Definition
Solitary rectal ulcer syndrome is a condition that occurs when asore (ulcer) develops in the rectum. The rectum is a muscular tube that is connected to the end of the colon, where stool passes through.
Solitary rectal ulcer syndrome is a rare disorder that occurs in individuals with chronic constipation. It can present rectal bleeding, straining of bowel movements and sense of incomplete passing of stools. In some cases, more than one rectal ulcer can occur in solitary rectal ulcer syndrome.
Treatment options for solitary rectal ulcer syndrome typically involve lifestyle changes, medications and surgical procedures if necessary.
Symptoms
Common signs and symptoms of solitary rectal ulcer syndrome include the following:
- Constipation
- A feeling of incomplete passing of stool
- Pelvic pain
- Pelvic fullness
- Mucus discharge from the rectum
- Rectal pain
- Rectal bleeding
- Anal sphincter spasms
- Straining during bowel movements
In some cases, individuals with solitary rectal ulcer syndrome may not experience any symptoms.
Causes
Doctors also believe that stress or injury to the rectum may cause rectal ulcers to form, though the exact cause it not always clear.
Examples of instances where the rectum could get injured include:
- Constipation
- Anal intercourse
- Attempts to manual disimpaction of hard stools
- Intussusception: The inversion of one portion of the intestine within another
- Radiation therapy
- Straining during bowel movements
- The use of ergotamine suppositories
- Tightening of pelvic floor muscles that can slow blood flow to the rectum
Complications
Possible complications that can arise from the development of solitary rectal ulcer syndrome include the following:
- Extreme rectal bleeding (Hemorrhage)
- Severe abnormal bowel function
- Formation of an sore
- Formation of a hole through the rectal wall underneath the ulcer
- Infection from a surgical procedure
Treatment
Treatment options for solitary rectal ulcer syndrome depend on the severity of the condition as well as an indivudal’s symptoms.
Individuals with mild signs and symptoms may find relief through:
- Making certain lifestyle changes through eating a healthier diet, maintaining a healthy weight, and exercising regularly.
- Taking certain medications such as topical steroids, sulfasalazine enemas and botulinum toxin (Botox) to help ease rectal ulcer symptoms.
- Going to behavior therapy to learn to relax the pelvic muscles and stop straining during bowel movements
- Biofeedback: A method that teaches control of certain involuntary body responses, such as tightening of the anus or pelvic floor muscles during defecation.
Individuals with more severe signs and symptoms may consider surgical procedures such as:
- Rectal prolapse surgery: A surgical procedure that involves the repairing of the rectal prolapse by anatomically correcting the position with stitches.
- Protectomy: A surgical procedure that involves removal of the rectum.
For some individuals who are surgically treated, a temporary or permanent opening may be needed to be formed in order to permit passing of stools (colostomy).
- Colostomy: A surgical procedure in which the colon is connected to an opening in the abdominal wall, a bag is then attached to the abdomen and waste is able to collect and further leave the body.
