However, 20% of the patients presented with diarrhea and 26% were asymptomatic. These findings show that there is a wide spectrum of clinical presentations. This study [1] also showed that the endoscopic findings were variable. [saudijgastro.com]

We are presenting the clinical and endoscopic spectrum of SRUS patients who presented to our hospital in the last twenty-one years. [bmcgastroenterol.biomedcentral.com]

Abstract We describe a highly unusual case of solitary rectal ulcer syndrome (SRUS) that presented as a large polyp protruding from the anal canal. A 67-year-old man presented with rectal bleeding and mucus discharge. [academic.oup.com]

Epidemiology Typically younger patients - average age of presentation ~30 years in one study. [3] Rare. Clinical presentation Usually presents as BRBPR ~ 85% of cases. [3] Abdominal pain present in approx. 1/3. [3] May be very painful. [librepathology.org]

An unusual progressive form of benign rectal ulceration was found in an infant who presented with repeated episodes of rectal bleeding. The ulceration failed to respond to medical treatment but was cured by anterior resection of the rectum. [ncbi.nlm.nih.gov]

• Asymptomatic

  The infection usually runs an asymptomatic course and the diagnosis is made by nucleic acid amplification techniques (NAAT) often after chlamydial screening or if complications occur. [paperity.org]

  When asked about symptoms after treatment, four patients were asymptomatic, three were much improved, and one was only slightly improved. [gut.bmj.com]

  In one series, 26% of people with SRUS were found to be asymptomatic and were only identified when being investigated for other pathologies [ 5 ]. [academic.oup.com]

  Tjandra reported that 26% of his series were asymptomatic. [1] It is reasonable to expect that patients with SRUS will have constipation, but some patients, unusually, may present with diarrhea. [saudijgastro.com]

  She continues to be asymptomatic at 1 year of follow up. Discussion Solitary rectal ulcer syndrome (SRUS) is a chronic, benign disorder of young adults, affecting the rectum, often related to straining or abnormal defecation. [tropicalgastro.com]

• Weight Loss

  The time that elapses during this period might have important clinical consequences like weight loss and anemia as demonstrated in the present series that 22% of patients presented with anemia and 16% had weight loss at the time of diagnosis. [bmcgastroenterol.biomedcentral.com]

  Palabras clave: Úlcera rectal Diagnóstico Tratamiento We present the case of an anorexic female patient who presented with considerable weight loss and the presence of blood and mucus in the stools of 1 year’s evolution. [elsevier.es]

  There was no history of fever, abdominal pain, anorexia or weight loss, joint paints, skin rash, drug/alcohol intake, digital evacuation of stools, or any other systemic or chronic illness. [tropicalgastro.com]

  These symptoms include: anemia due to blood loss malnutrition from poor eating unexplained weight loss UC can significantly impact a child’s life, especially if the condition isn’t treated and managed properly. [healthline.com]

  Ulcerative colitis can also be accompanied by a fever, diminished appetite and weight loss. Because the patient has a hard time absorbing nutrients from food, it can cause other symptoms like joint pain, eye problems, and liver disease. [livescience.com]

• Fatigue

  It started with feeling a little run down after working extra hard, perhaps there was some lightheadedness when he stood too quickly, and then came the fatigue. [medicinenet.com]

  Children may experience diarrhea with blood, stomach pain, abdominal cramping, and fatigue. In addition, they may experience issues compounded by the condition. [healthline.com]

  Patients also may experience anemia fatigue weight loss loss of appetite rectal bleeding loss of body fluids and nutrients skin lesions joint pain growth failure (specifically in children) About half of the people diagnosed with ulcerative colitis have [shafran.net]

  308 DOI: 10.17235/reed.2022.8546/2021 Silvia Espina Cadena, Elena del Valle Sanchez, Yolanda Martínez Santos, María Badía Martínez, Patricia Camo Monterde, Abstract We present the case of a 40-year-old male sent for fatigue, mild weight loss and rectal [reed.es]

