Solitary Rectal Ulcer Syndrome Treatment | Pristyn Care

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