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Colonic mucosal changes in portal hypertension
U C Ghoshal1, P K Biswas, G Roy
1Department of Gastroenterology, Seth Sukhlal Karnani Memorial Hospital & Institute of Postgraduate Medical Education and Research, 244, Acharya JC Bose Road, Calcutta-700020, India. ghoshal@sgpgi.ac.in
Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation
|June 12, 2001
Summary
Portal hypertension (PHT) patients frequently develop colorectal varices and portal hypertensive colopathy, unlike hemorrhoids. These conditions, along with hematochezia, require further investigation in PHT management.
Area of Science:
- Gastroenterology
- Hepatology
- Colorectal Surgery
Background:
- Portal hypertension (PHT) is a serious complication of liver disease.
- The gastrointestinal manifestations of PHT, particularly in the colon, are not fully understood.
- Hemorrhoids, colorectal varices, and portal hypertensive colopathy are potential complications.
Purpose of the Study:
- To determine the prevalence, type, extent, and predictors of hemorrhoids, colorectal varices, and portal hypertensive colopathy in patients with PHT.
- To assess the association between these colonic findings and hematochezia.
- To identify potential predictors for the development of colorectal varices and portal hypertensive colopathy.
Main Methods:
- Colonoscopy was performed on 41 consecutive patients with PHT.
- A control group of 25 patients with obscure gastrointestinal bleeding but without PHT was included.
- Frequency of hematochezia was assessed through specific inquiry and follow-up.
Main Results:
- Colorectal varices were found in 31.7% of PHT patients versus 0% of controls (p=0.005).
- Portal hypertensive colopathy was present in 36.6% of PHT patients versus 0% of controls (p=0.0005).
- Hemorrhoid prevalence was similar between groups (21.9% vs 16%, p=ns).
- No evaluated PHT parameters predicted colorectal varices or portal colopathy.
- Hematochezia was associated with colorectal varices, but not portal colopathy.
Conclusions:
- Colorectal varices and portal hypertensive colopathy are common in PHT patients.
- These findings are distinct from hemorrhoids and are not predicted by standard PHT severity markers.
- Colorectal varices, but not portal colopathy, are linked to hematochezia in PHT.