Solitary rectal ulcer syndrome: Role of hydrocortisone enema in pediatric patients.

Abstract

Objective: To evaluate the effectiveness of adding hydrocortisone enema in the traditional management of Solitary rectal ulcers (SRU) in pediatric patients. Study Design: Randomized Controlled Trial. Setting: Department of Pediatric Gastroenterology, Children’s Hospital and The Institute of Child’s Heath, Multan, Pakistan. Period: January, 2021 till December, 2021. Material & Methods: A total of 52 children (15 years or younger) diagnosed to have SRU were included. Demographic data, clinical and colonoscopic findings were collected. Children were randomly divided into two groups. Group-A received only conventional therapy while Group-B received hydrocortisone enema in addition to conventional therapy. After starting treatment, patients were followed up every 15 days up to duration of 6 months and response to the treatment in terms of complete resolution of symptoms was noted. Results: The Mean age of 52 children was 9 + 1.8 years. Twenty eight (53.8%) were boys. The mean duration of symptoms was 5 + 1.4 months. Most common presenting features were per-rectal bleed 48 (92.3%) and mucus in stool 27 (51.9%). It was found that 14/25 (56.0%) children in Group-A reported complete resolution of symptoms in comparison to 20/24 (83.3%) in Group-B (p=0.0380) at 2-months post treatment follow up. Forty one children completed the 6-months follow up period and included in the final analysis. It was found that 10/21 (47.6%) children reported completed resolution of symptoms while Group-B, 18/20 (90.0%) children had complete resolution of symptoms (p=0.0036) at 6-months follow up. Conclusion: In children with SRUS, hydrocortisone enemas along with conventional treatment were found to be significantly more useful in resolution of pretreatment symptoms in comparison to conventional treatment alone. Further studies involving large sets of population are needed to verify the findings of present study.