with progression of liver disease and worsening of Child-Pugh in cirrhotic patients.