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Solitary Rectal Ulcer Syndrome Treatment | Pristyn Care

Solitary rectal ulcer syndrome causes chronic rectal ulcers and bleeding. Pristyn Care offers biofeedback, lifestyle treatment, and surgical repair for lasting relief.

Solitary rectal ulcer syndrome causes chronic rectal ulcers and bleeding. Pristyn Care offers ... Read More

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    Dr. Galla Murali Mohan - A general-surgeon for Anal Fistula

    Dr. Galla Murali Mohan

    MBBS, MS-General Surgery
    34 Yrs.Exp.

    5.0/5

    34 Years Experience

    location icon Pristyn Care Archana Hospital, Madeenaguda, Hyderabad
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    080-6542-3724
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    Dr. Vipin Nagpal - A general-surgeon for Anal Fistula

    Dr. Vipin Nagpal

    MBBS, MS-General Surgery
    31 Yrs.Exp.

    5.0/5

    31 Years Experience

    location icon Pristyn Care Elantis Hospital, Lajpat Nagar, Delhi
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    080-6542-3711
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    Dr. Rakesh Shivhare - A general-surgeon for Anal Fistula

    Dr. Rakesh Shivhare

    MBBS, MS(GI & General Surgeon)
    30 Yrs.Exp.

    5.0/5

    30 Years Experience

    location icon Opp.Badwani Plaza, Manorama Ganj, Old Palasia, Indore, Madhya Pradesh 452003
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    080-6542-3720
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    Dr. Apoorv Shrivastava - A general-surgeon for Anal Fistula

    Dr. Apoorv Shrivastava

    MBBS, DNB-General Surgery
    25 Yrs.Exp.

    4.5/5

    25 Years Experience

    location icon Pristyn Care Eminent Hospital 6/1 Opp. Barwani Plaza, Manorama Ganj, Old Palasia, Indore - 452018
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    080-6542-3720

About Solitary Rectal Ulcer Syndrome

Solitary rectal ulcer syndrome (SRUS) is a chronic benign condition characterised by ulceration on the anterior rectal wall, typically 7-10 cm from the anal verge. Despite its name, multiple ulcers may be present. It results from repeated trauma due to prolonged straining, rectal prolapse, or paradoxical puborectalis contraction, causing mucosal ischaemia.

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Symptoms

Symptoms of SRUS include:

  • Passage of blood and mucus per rectum
  • Sensation of incomplete bowel emptying
  • Prolonged and excessive straining during defaecation
  • Rectal pain or discomfort
  • Feeling of a rectal mass or prolapse
  • Constipation and infrequent bowel movements
  • Digital evacuation of stools in severe cases

Are you going through any of these symptoms?

Causes

SRUS is caused by:

  • Chronic straining leading to repeated mucosal trauma
  • Rectal intussusception or internal rectal prolapse
  • Paradoxical puborectalis muscle contraction (dyssynergia)
  • Digital self-digitation during defaecation
  • Anterior rectal wall prolapse
  • Chronic constipation and delayed transit

Subtypes of SRUS

Variants:

  • Ulcerative type (classical single or multiple ulcers)
  • Polypoid type (elevated mucosal lesion)
  • Flat type (flat hyperaemic mucosa without ulceration)
  • Combination type

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Risk Factors

Risk factors include:

  • Chronic constipation and excessive straining
  • Rectal prolapse or intussusception
  • Psychological stress
  • Young adults (20-40 years)
  • Abnormal pelvic floor function
  • Laxative overuse

Who Is at Risk

Young adults, particularly those aged 20-40 with chronic constipation, excessive straining habits, or pelvic floor dysfunction are most commonly affected by SRUS.

Diagnosis

Diagnosis involves:

  • Colonoscopy with biopsy (shows fibromuscular obliteration of lamina propria)
  • Defaecography to identify prolapse or intussusception
  • Anorectal manometry to assess pelvic floor function
  • MRI defaecography for comprehensive pelvic floor evaluation
  • Histopathology to rule out IBD and malignancy

Treatment for Solitary Rectal Ulcer Syndrome

Pristyn Care offers biofeedback therapy, dietary modification, and surgical repair (rectopexy or Delorme procedure) for persistent SRUS, tailored to symptom severity and underlying cause.

Procedure

Treatment approach includes:

  • Conservative: high-fibre diet, bowel habit training, avoidance of straining
  • Biofeedback therapy to correct paradoxical puborectalis contraction
  • Topical sucralfate or mesalazine enemas for ulcer healing
  • Laparoscopic rectopexy for prolapse-related SRUS
  • Delorme procedure or mucosal resection in refractory cases
  • STARR (Stapled Transanal Rectal Resection) for obstructive defaecation

After the Surgery

Post-operative care includes:

  • High-fibre diet and adequate fluid intake
  • Stool softeners to prevent constipation
  • Biofeedback continuation post-surgery
  • Avoid straining during defaecation
  • Regular follow-up with flexible sigmoidoscopy
  • Psychological support if needed

Possible Complications of SRUS Treatment

Potential complications:

  • Recurrence of ulceration if underlying dysfunction persists
  • Bleeding post-operatively
  • Bowel frequency changes after STARR
  • Incomplete resolution of symptoms
  • Rare risk of rectal stricture after stapling procedures

Frequently Asked Questions

Is solitary rectal ulcer syndrome dangerous?

SRUS is a benign condition and is not cancerous, but it can cause significant quality-of-life issues. Biopsy is important to rule out malignancy, especially in older patients.

Can SRUS heal on its own?

Mild SRUS may improve with conservative measures like dietary changes and biofeedback. However, persistent or severe cases require medical or surgical intervention.

How effective is biofeedback therapy for SRUS?

Biofeedback is effective in 50-70% of patients with SRUS associated with dyssynergic defaecation. It helps retrain the pelvic floor muscles and reduce straining.

What is the difference between SRUS and rectal cancer?

SRUS is a benign inflammatory condition, while rectal cancer is malignant. Histopathology (biopsy) easily distinguishes between the two, as SRUS shows fibromuscular obliteration without dysplasia.

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Medically Reviewed By
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Dr. Galla Murali Mohan
MBBS, MS-General Surgery
34 Years Experience Overall
Last Updated : April 29, 2026

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