• Malnutrition

  These symptoms include: anemia due to blood loss malnutrition from poor eating unexplained weight loss UC can significantly impact a child’s life, especially if the condition isn’t treated and managed properly. [healthline.com]

  […] lumbar disc disease, cauda equina syndrome, spinal tumours, multiple sclerosis. [ 5 ] Psychiatric disease. [ 8 ] In children, rectal prolapse may be associated with cystic fibrosis, Ehlers-Danlos syndrome, Hirschsprung's disease, congenital megacolon, malnutrition [patient.info]

• Malaise

  The baseball world blamed Ichiro Suzuki's malaise on playing too much in the World Baseball Classic. [medicinenet.com]

• Rectal Pain

  […] incontinence Rectal pain However, some people with solitary rectal ulcer syndrome may experience no symptoms. [mayoclinic.org]

  He had also experienced intermittent constipation without rectal pain for five years, which he had managed with self-administered simple enemas once a week for the past three years, but these were not effective at relieving the constipation. [bmj.com]

  The symptoms associated with ulcerative proctitis include: Diarrhea Bleeding Tenesmus (a persistent urge to empty the bowel whether or not stool is present) Mucus discharge Rectal pain Accidental Bowel Leakage Patients may notice the passage of blood [colonrectal.org]

  Constipation and straining (pushing too hard) during a bowel movement can cause rectal ulcers to develop as well. Signs of a rectal ulcer may include: Blood in the stool. Bleeding from the anus. Rectal pain. Painful Bowel movements. [my.clevelandclinic.org]

• Hematochezia

  Here, we present a case of a 77-year-old woman who was admitted due to massive hematochezia while on anticoagulation. [hindawi.com]

  […] propria accompanying invasive glands Mean age 35 years Occurs in older patients Clinical Mean age 35 years May occur in children Probably due to excess straining during defecation Frequent history of constipation or diarrhe Frequently presents with hematochezia [surgpathcriteria.stanford.edu]

  Acute hemorrhagic rectal ulcer and stercoral ulcer are disorders that occur in aged subjects with various underlying diseases, and they are often accompanied by massive hematochezia. [ci.nii.ac.jp]

  Ertem D, Acar Y, Karaa EK, Pehlivanoglu E: A rare and often unrecognized cause of hematochezia and tenesmus in childhood: solitary rectal ulcer syndrome. Pediatrics 2002;110: e79. [karger.com]

  A rare and often unrecognized cause of hematochezia and tenesmus in childhood: solitary rectal ulcer syndrome. Pediatrics. 2002; 110 (6)[ PubMed ] 18. Martin de Carpi J, Vilar P, Varea V. [colorectalresearch.com]

• Nausea

  Common side-effects of nicorandil therapy include headaches, flushing, nausea and dizziness, but more recently a number of reports have linked its use with oral [3], anal [4], vulval and parastomal ulceration [5], as well as anal fistulation [6] (see [pssjournal.biomedcentral.com]

  However, sulfapyridine may lead to side effects such as nausea, vomiting, heartburn, diarrhea, and headache. [shafran.net]

  Common symptoms of ulcerative colitis include: abdominal pain increased abdominal sounds bloody stools diarrhea fever rectal pain weight loss malnutrition UC may cause additional conditions such as: joint pain joint swelling nausea and decreased appetite [healthline.com]

• Vomiting

  The patient may vomit blood, or the blood may pass into the intestine, get digested, and come out as black, tarry stools. Bleeding ulcers are a big deal. Often, having endoscopy is both diagnostic and therapeutic. [medicinenet.com]

  Appendix 1 Reported side-effects of nicorandil by likelihood of occurrence Very common (affect 1 in 10 people) Headaches Common (affect between 1 in 10 to 1 in 100 people) Dizziness Nausea and vomiting Flushing of the skin Uncommon (affect between 1 in [pssjournal.biomedcentral.com]

  However, sulfapyridine may lead to side effects such as nausea, vomiting, heartburn, diarrhea, and headache. [shafran.net]

• Ulcer

  Control subjects and patients with the solitary rectal ulcer syndrome, both with and without mucosal ulceration, have been studied. A high incidence of rectal prolapse (94%) was present in the patients who voided. [ncbi.nlm.nih.gov]

