Portal hypertensive colopathy: endoscopic findings and the relation to portal pressure

Portal hypertensive colopathy (PHC) is a new clinical entity in patients with liver cirrhosis. In this study, colonoscopic findings and clinical features including upper gastrointestinal endoscopy and hepatic hemodynamics were prospectively investigated among 35 PH patients with a hepatic venous pressure gradient (HVPG) of greater than 12 mmHg due to chronic liver diseases. Colonoscopy was also performed in 100 patients without liver disease as non-PH controls. The colonoscopy revealed vascular ectasias, vascular irregularity, vascular dilatation, solitary red spots, diffuse red spots, and hemorrhoids in 26, 32, 30, 25, 10 and 25, respectively, of 35 PH patients compared to 3, 7, 3, 11, 0 and 19, respectively, in controls. PHC was endoscopically diagnosed in 27 of 35 PH patients according to our criteria. These patients with PHC were more frequently associated with esophageal varices and portal hypertensive gastropathy, and had higher HVPG than PH patients without PHC. Portal hypertension is an important factor in the etiology of PHC.