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 F2α (PGF2α) 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 PGF2α 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: PGF2α 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.
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