  Yamigawa Variants in solitary ulcer syndrome of the rectum Acta Pathol Jpn, 38 (1988), pp. 471-478 [17.] L.F. Knoepp Jr, W.M. Davis Solitary rectal ulcer syndrome: not always ulcerated South Med J, 10 (1992), pp. 1033-1034 [18.] Y.S. Kang, M.A. [elsevier.es]

• Pruritus

  Common Causes Anal ulcers can arise from sexually transmitted diseases, pruritus ani (anal itching), and even the side effects of certain drugs. Others causes can include: Crohn’s Disease Crohn’s Disease is a frequent cause of anal ulcers. [crssny.com]

  The symptoms are identical to advanced hemorrhoidal disease, [12] and include: Fecal leakage causing staining of undergarments Rectal bleeding mucous rectal discharge Rectal pain Pruritus ani Cause [ edit ] The condition, along with complete rectal prolapse [en.wikipedia.org]

Laboratory workup revealed a WBC count of 8.6 × 109/L, hemoglobin level of 8.9 g/dL, and platelet count of 250,000/μL. [hindawi.com]

• Chlamydia

  Chlamydia infections occur nearly exclusively in the postpubertal period. The peak age group is 15–25 years. [paperity.org]

  Neisseria gonorrhoeae, Chlamydia trachomatis and syphilis can also infect the anus. Crohn's disease and, more commonly, ulcerative colitis can involve the rectal area, presenting as proctitis or fistulae. [aafp.org]

• Chlamydia Trachomatis

  Der Hautarzt, Dec 2016 Chlamydia trachomatis is the most common pathogen of sexually transmitted bacterial infections worldwide. Every year in Germany approximately 300,000 new infections are to be expected. [paperity.org]

  Neisseria gonorrhoeae, Chlamydia trachomatis and syphilis can also infect the anus. Crohn's disease and, more commonly, ulcerative colitis can involve the rectal area, presenting as proctitis or fistulae. [aafp.org]

• Colonic Ulcer

  Article CAS PubMed Google Scholar Titi MA, Seow C, Molloy RG: Nicorandil-induced colonic ulceration: a new cause of colonic ulceration. Report of four cases. Dis Colon Rectum. 2008, 51: 1570-3. 10.1007/s10350-008-9218-3. [pssjournal.biomedcentral.com]

The clinical course of this complication and results of treatment options are unknown. [ncbi.nlm.nih.gov]

Anorectal physiological studies were performed in 11 patients before treatment. A standardised questionnaire was used before and after treatment, and all but two patients were examined after treatment. [gut.bmj.com]

The choice of treatment depends on the severity of the rectal ulcer and the ability of the patient to cope with a specific kind of treatment method. [mademan.com]

There are 4 basic pillars of treatment: hygiene-dietary measures, pharmacological treatment, biofeedback and surgery. [elsevier.es]

Some individuals with more severe or significant damage may require more intensive treatment regimens. In any case, dietary changes and lifestyle remedies offer at least some level of treatment for affected individuals. [earthclinic.com]

In these cases there are more therapeutic possibilities and the prognosis is slightly better. There is no method of choice for SRUS treatment and the prognosis is hard to predict. [omicsonline.org]

[…] distal rectum may be noted ulcer is variably identified Defecating proctogram 1 spastic pelvic floor syndrome: inability for the pelvic floor to relax during the straining phase rectal wall infoldIngs slowly leading to an intussusception Treatment and prognosis [radiopaedia.org]

If the underlying disease is improved and hemostasis can be achieved, the prognosis is likely to be good. Hemostasis is therefore extremely important. [webview.isho.jp]

Prognosis was largely dependent on accurate diagnosis and management of the underlying disorders. [thedoctorsdoctor.com]

The prognosis for elderly patients presenting with rectal prolapse is variable and depends on the nature of any underlying or associated problems and the age and general well-being of the patient. [patient.info]

