Solitary rectal ulcer syndrome
- 1 December 1998
- journal article
- review article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 85 (12), 1617-1623
- https://doi.org/10.1046/j.1365-2168.1998.00935.x
Abstract
Background: Solitary rectal ulcer syndrome is a rare disorder characterized by erythema or ulceration of the rectal wall, associated with typical histological features, and disturbed defaecatory behaviour with the passage of blood and mucus. Methods: This is a review based on a literature search using a computer database (Medline) and manual cross-referencing. Results: The pathogenesis is likely to vary in different patients; it includes trauma from straining, direct digital trauma and possibly primary neuromuscular pathology. The histological findings of extension of the muscularis mucosa between crypts and muscularis propria disorganization on full-thickness specimens are characteristic. Biofeedback defaecation retraining, including habit training, can lead to symptom improvement and return to work in a majority of patients. Abdominal rectopexy offers long-term symptom improvement in approximately 50 per cent of patients. Rectal ulceration may persist after any treatment, even if symptoms improve. Conclusion: Behavioural therapy and carefully considered operations offer the best treatment results. Further work on psychological factors and neuromuscular and vascular pathology is required.This publication has 67 references indexed in Scilit:
- Ileostomy polyps, adenomas, and adenocarcinomas.Gut, 1995
- Evacuation proctography in patients with solitary rectal ulcer syndrome: anatomic abnormalities and frequency of impaired emptying and prolapse.American Journal of Roentgenology, 1995
- Solitary rectal ulcer syndrome in a childThe Journal of Pediatrics, 1993
- Solitary rectal ulcer: An unusual cause of rectal bleeding in childrenEuropean Journal of Pediatrics, 1992
- Solitary rectal ulcer: The place of biofeedback and surgery in the treatment of the syndromeWorld Journal of Surgery, 1992
- Solitary rectal ulcer syndrome: A radiologic diagnosis?Gastrointestinal Radiology, 1986
- Anorectal incontinence and rectal prolapse: differential assessment of the innervation to puborectalis and external anal sphincter muscles.Gut, 1985
- Das akut blutende MastdarmulcusDeutsche Medizinische Wochenschrift (1946), 1985
- Treatment of solitary rectal ulcer syndrome with high-fiber diet and abstention of straining at defecationDigestive Diseases and Sciences, 1984
- “The Evolution of the Solitary Ulcer of the Rectum” - An Endoscopic and Histopathological Study -Endoscopy, 1982