Abstract
Solitary rectal ulcer syndrome (SRUS) is a condition combining disturbances to bowel function and ulcer-related symptoms such as the passage of blood and mucus rectally. Ulceration is not always present but the main feature of the condition is erythema or ulceration of the anterior rectal wall [1]. It was first described by Cruveilhier in 1829 [2]; however, it was not until 1969 that Madigan and Morson [3] proposed the clinicopathological features accepted today. It is an uncommon condition with an annual incidence of 1 in 100,000 to 3.6 in 100,000. It affects young adults, occurring most commonly in the third decade in men and in the fourth decade in women [4], with a slightly higher rate of occurrence in women [5]. As a result of the low incidence/prevalence of SRUS, good-quality articles on etiology and therapy are scarce or even lacking. It is associated with other pelvic floor disorders with overlapping symptomatology. Although a variety of both conservative and surgical therapies have been described, a lack of consensus regarding the exact underlying etiology remains.
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References
Tjandra JJ, Fazio VW, Church IM et al (1992) Clinical conundrum of solitary rectal ulcer. Dis Colon Rectum 35:227–234
Cruveilhier J (1829) Ulcere chronique du rectum. In: Anatomiepathologique du corps humain. JB Baillière, Paris
Madigan MR, Morson BC (1969) Solitary ulcer of the rectum. Gut 10:871–881
Sharara AI, Azar C, Amr SS et al (2005) Solitary rectal ulcer syndrome: endoscopic spectrum and review of the literature. Gastrointest Endosc 62:755–762
Haray PN, Morris-Stiff GJ, Foster ME (1997) Solitary rectal ulcer syndrome: an underdiagnosed condition. Int J Colorectal Dis 12:313–315
Rao S, Ozturk R, De Ocampo S, Stessman M (2006) Pathophysiology and role of biofeedback therapy in solitary rectal ulcer syndrome. Am J Gastroenterol 101:613–618
Schweiger M, Alexander-Williams J (1977) Solitary-ulcer syndrome of the rectum: its association with occult rectal prolapse. Lancet 309:170–171
Sun WM, Read NW, Donnelly TC et al (1989) A common pathophysiology for full thickness rectal prolapse, anterior mucosal prolapse and solitary rectal ulcer. Br J Surg 76:290–295
Kang YS, Kamm MA, Nicholls RJ (1995) Solitary rectal ulcer and complete rectal prolapse: one condition or two? Int J Colorectal Dis 10:87–90
Womack NR, Williams NS, Holmfield JHM, Morrison JFB (1987) Pressure and prolapse the cause of solitary rectal ulcer. Gut 28:1228–1233
Chiang JM, Changchien CR, Chen JR (2006) Solitary rectal ulcer syndrome. Int J Colorectal Dis 21:348–356
Martin CJ, Parks TG, Biggart JD (1981) Solitary rectal ulcer syndrome in Northern Ireland, 1971–80. Br J Surg 68:744–747
Ford MJ, Anderson JR, Gilmour HM et al (1983) Clinical spectrum of “solitary ulcer” of the rectum. Gastroenterology 84:1533–1540
Madigan MR (1964) Solitary ulcer of the rectum. Proc R Soc Med 47:603
de la Portilla F, Borrero JJ, Rafel E (2005) Hereditary vacuolar internal anal sphincter myopathy causing proctalgia fugax and constipation: a new case contribution. Eur J Gastroenterol Hepatol 17:359–361
Ho YH, Ho JM, Parry BR (1995) Solitary rectal ulcer syndrome: The clinical entity and anorectal physiology findings in Singapore. Aust N Z J Surg 65:93–97
Hompes R, Harmston C, Wijffels N (2012) Excellent response rate of anismus to botulinum toxin if rectal prolapse misdiagnosed as anismus (‘pseudoanismus’) is excluded. Colorectal Dis 14:224–230
Arhan P, Devroede G, Jehannin B et al (1981) Segmental colonic transit time. Dis Colon Rectum 24:625–629
van den Brandt Gradel V, Huibregtse K, Tytgat GN (1984) Treatment of solitary rectal ulcer syndrome with high fibre diet and abstention of straining at defaecation. Dig Dis Sci 29:1005–1008
Zagar SA, Khuroo MS, Mahajan R (1991) Sucralfateretension enemas in solitary rectal ulcer. Dis Colon Rectum 34:455–457
Ederle A, Bulighin G, Orlandi PG, Pilati S (1992) Endoscopic application of human fibrin sealant in the treatment of solitary rectal ulcer syndrome [letter]. Endoscopy 24:736–737
Malouf AJ, Vaizey CJ, Kamm MA (2001) Results of behavioural treatment (biofeedback) for solitary rectal ulcer syndrome. Dis Colon Rectum 44:72–76
Jarrett M, Vaizey CJ, Emmanuel AV et al (2004) Behavioural therapy (biofeedback) for solitary rectal ulcer syndrome improves symptoms, mucosal blood flow. Gut 53:368–370
Binnie NR, Papachrysostomou M, Clare N, Smith AN (1992) Solitary rectal ulcer: the place of biofeedback and surgery in the treatment of the syndrome. World J Surg 16:836–840
Boccasanta P, Venturi M, Calabro G et al (2008) Stapled transanal rectal resection in solitary rectal ulcer associated with prolapse of the rectum: a prospective study. Dis Colon Rectum 51:348–354
Sitzler PA, Kamm MA, Nicholls RJ (1996) Surgery for solitary rectal ulcer syndrome. Int J Colorectal Dis 11:136
Evans C, Jenes OM, Cunningham C, Lindsey I (2010) Management of solitary rectal ulcer syndrome: Ignore the ulcer, treat the underlying posterior compartment prolapse [abstract]. Colorectal Dis 12:23
Badrek-Amoudi A, Roe T, Mabey K et al (2012) Laparoscopic ventral mesh rectopexy (LVMR) in the management of solitary rectal ulcer syndrome (SRUS): a cause for optimism? Colorectal Dis 15:575–581
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Wijffels, N.A.T., Chambers, W. (2014). Solitary Rectal Ulcer Syndrome and Obstructed Defecation: Common Pathology. In: Gaspari, A.L., Sileri, P. (eds) Pelvic Floor Disorders: Surgical Approach. Updates in Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5441-7_10
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DOI: https://doi.org/10.1007/978-88-470-5441-7_10
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