Definition

What is solitary rectal ulcer syndrome?

Solitary rectal ulcer syndrome is a condition that occurs when one or more open sores (ulcers) develop in the rectum. The rectum is a muscular tube that’s connected to the end of your colon. Stool passes through the rectum on its way out of the body.

Solitary rectal ulcer syndrome is a rare and poorly understood disorder that often occurs in people with chronic constipation. Solitary rectal ulcer syndrome can cause rectal bleeding and straining during bowel movements. Despite its name, sometimes more than one rectal ulcer occurs in solitary rectal ulcer syndrome.

How common is solitary rectal ulcer syndrome?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of solitary rectal ulcer syndrome?

The common symptoms of solitary rectal ulcer syndrome are:

  • Constipation
  • Rectal bleeding
  • Straining during bowel movements
  • Pain or a feeling of fullness in your pelvis
  • A feeling of incomplete passing of stool
  • Passing mucus from your rectum
  • Fecal incontinence
  • Rectal pain

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes solitary rectal ulcer syndrome?

It’s not always clear what causes solitary rectal ulcer syndrome. Doctors believe stress or injury to the rectum may cause rectal ulcers to form.

Examples of situations that could injure the rectum include:

  • Constipation or impacted stool
  • Straining during bowel movements
  • Rectal prolapse, which occurs when the rectum protrudes from the anus
  • Uncoordinated tightening of the pelvic floor muscles that slows blood flow to the rectum
  • Attempts to manually remove impacted stool
  • Intussusception, which occurs when part of the intestine slides inside another part

Risk factors

What increases my risk for solitary rectal ulcer syndrome?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is solitary rectal ulcer syndrome diagnosed?

  • Clinical evaluation
  • Flexible sigmoidoscopy with biopsy

Diagnosis of solitary rectal ulcer syndrome is typically made by clinical history alone, but flexible sigmoidoscopy with biopsy is sometimes done for confirmation. Assessment for internal or full-thickness rectal prolapse should be done (see diagnosis of rectal prolapse).

Histopathologic examination of the biopsy specimen shows a thickened mucosal layer with distortion of the crypt architecture and replacement of the lamina propria with smooth muscle and collagen, leading to hypertrophy and disorganization of the muscularis mucosa.

How is solitary rectal ulcer syndrome treated?

Treatment for solitary rectal ulcer syndrome depends on the severity of your condition. People with mild signs and symptoms may find relief through lifestyle changes, while people with more-severe signs and symptoms may require treatment.

Lifestyle changes

Dietary changes, including increasing fiber in your diet

Behavior therapy to stop straining during bowel movements

Some people strain during bowel movements out of habit. Behavior therapy can help you learn to relax your pelvic muscles during bowel movements.

In one technique called biofeedback, a specialist teaches you to control certain involuntary body responses, such as tightening of your anus or pelvic floor muscles during defecation. Biofeedback may make you more aware of your straining and help you to control it.

Medications

Certain treatments such as topical steroids, sulfasalazine enemas and botulinum toxin (Botox) may help ease your rectal ulcer symptoms. However, these treatments don’t work for everyone, and some are still considered experimental.

Surgery

Surgical procedures used to treat solitary rectal ulcer syndrome include:

  • Rectal prolapse surgery. If you have a rectal prolapse that’s causing symptoms, your doctor may recommend a rectopexy procedure. Rectopexy secures the rectum in its anatomically correct position.
  • Surgery to remove the rectum. An operation to remove the rectum may be an option for people with severe signs and symptoms who haven’t been helped by other treatments. The surgeon may connect the colon to an opening in the abdomen for waste to leave the body (colostomy). If you have a colostomy, a pouch or bag is then attached to your abdomen to collect waste.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage solitary rectal ulcer syndrome?

The following lifestyles and home remedies might help you cope with solitary rectal ulcer syndrome:

  • Increase the amount of fiber in your diet. Fiber adds bulk to your stool. The bulk helps push the contents of your intestines along so that they can be eliminated when you have a bowel movement. Try to eat at least 20 to 35 grams of fiber each day. Nutrition labels on food packaging list the amount of fiber in a serving.The best sources of fiber are fruits, vegetables and whole grains. Eat fruits and vegetables with the skin on, and choose whole fruits and vegetables over juices. Look for breads and cereals that list whole wheat, oats or bran as the first ingredients.
  • Try bulk laxatives and stool softeners. Bulk laxativesabsorb fluid in the intestines and make stools bulkier, which helps trigger the bowel to contract and push stool out. However, they should be taken with water, or they can cause obstruction. Stool softeners help mix fluid into stools, making them easier to pass.
  • Drink water throughout the day. Drinking enough water and other fluids helps to keep your bowel movements soft and easy to pass. For variety, you may want to add lemon juice to water for flavor. Or try other noncarbonated and caffeine-free beverages. Prune juice can be helpful because it has a natural laxative effect.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: December 8, 2017 | Last Modified: December 8, 2017

Want to live your best life?
Get the Hello Doktor Daily newsletter for health tips, wellness updates and more.