Solitary rectal ulcer syndrome is a rare condition that's often linked to chronic constipation. Learn more about symptoms and treatment.
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 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 the name, sometimes more than one rectal ulcer occurs in solitary rectal ulcer syndrome.
Solitary rectal ulcer syndrome may improve with simple lifestyle strategies, such as changing your diet and drinking more fluids. In severe cases, however, surgery may be needed.
Signs and symptoms of solitary rectal ulcer syndrome include:
However, some people with solitary rectal ulcer syndrome may experience no symptoms.
Make an appointment with your doctor if you notice any signs or symptoms that worry you.
Several other conditions may cause signs and symptoms similar to those of solitary rectal ulcer syndrome. At your appointment, your doctor may recommend tests and procedures to identify or rule out causes other than 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.
Among the things that could injure the rectum are:
You may have one or more of the following tests to diagnose solitary rectal ulcer syndrome:
Other imaging studies. Your doctor may order an imaging study called defecation proctography. In this study, a soft paste made of barium is inserted 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 a similar test called magnetic resonance defecography. This test is done with a magnetic resonance imaging machine and provides a 3D image of the rectum.
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 medical or surgical treatment.
Behavior therapy. You may strain during bowel movements out of habit. Behavior therapy can help you learn to relax your pelvic muscles during bowel movements.
In one behavioral technique, called biofeedback, a specialist teaches you to control certain involuntary body responses, such as the 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.
Surgical procedures used to treat solitary rectal ulcer syndrome include:
You can make changes to your daily life that may help relieve your symptoms. Such changes are likely to include:
Increasing 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. Aim for 14 grams of fiber for every 1,000 calories in your daily diet.
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.
Trying bulk laxatives and stool softeners. Bulk laxatives, such as psyllium husk (Metamucil, Natural Fiber Therapy, others) and calcium polycarbophil (FiberCon, Fiber-Lax, others), absorb 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, such as docusate (Colace, Surfak, others), help mix fluid into stools, making them easier to pass.
Start by seeing your primary doctor if you have signs or symptoms that worry you. If your doctor suspects that you may have solitary rectal ulcer syndrome, you may be referred to a doctor who specializes in the digestive system (gastroenterologist).
For solitary rectal ulcer syndrome, some basic questions to ask your doctor include:
Your doctor is likely to ask you a number of questions. If you've thought about your answers, you may have additional time to go over any points you want to spend more time on.
Your doctor may ask:
July 23rd, 2021