The solitary rectal ulcer syndrome is a condition that happens when one or more open sores (known as ulcers) develop in the rectum. We know that the rectum is a muscular tube connected to the end of your colon. The stool passes through the rectum on its way out of your body. The solitary rectal ulcer syndrome is a rare and poorly understood disorder that often happens in people with chronic constipation. The solitary rectal ulcer syndrome can cause rectal bleeding and strain during bowel movements.
But, despite the name, there are some cases when more than one rectal ulcer happens in the solitary rectal ulcer syndrome. The solitary rectal ulcer syndrome can improve with simple lifestyle changes, such as drinking more fluids and changing your diet. If the solitary rectal ulcer syndrome is a severe case, then surgery may be needed. The solitary rectal ulcer syndrome is not so common condition, so not many people are informed about it. The solitary rectal ulcer syndrome can be present with a sense of incomplete evacuation, straining during defecation, and rectal bleeding.
It appears that men and women are affected equally, but a slight female preponderance has been suggested in some studies. One study was shown that one in 100,000 individuals are affected with solitary rectal ulcer syndrome on annual basis . There was another study in which was participating 80 patients and the median age at diagnosis was 48 years and it is ranging from 14 – 76 years. The pathogenesis of this condition is completely understood. But, it seems that many different factors could lead to solitary rectal ulcer syndrome.
Solitary Rectal Ulcer Syndrome
The most common signs and symptoms of solitary rectal ulcer syndrome include :
- Rectal pain
- Fecal incontinence
- Passing mucus from your rectum
- Rectal bleeding
- A feeling of incomplete passing of stool
- Pain or a feeling of fullness in your pelvis
- Straining during bowel movements
But, some people with solitary rectal ulcer syndrome may experience no symptoms. You need to make an appointment with your doctor if you notice any signs that worry you. Some conditions can cause you signs and symptoms which are similar to those of solitary rectal ulcer syndrome. When you are at your appointment, your doctor can recommend tests and procedures which can help to identify or rule out causes other than solitary rectal ulcer syndrome. You need to tell your doctor all the symptoms that you have, so your doctor can diagnose your condition in the right way.
You need to ask your doctor if you need to make restrictions on your diet. You need to tell your doctor any major stresses or recent life changes, so your doctor can know if they have some link with the solitary rectal ulcer syndrome. If you are taking some medications, vitamins, or supplements, then you need to tell them to your doctor, so the correct dosage will be made. If you have any questions for your doctor, then you do not doubt to ask him, so he can tell you some advice about your condition and how to deal with the solitary rectal ulcer syndrome.
Your doctor must do tests, so he or she can diagnose the solitary rectal ulcer syndrome. The most common tests which are used to diagnose solitary rectal ulcer syndrome include ultrasound, sigmoidoscopy, and defecation proctography. If you visit a doctor in a specialized center, then he or she can offer a similar test called magnetic resonance defecography.
It is not known in all cases why solitary rectal ulcer syndrome happens. Doctors believe that injury or stress to the rectum can cause rectal ulcers to form. The most common things which can injure the rectum include:
- Intussusceptions, which occurs when one part of the intestine slides inside another part 
- Constipation or impacted stool 
- Attempts to manually remove impacted stool
- Straining during bowel movements 
- The uncoordinated constricting of the pelvic floor muscles that slows blood flow to the rectum 
- Rectal prolapsed, which happens when the rectum protrudes from the anus 
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 Forootan M, Darvishi M. Solitary rectal ulcer syndrome: A systematic review. Medicine (Baltimore). 2018;97(18):e0565. doi:10.1097/MD.0000000000010565
 Al-Brahim N, Al-Awadhi N, Al-Enezi S, et al. Solitary rectal ulcer syndrome: A clinicopathological study of 13 cases. The Saudi Journal of Gastroenterology. 2009;15(3):188-92.
 AlGhulaygah AI, Abu-Farhaneh EH, AlSohaibani FI, et al. Solitary rectal ulcer syndrome: A single-center case series. The Saudi Journal of Gastroenterology. 2016;22(6):456–60.
 Abid S, Khawaja A, Bhimani SA, et al. The clinical, endoscopic and histological spectrum of the solitary rectal ulcer syndrome: a single-center experience of 116 cases. BMC Gastroenterology. 2012;12.