Colonic Mucosal Changes and Rectal Varices in Patients with Liver Cirrhosis

Lee, Min Ho; Choi, Ho Soon; Kee, Chun Suk; Han, dong Soo; Park, Geun Tae; Lee, Oh Young; Yoon, Byoung Chul; Jang, Se Jin; Sohn, Joo Hun; Chun, Yong Chul; Ham, Jun Soo; Park, Kyoung Nam

Abstract

BACKGROUND AND AIMS: Colonic mucosal lesions akin to mucosal changes in portal hypertensive gastropathy have been observed occasionlly in patients with portal hypertension. However the exact prevalence of these lesions, their relationship to the severity of the liver disease and their associations with gastric mucosal changes is still unclear. The present study assesses the prevalence of rectal varices and colonopathy and factors associated with them in liver cirrhosis.
METHODS
Thirty one cirrhotic patients and 40 controls underwent endoscopic examinations of upper and lower gastrointestinal tract.
RESULTS
Colonic mucosal changes were observed in 16 patients (51.6%) while 0 in control group. They included increased vascularity (12/16, 75.0%), spider like lesion (4/16, 25.0%), nonspecific colitis lesion (1/16, 6.3%). Rectal varices were observed in 2 patients (12.5%) but they were not observed in the controls. Pathologic finding in patients with increased vacularity showed dilatation and increase of vessels (5 of 6 patients), but there was no abnormal finding in patients with spider like lesion (0 of 3 patients). The colonic mucosal changes were not associated with the Child's grade of cirrhosis, the grade of esophageal varices, the presence of gastric varices, the history of bleeding or the patient's experience of ligation therapy. However, cirrhotic patients with portal hypertensive gastropathy had higher prevalence (70.6%) of colonic mucosal change than the patients without it (28.6%, p<0.05).
CONCLUSIONS
Colonic mucosal changes occur frequently in patients with portal hypertensive gastropathy. However, the prevalence of rectal varices is lower in these patients.