Prevalence and Factors Influencing Hemorrhoids, Anorectal Varices, and Colopathy in Patients with Portal Hypertension

Abstract

It is concluded that the prevalence of hemorrhoids is not increased in patients with portal hypertension. However, the prevalence of anorectal varices and colopathy is higher in these patients. Portal colopathy occurs more commonly in patients with large esophageal varices, those with gastric varices, and those who do not have anorectal varices.

Hypertensive portal colopathy in schistosomiasis mansoni: proposal for a classification

“…Therefore, they may occasionally be subjected to massive bleeding (Weinshall & Cheer 1986). The prevalence of the rectal varices has varied from 0% to 92% in cirrhotic patients ( Hosking et al 1989, Rabinovitz et al 1995, Misra et al 1996. Our findings are in agreement with Hosking et al (1989), who concluded that rectal varices reflect a later stage in the development of the portal hypertension, being observed more frequently in patients with large esophageal and gastric varices.…”

“…However, in a study by Eleftheriadis et al (1993) on cirrhotic patients with accentuated portal hypertension who had undergone sclerotherapy for the erradication of esophageal varices and had no prior history of lower gastrointestinal bleeding, a high frequency of portal colopathy (93%) was observed, with lesion-like telangiectasias predominating (70%). In the present series, colitis-like (erythemas) alterations in the mucosa were seen in 32.2% of the cases in relation to what was observed in cirrhotic patients, 27% (Misra et al 1996), 32% (Rabinovitz et al 1995) and 38% (Bini et al 2000). Rectal varices are collateral portosystemic dilated veins in patients with portal hypertension and communicate the venous flow of the superior hemorrhoid veins to the medium and inferior hemorrhoid veins (Jacobs et al 1989, Hosking et al 1989).…”

“…While vascular lesions in the colonic mucosa of cirrhotic patients with portal hypertension have been reported (Kosareck et al 1991, Viggiano & Gostout 1992, Rabinovitz et al 1995, Chen et al 1996, Ganguly et al 1995, Misra et al 1996, Bresci et al 1998, Bini et al 2000, studies on hepatosplenic schistosomiasis mansoni are scarce (Mohamed et al 1990, Sanguino et al 1993, Geboes et al 1995.…”

“…Endoscopic abnormalities in the colonic mucosa of patients with portal hypertension due to hepatic cirrhosis with risk of intermittent hemorrhage are well described (Kosareck et al 1991, Viggiano & Gostout 1992, Rabinovitz et al 1995, Ganguly et al 1995, Chen et al 1996, Misra et al 1996, Bresci et al 1998, Bini et al 2000. The most frequent alterations are defined as telangiectasias or vascular ectasias, angiodysplasia-like lesions, red spots, and erythema.…”

A study on portal hypertensive colopathy in patients with cirrhosis of liver

“…These complications are the most common causes of gastrointestinal haemorrhage leading to threatening outcomes ending up in high In India, Portal hypertensive changes in lower gastrointestinal tract due to cirrhosis is less explored, except for one study done on prevalence of colonic and other changes due to portal hypertensive colopathy (PHC). 4 The mucosal lesions in patients with liver cirrhosis were which was one of important causes of lower gastrointestinal tract bleeding. 5,6 The prevalence of PHC and factors influencing it are not well established in literature particularly in South Indian population.…”