Skip to main content

Advertisement

Log in

Anorectal function in the solitary rectal ulcer syndrome

  • Published:
Diseases of the Colon & Rectum

Abstract

The anorectal function of nine patients with solitary rectal ulcer syndrome (SRUS) (5 F: 4 M, median age, 27 (range, 19–41 years) and nine control subjects (5 F: 4 M, median age, 47 (35–66)P<0.01) has been investigated by a new technique that radiologically visualizes the anorectum during voiding of a semisolid contrast medium, while simultaneously measuring intrarectal pressure and anal sphincter EMG activity. A degree of rectal prolapse was demonstrated in eight of the SRUS patients; six of these lesions were clinically occult. Abnormal failure of the anal sphincter to relax on voiding was present in seven of the SRUS patients. These abnormalities resulted in the SRUS patients requiring a greater increase in intrarectal pressure (median, 100 cm water) to void than the control subjects (median, 65 cm water,P<0.01). This combination of high intrarectal pressure and rectal prolapse during straining seems to be the cause of SRUS

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Jalan KN, Brunt PW, Maclean N, Sircus W. Benign solitary ulcer of the rectum—a report of 5 cases. Scand J Gastroenterol 1970;5: 143–7.

    PubMed  CAS  Google Scholar 

  2. Miller SM, Juhl JH. Nonspecific ulcers of the colon. Minn Med 1967;50:1327–32.

    PubMed  CAS  Google Scholar 

  3. Thomson H, Hill D. Solitary rectal ulcer: always a self-induced condition? Br J Surg 1980:67:784–5.

    PubMed  CAS  Google Scholar 

  4. Madigan MR, Morson BC: Solitary ulcer of the rectum. Gut 1969;10:871–81.

    PubMed  CAS  Google Scholar 

  5. Rutter KR, Riddell RH. The solitary ulcer syndrome of the rectum. Clin Gastroenterol 1975;4:505–30.

    PubMed  CAS  Google Scholar 

  6. Schweiger M, Alexander-Williams J. Solitary-ulcer syndrome of the rectum: its association with occult renal prolapse. Lancet 1977;1:170–1.

    Article  Google Scholar 

  7. White CM, Findlay JM, Price JJ. The occult rectal prolapse syndrome. Br J Surg 1980;67:528–30.

    PubMed  CAS  Google Scholar 

  8. Mahieu P, Pringot J, Vanheuverzwijn R, Goncette L. Les prolapsus du rectum. Acta Gastroenterol Belg 1981;44:502–12.

    PubMed  CAS  Google Scholar 

  9. Rutter KR. Electromyographic changes in certain pelvic floor abnormalities. Proc R Soc Med 1974;67:53–6.

    PubMed  CAS  Google Scholar 

  10. Lane RH, Clinical application of anorectal physiology. Proc R Soc Med 1974;68:28–30.

    Google Scholar 

  11. Womack NR, Williams NS, Holmfield JH, Morrison JF, Simpkins KC. New method for the dynamic assessment of anorectal function in constipation. Br J Surg 1985;72:994–8.

    PubMed  CAS  Google Scholar 

  12. Basmajian JV, Stecko G. A new bipolar electrode for electromyography. J Appl Physiol 1962:17:849.

    Google Scholar 

  13. DuBoulay CE, Fairbrother J, Isaacson PG. Mucosal prolapse syndrome—a unifying concept for solitary ulcer and related disorders. J Clin Pathol 1983;36:1264–8.

    CAS  Google Scholar 

  14. Porter NH. A physiological study of the pelvic floor in rectal prolapse. Ann R Coll Surg Engl 1962;31:379–404.

    PubMed  CAS  Google Scholar 

  15. Kiff ES, Barnes PR, Swash M. Evidence of pudendal neuropathy in patients with perineal descent and chronic straining at stool. Gut 1984;25:1279–82.

    PubMed  CAS  Google Scholar 

  16. Frenckner B, Ihre T. Function of the anal sphincters in patients with intussusception of the rectum. Gut 1976;17:147–51.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This work was supported by a grant from the Medical Research Council.

About this article

Cite this article

Womack, N.R., Williams, N.S., Holmfield Mist, J.H. et al. Anorectal function in the solitary rectal ulcer syndrome. Dis Colon Rectum 30, 319–323 (1987). https://doi.org/10.1007/BF02555447

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02555447

Key words

Navigation