Haemorrhoids - a collagen disease?
OBJECTIVE
The cause of haemorrhoidal disease is unknown, epidemiological data and histopathological findings support the hypothesis that reduced connective tissue stability is associated with the incidence of haemorrhoids. Therefore the aim of this study was to analyse the quantity and quality of collagen formation in the corpus cavernosum recti in patients with III°/IV° haemorrhoids in comparison with persons without haemorrhoids.


METHODS
Haemorrhoidectomy specimens of 31 patients with III°/IV° haemorrhoids were examined. The specimens of 20 persons who died a natural death and who had no haemorrhoidal disease served as the controls. The amount of collagen was estimated photometrically by calculating the collagen/protein ratio. The collagen I/III ratio served as parameter for the quality of collagen formation and was calculated using cross polarization spectroscopy.


RESULTS
Patients with haemorrhoids had a significantly reduced collagen/protein ratio (42.2 ± 16.2μg/mg vs 72.5±31.0μg/mg; P= 0.02) and a significantly reduced collagen I/III ratio (2.0±0.1 vs 4.6±0.3; P<0.001) compared with persons without haemorrhoidal disease. There was no correlation with patients' age or gender.


CONCLUSIONS
There is a fundamental disorder of collagen metabolism in patients with haemorrhoidal disease. It remains unclear whether this is due to exogenous or endogenous influences.
Willis
S
S
Department of Surgery, Klinikum Ludwigshafen, Germany. williss@klilu.de
Junge
K
K
Ebrahimi
R
R
Prescher
A
A
Schumpelick
V
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003094:Collagen / Q000096:biosynthesis*; D024042:Collagen Type I / Q000032:analysis; D024061:Collagen Type III / Q000032:analysis; D005260:Female; D006484:Hemorrhoids / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011506:Proteins / Q000032:analysis
D024042:Collagen Type I; D024061:Collagen Type III; D011506:Proteins; D003094:Collagen