Solitary Rectal Ulcer Syndrome

1 What is Solitary Rectal Ulcer Syndrome?

A condition that occurs when one or more sores or ulcers develop in rectum – a muscular tube that is connected to the end of your colon where the stool passes through – is called solitary rectal ulcer syndrome. It is rare condition and often happens in people with chronic constipation.

This can cause straining during bowel movements and rectal bleeding.

Changing your diet with fluid intake or surgery are the treatments for solitary rectal ulcer syndrome.

2 Symptoms

The signs and symptoms of solitary rectal ulcer syndrome include:

  • rectal bleeding,
  • constipation,
  • pain or feeling of fullness in your pelvis,
  • straining during bowel movements,
  • passing mucus form your rectum,
  • a feeling of incomplete passing of stool,
  • rectal pain,
  • and fecal incontinence.

In some cases there are no signs and symptoms.

To rule out other conditions, your doctor may recommend tests and procedures.

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3 Causes

Doctors believed that stress or injury to the rectum may cause solitary rectal ulcer syndrome.

Examples of situations are:

  • straining during bowel movements;
  • impacted stool or constipation;
  • attempts to manually remove impacted stool;
  • rectal prolapsed;
  • uncoordinated tightening of the pelvic floor muscles that will slow the blood flow to the rectum;
  • and intussusceptions.

4 Making a Diagnosis

Making a diagnosis of solitary rectal ulcer syndrome is done by performing several tests.

Consult your doctor and he may refer you to a gastroenterologist who specializes in the digestive system.

Write down the symptoms that you are experiencing and the major stresses or recent life changes in your life. Make a list of all the supplements, medications and vitamins that you are taking.

Some of the questions that you can ask your doctor include:

  • What is likely causing my symptoms?
  • What are the other possible causes?
  • What kind of tests do I need?
  • Do I need treatment?
  • What are the treatment options?
  • Do I need to follow any restrictions?
  • Do I need follow up visits?

Your doctor may also ask you questions such as:

  • When did you first experience the symptoms?
  • How severe are they?
  • Are they occasional or continuous?
  • Have you recently had constipation?

Your doctor may recommend tests such as:

  • sigmoidoscopy – to examine your colon and rectum by inserting a flexible tube equipped with a lens, your doctor may also have biopsy if he found a lesion,
  • ultrasound – to differentiate solitary rectal ulcer syndrome to other conditions,
  • imaging studies – such as defecation proctography to look at your rectum by inserting a soft paste made of barium into your rectum.

This barium will show up on X-ray and may reveal problems or prolapsed with muscle coordination and muscle function.

Some centers may have magnetic resonance defecography that produces 3-dimensional image of the rectum.

5 Treatment

Depending on the severity of solitary rectal ulcer syndrome your doctor will suggest the treatments.

Some may have mild symptoms while others may have severe. These are:

  • you should have lifestyle changes and dietary changes, including increasing fiber in your diet;
  • there is a behavior therapy in which it can help you relax your pelvic muscles during bowel movements such as Biofeedback technique that can help you control certain involuntary body responses;
  • medications such as topical steroids, botulinum toxin (Botox) and sulfasalazine enemas to ease the symptoms but these does not work for everyone;
  • rectal prolapse surgery such as rectopexy procedure that will put your rectum in its correct position;
  • surgery to remove the rectum, this is for people who have severe symptoms that other treatments cannot help, you will have a colostomy, a bag will be attached to your abdomen to collect waste.

6 Prevention

To prevent solitary rectal ulcer syndrome you must prevent being constipated.

You can have dietary changes that are high in fiber with a combination of stool softeners and with lots of fluid intake.

You should exercise regularly to help regulate the system and relieve pain and inflammation.

7 Alternative and Homeopathic Remedies

There are no homeopathic or alternative remedies for solitary rectal ulcer syndrome.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with solitary rectal ulcer syndrome. These include:

Increase the amount of fiber in your diet

By eating at least 20 to 35 grams of fiber each day because this add bulks in your stool that helps pushes the contents in your intestines.

The foods that are rich in fiber are whole grains such as

  • cereals,
  • breads,
  • bran or oats
  • and eat fruits and vegetables with their skin on.

Bulk laxatives and stool softeners

Making it easier to pass such as Metamucil and FiberCon that can push the stool out.

Drink water throughout the day

This will make your stool soft. You can also have other fluids such as

  • prune juice that has a natural laxative effect,
  • lemon juice or noncarbonated and caffeine-free drinks.

9 Risks and Complications

There are several risks and complications associated with solitary rectal ulcer syndrome.

People with certain psychological disorders such as OCD are at risk of having solitary rectal ulcer syndrome if they practice abnormal toileting behaviors.

The complications include:

  • excessive rectal bleeding or hemorrhage;
  • formation of an abscess;
  • extreme disturbance of bowel function;
  • formation of a hole (perforation) through the rectal wall beneath the ulcer;
  • and surgical infection.
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