Colonoscopic findings in Patients of Portal Hypertension Due to Different Etiologies and their Correlation

Recently, it is established that portal hypertension also produces vascular changes throughout the colon similar to lesion on Upper GI endoscopy. So we planned this study to see the spectrum and frequency of colonic lesions in patients with portal hypertension due to different etiologies, to assess whether the presence of portal hypertension related colonic lesions correlates with severity of liver disease as indicated by CTP and MELD scores and to study the relationship between upper GI lesions of portal hypertension and colonic lesions.

This study was done over a period of one year. In this study, 100 patients of portal hypertension due to different etiologies were taken if they met the inclusion criteria.

The frequency of portal hypertension related colonic lesions including rectal varices, rectopathy and portal hypertensive colopathy increases with increase in the severity of liver disease as ascertained by Child-turcotte-Pugh score. Portal hypertension related colonic lesions and hemorrhoids are more frequent in cirrhotic patients with higher MELD score. Rectal varices are more frequent among who had esophageal varices on upper GI endoscopy. There is significant increase in bleeding PR as frequency of hemorrhoids increases, whereas there was not any significant relationship between bleeding PR and rectal varices suggesting that cause of lower GI bleeding in present were haemorrhoids most likly.

Patients with portal hypertension due to any etiology have significantly higher frequency of colonic lesions as severity of liver disease increases indicated by worsening CTP and MELD scores. Inspite of large number of lower GI manifestations of Portal Hypertension seen in our patients none had significant life threatening lower GI bleeds. So it can be concluded that only upper GI manifestation of Portal Hypertension are clinically significant.