Solitary Rectal Ulcer Syndrome

Synonyms

Mucosal prolapse syndrome – part of; SRUS

Definition

Solitary rectal ulcer syndrome (SRUS) is the part of the spectrum of mucosal prolapse syndrome. It affects mainly young females with defecation problems and changed bowel habits. Excessive and prolonged straining on defecation leads to rectal mucosal prolapse with secondary ulceration and polypoid lesions development. Anterior wall of the rectum is particularly vulnerable to prolapse on straining, since it is physiologically redundant. Most of SRUS cases locate at the anterior wall of the rectum. While the mucosa is impacted to anal canal, it may become ischemic due to obliteration of mucosal vessels. Patients with SRUS have rectal bleeding, diarrhea, anorectal pain, pruritus, abdominal pain, and difficulty in defecating. These include constipation, straining, increased laxative use, and incomplete rectal evacuation.

SRUS is a misnomer – patients may have no ulceration and the lesions may be multiple.

Clinical Features

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