title: Prevalence, variability, and outcomes in portal hypertensive colopathy: a study in patients with cirrhosis and paired controls.
abstract: BACKGROUND
  Management of portal hypertensive colopathy (PHC) has been challenged by controversial results in its prevalence and clinical relevance.
  
  
  OBJECTIVE
  To describe the PHC prevalence and to evaluate the variability in diagnosis, the relation to severity of liver disease, and the incidence of severe outcomes.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Endoscopic unit of a tertiary-care academic center in Rio de Janeiro, Brazil.
  
  
  METHODS
  Patients with cirrhosis with portal hypertension and controls paired for age and sex.
  
  
  METHODS
  All patients were submitted to standard and image-enhanced colonoscopies, which were recorded in a coded video file and analyzed twice by a blinded endoscopist.
  
  
  METHODS
  The prevalence of PHC.
  
  
  RESULTS
  A total of 51 patients with cirrhosis (55% male, mean age 59 years) and 51 healthy controls (43% male, mean age 61 years) were included. The top ranking colonoscopic findings were angiodysplasia-like lesions, nonspecific vascular pattern, red spots, and colorectal varices, all significantly more frequent in patients with cirrhosis compared with controls. PHC prevalence was 71% in patients with cirrhosis. For PHC, interobserver and intraobserver agreement (k values [standard error]) were 0.68 (0.09) and 0.63 (0.10), respectively. Intraobserver agreement for colonoscopic findings was satisfactory. PHC was not related to more severe liver disease or liver stiffness. Only 5 patients developed severe outcomes during follow-up.
  
  
  CONCLUSIONS
  The exclusion of patients with cirrhosis without esophageal varices and the absence of an interobserver agreement analysis by double-blinded endoscopists.
  
  
  CONCLUSIONS
  PHC was highly prevalent in patients with cirrhosis, and its diagnostic agreement was satisfactory. PHC is not associated with relevant severe outcomes in a 12-month follow-up.
authors.affiliation: Gastroenterology and Hepatology Department, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Raquel A P
authors.initials: RA
authors.lastname: Guimarães
authors.affiliation: Laboratory of Clinical Research on STD/AIDS, National Institute of Infectious Disease-Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
authors.forename: Hugo
authors.initials: H
authors.lastname: Perazzo
authors.affiliation: Gastroenterology and Hepatology Department, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Lilian
authors.initials: L
authors.lastname: Machado
authors.affiliation: Gastroenterology and Hepatology Department, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Carlos
authors.initials: C
authors.lastname: Terra
authors.affiliation: Gastroenterology and Hepatology Department, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Internal Medicine Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Renata M
authors.initials: RM
authors.lastname: Perez
authors.affiliation: Gastroenterology and Hepatology Department, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; Internal Medicine Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Fatima A F
authors.initials: FA
authors.lastname: Figueiredo
mesh_terms: D000368:Aged; D016888:Angiodysplasia / Q000453:epidemiology* / Q000209:etiology; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D003108:Colonic Diseases / Q000453:epidemiology* / Q000209:etiology; D003113:Colonoscopy; D003430:Cross-Sectional Studies; D004932:Esophageal and Gastric Varices / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000453:epidemiology*; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014648:Varicose Veins / Q000453:epidemiology* / Q000209:etiology