TERMINOLOGY Definitions Solitary rectal ulcer syndrome (SRUS) Chronic benign defecation disorder with histologic features of mucosal prolapse ETIOLOGY/PATHOGENESIS Contraction of Sphincter during Defecation Excessive straining → compression of rectal [basicmedicalkey.com]

[…] since not necessarily solitary, ulcerated or rectal) Epidemiology Uncommon (incidence of 1 per 100,000 per year) Usually third and fourth decade More common in women Rarely in children ( Pediatrics 2002;110:e79 ) Sites Usually in rectosigmoid colon Etiology [pathologyoutlines.com]

Major complaints include: feeling of "incomplete emptying of the rectum": tenesmus chronic constipation strenuous defecation rectal bleeding rectal mucus secretions non-specific pelvic pain Etiology Two functional disorders of defecation have been recognized [radiopaedia.org]

The exact etiology is not well understood. One theory is that abnormal rectal evacuation due to paradoxical contraction of the puborectalis muscle may play a role in the etiology of this disease. [saudijgastro.com]

Etiologic classification of colitis was lacking in 59% of the cases interpreted by the reviewers as suggestive or diagnostic of a specific cause. [thedoctorsdoctor.com]

Definition / general Solitary or multiple ulcerated or polypoid lesions 4 - 10 cm from anal margin Terminology Also called mucosal prolapse syndrome (may be a better term since not necessarily solitary, ulcerated or rectal) Epidemiology Uncommon (incidence [pathologyoutlines.com]

Epidemiology Typically younger patients - average age of presentation ~30 years in one study. [3] Rare. Clinical presentation Usually presents as BRBPR ~ 85% of cases. [3] Abdominal pain present in approx. 1/3. [3] May be very painful. [librepathology.org]

Epidemiology Uncommon but the true incidence is unknown because of under-reporting, especially in the elderly population. [patient.info]

Epidemiology of genital human papillomavirus infections. Epidemiol Rev. 1998;10:122–63. ... 2. Pfenninger JL. Androscopy: a technique for examining men for condyloma. J Fam Pract. 1989;29:286–8. 3. Centers for Disease Control and Prevention. [aafp.org]

Pathophysiology and role of biofeedback therapy in solitary rectal ulcer syndrome. Am J Gastroenterol. 2006; 101 (3): 613-8[ DOI ][ PubMed ] [ircmj.com]

Abe A common pathophysiology for full thickness rectal prolapse, anterior mucosal prolapse and solitary rectal ulcer Br J Surg, 3 (1989), pp. 290-295 [15.] A.M. Lessells, J. Swanson Beck, R.A. Burnett, S.R. Howatson, F.D. Lee, K.M. [elsevier.es]

Solitary rectal ulcer syndrome: Clinical features, pathophysiology, diagnosis and treatment strategies. World Journal of Gastroenterology. 2014;20:738. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921483/. Accessed July 26, 2018. [mayoclinic.org]

Although additional tests are available, they play little role in the patient’s management, but provide insights into the pathophysiology and are useful for research purposes. [abdominalkey.com]

Prevention How can you prevent rectal ulcers? It isn’t possible to prevent IBD (a condition that causes rectal ulcers). You can reduce your risk of developing a rectal ulcer by staying hydrated and eating foods that are rich in fiber. [my.clevelandclinic.org]

Stool bulking agents and biofeedback constipation management to prevent paradoxical puborectalis contraction. Topical corticosteroids, salicylates, sucralfate enemas, and biofeedback has been described but experience is limited. [gastroenterologybook.com]

Your doctor will give you a sedative to help you relax and prevent any discomfort. Once the medicine takes effect, the doctor will insert a lighted scope called a colonoscope into your anus. [healthline.com]

Risk factors for pressure ulcer: suggestions for prevention. Rev Esc Enferm USP. 1999;33(3):279-83. [ Links ] 3. Marin Vivo G, Calixto Rodriguez J, Rodriguez Martinez X. Sistema de control fecal Flexi-Seal FMS. [scielo.br]

It is widely used as a second-line medication in the prevention and long-term treatment of angina. [pssjournal.biomedcentral.com]