Background: It is a great challenge and complex process to manage complications in liver disease. Endoscopy was introduced and gained wide acceptance in the management of patients with liver disease.  
The aim of the work: The study aimed to assess the prevalence and clinical value of various forms of colonic mucosal changes in patients with liver cirrhosis and portal hypertension [PHT]. In addition to correlate these changes with oesophageal varices [OV] and portal hypertensive gastropathy [PHG].
Subjects and Methods: This prospective observational study included 50 adult patients with established diagnosis of liver cirrhosis and PHT. They were evaluated clinically, and then submitted to abdominal ultrasound, upper and lower gastrointestinal endoscopy.
Results: Esophageal varices and portal hypertension gastropathy, significantly associated with colonic hyperemia [colonic hyperemia was reported among 57.5% of esophageal varices compared to 20.0% of cases without varices; and reported with 60.0% of patients with compared to 26.7% of those without PHG].
Conclusion: The prevalence of hyperemia [colopathy] is associated with esophageal varices and portal hypertensive gastropathy.