Evaluation of Solitary Rectal Ulcer Syndrome from Twenty-Four Iraqi Patients

Abstract

Background: Solitary rectal ulcer syndrome (SRUS) is a rare benign rectal disorder that can present with bleeding, mucus passage, straining during defecation, constipation, rectal prolapse, and a feeling of incomplete evacuation. It is characterized by a combination of clinical findings, histological abnormalities, and symptoms. Since patients frequently come with lesions that are neither solitary nor ulcerated, the nomenclature of the syndrome is deceptive. Multiple factors may be implicated in the etiology and pathogenesis of the illness, which is usually linked to pelvic floor abnormalities. Objectives: To study the distribution of age and sex for this syndrome among a sample of Iraqi patients and to further characterize this syndrome in our population. Materials and Methods: A retro-prospective, descriptive single-center study with this research design was carried out at the Baghdad Gastroenterology and Hepatology Teaching Hospital involved reading reports from (1784) lower gastrointestinal endoscopies (sigmoidoscopy and colonoscopy) performed at the Baghdad Gastroenterology and Hepatology hospital over the course of fourteen months. Of those, twenty-four patients who met the requirements for the clinical, endoscopic, and histological diagnosis of SRUS were examined and monitored. Results: Sixteen patients were female and eight patients were male, mean age was (26.5±9.69), mean duration of symptoms until diagnosis was 12.083 months ±11.5. The most frequent symptom was bleeding per rectum (95.8%).All patients(100%) were subjected to several treatment options, they were advised on normal defecatory behavior and bowel habits, Sulfasalazine enema1-2gm/day for(3-6 months),sucralfate enema(2gm/day for 3months), only four patients(16.6%)ended with endoscopic treatment and two patients(8.3%)ended with surgery. Conclusion: SRUS is a chronic, benign disorder in young adults, often related to straining or abnormal defecation. SRUS remains a well-defined but nonspecific entity with varied presentation, characterized by a rectal lesion caused by straining during defecation. Clinicians, surgeons, and pathologists should be aware of the features of SRUS so that it is not confused with other conditions.