Frequency and Severity of Portal Hypertensive Gastropathy in Cirrhosis

Abstract

Introduction: Portal hypertensive gastropathy (PHG) is a common endoscopic finding in patients with Cirrhosis. The pathophysiology of PHG was not clearly understood. It was thought that Portal Hypertension was an important triggering factor for the development of PHG but the other factor must be considered for its progression. It is one of the clinically important gastric mucosal lesions because it may cause acute and chronic gastrointestinal blood loss leading to anemia. The aim of our study is to determine the frequency and severity of PHG in patient with Cirrhosis.

Methods: This was a Cross-sectional observational study involving 61 consecutive Cirrhotic Patients, who attended Upper GI endoscopy were enrolled in this study as per inclusion and exclusion criteria in the Department of Gastroenterology Tribhuvan University Institute of Medicine. Child-Pugh’s score and MELD score was determined at the entry to determine the severity of liver disease. Data regarding clinical and laboratory investigations were collected. Variceal size was measured endoscopically and the severity of PHG was graded according to Mac Cormack Classification.

Results: Out of total 61 patients, the frequency of PHG was found to be 47.5% among them where 44.2% patients had mild PHG and 3.3% patients having severe PHG. There were 29.5% patients in child pugh A, 39.3% in child pugh B and 31.2% in child pugh C. During analysis insignificant relation was found between the PHG with Child pugh score (ρ=0.4) and MELD score (ρ=0.7).When PHG frequency was related to alcohol intake the relations were statistically not significant. There was no association found between portal hypertensive gastropathy with esophageal varices and gender of the patient.

Conclusion: Our data showed that the frequency and the severity of PHG are not influenced by the Gender of the patient, etiology and severity of cirrhosis or by presence of esophageal varices.