Inflammation-Related Factors in Haemorrhoids

Abstract

Objective:

To establish whether eicosanoid production characterizes the inflammatory processes of the haemorrhoidal plexus.

Design:

Open, single patient group study.

Setting:

Private practice.

Patients:

Fourteen patients selected for haemorrhoidectomy.

Interventions:

Specimens were obtained during either the acute (five patients, group I) or chronic (nine patients, group II) phase of the disease. We assayed the concentrations of prostaglandins E₂ (PGE₂) and F_2α (PGF_2α) and of leukotriene B₄ (LTB₄) in the vascular and mucosal tissues of the anterior and posterior haemorrhoidal plexus.

Results:

Very high levels of prostaglandins were recorded (up to 1445 <g/g fresh tissue of PGE₂ in group I), which were consistently higher in group II than group I (p <0.05, Wilcoxon distribution free test) for 10 out of 18 parameters measured. Four to 20 times more PGE₂ than PGF_2α was produced. These two eicosanoids were strongly correlated (0.73–0.93 according to sample). LTB₄ production was up to 20 times lower than that of PGE₂ (6–10 ng/g, group II; 17–52 ng/g, group I).

Conclusions:

PGF_2α and LTB₄ seem to be valuable independent study parameters to be included in the design of protocols investigating the action of anti-inflammatory agents on haemorrhoids.