Natural history of portal hypertensive gastropathy in patients with liver cirrhosis

Massimo Primignani, Luca Carpinelli, Paoletta Preatoni, Giorgio Battaglia, Alessandra Carta, Alberto Prada, Renzo Cestari, Paolo Angeli, Angelo Gatta, Alfredo Rossi, Giancarlo Spinzi, Roberto De Franchis

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Aims: The clinical importance of portal hypertensive gastropathy (PHG) as a source of gastrointestinal bleeding in patients with cirrhosis is poorly defined. We investigated the natural history of this condition in a large series of patients. Methods: All patients with cirrhosis seen at 7 hospitals during June and July 1992 were followed up with clinical and endoscopic examinations every 6 months for up to 3 years. Gastropathy was classified according to the classification of the New Italian Endoscopic Club. Results: The prevalence of gastropathy was 80% and was correlated with the duration of disease, presence and size of esophagogastric varices, and a previous history of endoscopic variceal sclerotherapy. During 18 ± 8 months of follow-up, gastropathy was stable in 29% of patients, deteriorated in 23%, improved in 23%, and fluctuated with time in 25%. The evolution of gastropathy with time was identical in patients with and without previous or current sclerotherapy. Acute bleeding from gastropathy occurred in 8 of 315 patients (2.5%). The bleeding-related mortality rate was 12.5%. Chronic bleeding occurred in 34 patients (10.8%). Conclusions: PHG is common in patients with cirrhosis, and its prevalence parallels the severity of portal hypertension. Gastropathy can progress from mild to severe and vice versa or even disappear completely. Bleeding from this lesion is relatively uncommon and rarely severe. Sclerotherapy of esophageal varices does not seem to influence the natural history-of this condition.

Original languageEnglish
Pages (from-to)181-187
Number of pages7
JournalGastroenterology
Volume119
Issue number1
Publication statusPublished - Jul 2000

ASJC Scopus subject areas

  • Gastroenterology

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