INFLAMMATION-RELATED FACTORS IN HEMORRHOIDS

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 E(2) (PGE(2)) and F-2 alpha (PGF(2 alpha)) and of leukotriene B-4 (LTB(4)) in the vascular and mucosal tissues of the anterior and posterior haemorrhoidal plexus. Results: Very high levels of prostaglandins were recorded (up to 1445 mu g/g fresh tissue of PGE(2) 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 PGE(2) than PGF(2 alpha) was produced. These two eicosanoids were strongly correlated (0.73-0.93 according to sample). LTB(4) production was up to 20 times lower than that of PGE(2) (6-10 ng/g, group II; 17-52 ng/ g, group I). Conclusions: PGF(2 alpha) and LTB(4) seem to be valuable independent study parameters to be included in the design of protocols investigating the action of antiinflammatory agents on haemorrhoids.