Prevalelence and Factors Associated with Portal Hypertensive Gastropathy among Patients with Portal Hypertension

Introduction: Portal hypertensive gastropathy (PHG) is an under-recognized cause of morbidity in patients with portal hypertension (PH), with a reported prevalence of 20–80%. Portal hypertension and the severity of liver disease are the key predictors of PHG. This study aimed to determine the prevalence, severity, and associated risk factors of PHG in patients with PH. Methods: This observational study was conducted from August 2022 to December 2024 and enrolled subjects of any age and sex with clinical or laboratory evidence of PH, irrespective of etiology. Statistical analysis was performed using SPSS version 27, with a p-value of ≤0.05 considered statistically significant. Results: Among the participants (n = 128), 81 (63.5%) were male and 47 (36.5%) were female. The mean age was 51.45 ± 12.76 years, with no significant sex difference (p = 0.190). Most patients with cirrhotic PH (n=126, 98.4%) presented with features of decompensated cirrhosis: ascites in 61.7%, upper gastrointestinal bleeding (UGIB) in 28.9%, and hepatic encephalopathy in 23.4%. Chronic hepatitis B virus infection (CHBV) (31.5%), cryptogenic cirrhosis (23.0%), nonalcoholic steatohepatitis (NASH)-related cirrhosis (13.5%), and mixed etiology (6.3%) were common causes of cirrhosis. Approximately 71.5% of patients (mild: 54; severe: 37) had endoscopic features of PHG, with similar prevalence and severity in both sexes (p = 0.611). No significant associations were observed between Child–Turcotte–Pugh (CTP) score (p = 0.385), variceal grade (p = 0.812), thrombocytopenia, prior variceal obliteration (p = 0.343) and the severity of PHG. Hypoalbuminemia was associated with a two-fold increase in the odds of PHG (OR 2.08; p = 0.130). Conclusion: PHG is common in cirrhotic portal hypertension, particularly in advanced liver disease. However, this cross-sectional study could not establish the temporal relationship between PHG progression and the severity of liver disease. A longitudinal cohort study is recommended to better identify predictive factors for PHG. Medicine Today 2026, Vol.38 (2): 208-213