Solitary rectal ulcer syndrome

Diagnosis

The following tests may be used to identify solitary rectal ulcer syndrome in you:

• Sigmoidoscopy. A sigmoidoscopy is a medical procedure in which a slender and flexible tube equipped with a small camera is inserted into your rectum to inspect your rectum and a portion of your colon. In case any abnormality is detected, the doctor may obtain a sample of tissue for further examination in a laboratory.
• Ultrasound. An imaging modality that employs sound waves to produce images is known as an ultrasound. If your physician suspects solitary rectal ulcer syndrome and needs to distinguish it from other medical conditions, they may suggest an ultrasound.
• Other imaging studies. Your healthcare provider may recommend a test called defecation proctography to examine any potential issues with muscle coordination or prolapse. During this test, a paste made of barium will be inserted into your rectum, which you will expel as if it were stool. The barium paste will be visible on X-rays, allowing your healthcare provider to identify any problems. Some specialized facilities may offer a similar test called magnetic resonance defecography, which uses a magnetic resonance imaging machine to create a 3D image of the rectum.

Treatment

The severity of your problem will determine how you are treated for solitary rectal ulcer syndrome. While some with more severe symptoms may need medical or surgical treatment, those with milder symptoms may find relief via dietary or lifestyle modifications.

• Dietary changes. You might receive advice on increasing your dietary fiber intake to help with constipation.
• Behavior therapy. Straining during bowel movements could be a result of habitual behavior. Behavioral therapy may be beneficial in aiding individuals to learn to relax their pelvic muscles while passing stool. A technique known as biofeedback involves a specialist training an individual to manage specific involuntary bodily responses, such as the tightening of the pelvic floor or anus muscles during defecation. Through biofeedback, an individual may become more conscious of their straining and can develop better control over it.
• Medications. Your rectal ulcer symptoms may be lessened by some therapies such topical steroids, sulfasalazine enemas, and onabotulinumtoxinA (Botox). Unfortunately, not everyone responds well to these treatments, and several are still regarded as experimental.

Solitary rectal ulcer syndrome is treated surgically using the following techniques:

• • Surgery to correct rectal prolapse. Your doctor might advise a rectopexy procedure if you have a rectal prolapse that’s producing symptoms. The rectum is kept in its anatomically right place via rectopexy.
  • Surgical removal of the rectum. If you have severe symptoms that have not responded to conventional therapies, an operation to remove the rectum may be a possibility. The surgeon could join the colon to an abdominal hole to allow waste to exit the body (colostomy). A pouch or bag is then placed to your abdomen to collect waste if you have a colostomy.