Aim: In patients with cirrhosis of liver with portal hypertension, one of the important cause for lower gastrointestinal bleed is portal hypertensive colopathy. In this study, we evaluated the prevalence of colopathy in patients with cirrhosis of liver and factors associated with it.
Methods: We evaluated the liver function test, ascitic fluid analysis, complete blood count, prothrombin time and child pugh class with colonoscopic findings in 25 patients over the period of 6 months. All patients underwent upper gastrointestinal endoscopy and full length colonoscopy to observe changes due to portal hypertension.
Results: We found portal hypertensive colopathy in 17 (68%) patients.Among these patients solitary vascular ectasia in 9 (36%), diffuse vascular ectasia in 10(40%), redness in 7 (28%) and rectal varix in 1 (4%) were noted.There was no significant relationship between Child- Turcott-Pugh class (CTP) and prevalence of portal hypertensive colopathy. Colonic mucosal changes were significantly associated with presence of esophageal varices and portal hypertensive gastropathy. Laboratory parameters such as platelet count, bilirubin level, International normalised ratio, serum albumin level and serum alanine aminotransferase (ALT) level were not related to presence of portal hypertensive colopathy. High serum ascities albumin gradient (SAAG) ascites in cirrhotic patients was associated with occurrence of portal hypertensive colopathy.
Conclusion: Portal hypertensive colopathy should be considered in the differential diagnosis of lower GI bleed in the clinical scenario of chronic liver disease. Patients with esophageal varix, portal hypertensive gastropathy, high SAAG ascites, and CTP class B and C should be submitted for full length colonoscopic examination.
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2017: 6.614
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