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.
How common is solitary rectal ulcer syndrome?
Solitary rectal ulcer syndrome is a rare and poorly understood disorder that often occurs in people with chronic constipation. Please discuss with your doctor for further information.
What are the symptoms of solitary rectal ulcer syndrome?
The common symptoms of solitary rectal ulcer syndrome are:
- 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
However, some people with solitary rectal ulcer syndrome may experience no symptoms.
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.
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.
What increases my risk for solitary rectal ulcer syndrome?
There are many risk factors for solitary rectal ulcer syndrome, such as:
- Rectal prolapse
- Paradoxical contraction of the puborectalis muscle
- Chronic constipation
- Attempts at manual disimpaction of hard stools
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?
Tests and procedures used to diagnose rectal ulcers include:
- During this test, your doctor inserts a flexible tube equipped with a lens into your rectum to examine your rectum and part of your colon. If a lesion is found, your doctor may take a tissue sample (biopsy) for laboratory testing.
- This imaging technique uses sound waves to create pictures. Your doctor may recommend an ultrasound to help differentiate solitary rectal ulcer syndrome from other conditions.
- Imaging studies. Your doctor may recommend an imaging procedure, such as defecation proctography. This test allows the doctor to look at your rectum. During this procedure, your doctor inserts a soft paste made of barium into your rectum. You then pass the barium paste as you would stool. The barium shows up on X-rays and may reveal a prolapse or problems with muscle function and muscle coordination. Specialized centers may offer magnetic resonance defecography. This test is done on a magnetic resonance imaging (MRI) machine and provides a 3-dimensional image of the rectum.
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.
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.
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.
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.
- Solitary rectal ulcer syndrome. http://www.mayoclinic.org/diseases-conditions/rectal-ulcer/basics/definition/con-20027352. Accessed 17 Apr 2017
- solitary rectal ulcer syndrome. https://www.msdmanuals.com/en-sg/professional/gastrointestinal-disorders/anorectal-disorders/solitary-rectal-ulcer-syndrome. Accessed 17 Apr 2017
- Solitary rectal ulcer syndrome. http://www.uptodate.com/contents/solitary-rectal-ulcer-syndrome. Accessed 17 Apr 2017
Review Date: August 4, 2017 | Last Modified: August 4, 2017