Solitary Rectal Ulcer Syndrome in Patients Presenting With Lower Gastrointestinal Bleeding: A Tertiary-Care Hospital Experience

Abstract

Background: Solitary rectal ulcer syndrome (SRUS) is a benign rectal condition associated with defecation disorder that has multifactor pathologies and variable findings on presentation, endoscopy, and histopathology. A diagnostic dilemma with an overlap of differentials and step-wise management that starts with conservative therapies and goes up to repeated surgeries in case of failure of the conservative approach.Objective: This study aims to observe clinical, endoscopic, and histological features of SRUS in patients presenting with lower gastrointestinal bleeding.

Rectal bleeding as a symptom of solitary rectal ulcer syndrome mimicking rectal neoplasm on colonoscopy: A case report

“…The most common symptoms of SRUS are rectal bleeding, constipation, anemia, and abdominal pain 7 . In our case, rectal bleeding, chronic constipation, and mild anemia were present, but there was no abdominal pain, and the abdominal examination was normal.…”

“…The most common symptoms of SRUS are rectal bleeding, constipation, anemia, and abdominal pain. 7 In our case, rectal bleeding, chronic constipation, and mild anemia were present, but there was no abdominal pain, and the abdominal examination was normal. The most common colonoscopy findings are solitary lesions, ulcerative lesions, multiple lesions, and erythematous lesions 7 ; however, some patients do not have any ulcers.…”

“…SRUS is a spectrum of clinicopathological abnormalities 4 ; in this report, we presented a polypoid lesion of the rectum, a rare variant of SRUS. 6 , 7 As mentioned, the exact pathogenesis of SRUS is unknown, and several factors are proposed to play roles in its development. 5 In our case, it was probably due to excessive straining to defecate, as a result of chronic constipation.…”

“… 1 , 2 Ulcers are usually located in the anterolateral wall of the rectum within 3–10 cm of the anal verge. 1 , 2 , 7 In addition, prolapse of rectal mucosa may be seen in a variety of situations such as the margin of hemorrhoid, diverticula, and any polypoid lesion. The partial mucosal prolapse of rectal mucosa (Not full‐thickness prolapse) in the anterior wall of the rectum is more favorable for SRUS.…”

“…The differential features of SRUS from rectal cancer are summarized in Table 1. [7][8][9][10] Treatment is based on the severity of the disease and the patient's symptoms, such as the severity of bleeding, constipation, ulcers, and rectal prolapse. Patient education and lifestyle changes are the first steps of treatment.…”