Role of colonoscopy in haemorrhoids with other colorectal disorders

Background: Haemorrhoids are the enlargement or engorgement of the normal fibrovascular anal cushions. These fibrovascular cushions lose their attachment to the underlying rectal wall and lead to prolapse with repeated straining over time, thinning of rectal mucosa and subsequent bleeding. The objective of the present endeavour was to study the prevalence of associated colorectal lesions like colonic carcinoma, diverticular disease, inflammatory bowel disease which present the rectal bleeding and role of colonoscopy in these lesionsMethods: This study was conducted in hundred fifty patients presenting with bleeding and haemorrhoids were analyzed. All patients were examined locally and endoscopically. All significant endoscopic findings (diverticuli, polyps, cancer, angiodysplasia and varices or colitis) were recorded.Results: Majority of patients were males (102), accounting for (68 percent). The main symptom at the time of presentation was rectal bleeding (90 percent). The digital rectal examination was normal in 114 patients. The commonest finding on proctoscopy examination was haemorrhoids. Colonoscopy showed haemorrhoids in maximum patients (147 percent). The associate lesions with altered bowel habits were growth in 12, worm in 6, solitary rectal ulcer in 3, pancolitis in 3.Conclusions: It can be concluded that in the present study colonoscopy revealed a high proportion of colorectal pathologies with haemorrhoids presenting with bleeding per rectum. Colonoscopy thus proved to be very useful procedure in patients with haemorrhoids especially in elderly.

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Solitary Rectal Ulcer Syndrome: Uncommon Cause of Rectal Bleeding in Children

Journal of Nepal Medical Association ◽

10.31729/jnma.167 ◽

2008 ◽

Vol 47 (172) ◽

Author(s):

Sudhamshu KC ◽

D Sharma ◽

B Bashnet ◽

AK Mishra

Keyword(s):

Rectal Bleeding ◽

Adult Population ◽

Rectal Polyp ◽

Rectal Ulcer ◽

Pediatric Age ◽

Proctoscopic Examination ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome ◽

Common Causes ◽

Bleeding Per Rectum

Rectal polyp and hemorrhoids are common causes of bleeding per rectum in pediatric age group.However, there are some other causes which should be considered in differential diagnosis. We haveacquainted a case of rectal bleeding due to solitary rectal ulcer in a child of 10 year. Colonoscopicexamination was required for diagnosis as proctoscopic examination and digital rectal examinationmissed the diagnosis, probably due to poor co-operation by the patient and rare nature of the disease.Although well recognized in the adult population, the pediatric experience with this condition islimited.Key word: children, rectal bleeding, solitary rectal ulcer

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Solitary Rectal Ulcer Syndrome in a 12-Year Bangladeshi Boy: an Unusual Cause of Rectal Bleeding

KYAMC Journal ◽

10.3329/kyamcj.v11i2.48425 ◽

2020 ◽

Vol 11 (2) ◽

pp. 104-107

Author(s):

Md Benzamin ◽

Kaniz Fathema ◽

Dipawnita Saha ◽

Bodhrun Nahar ◽

Sharmin Akther ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Rectal Bleeding ◽

Bowel Disease ◽

Clinical Condition ◽

Rectal Polyp ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome ◽

Inflammatory Bowel

Solitary rectal ulcer syndrome (SRUS) is an uncommon cause of per rectal bleeding in children. Due to it's wide variety of presentation and rarity, it is frequently misdiagnosed as other clinical condition like inflammatory bowel disease, rectal polyp, amoebiasis or malignancy. Here we presenting a case initially misdiagnosed as ulcerative colitis, latter after thorough evaluation diagnosed as a case of SRUS. KYAMC Journal Vol. 11, No.-2, July 2020, Page 104-107

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An unusual case of solitary rectal ulcer syndrome mimicking inflammatory bowel disease and malignancy

Arab Journal of Gastroenterology ◽

10.1016/j.ajg.2012.02.004 ◽

2012 ◽

Vol 13 (2) ◽

pp. 102 ◽

Cited By ~ 3

Author(s):

Sachin B. Ingle ◽

Yogesh G. Patle ◽

Hemant G. Murdeshwar ◽

Chitra R. Hinge (Ingle)

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Unusual Case ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome ◽

Inflammatory Bowel

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Pathology of the rectal wall in solitary rectal ulcer syndrome and complete rectal prolapse.

Gut ◽

10.1136/gut.38.4.587 ◽

1996 ◽

Vol 38 (4) ◽

pp. 587-590 ◽

Cited By ~ 41

Author(s):

Y S Kang ◽

M A Kamm ◽

A F Engel ◽

I C Talbot

Keyword(s):

Rectal Prolapse ◽

Rectal Wall ◽

Complete Rectal Prolapse ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome

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Solitary rectal ulcer syndrome—The role of autofluorescence colonoscopy

Photodiagnosis and Photodynamic Therapy ◽

10.1016/j.pdpdt.2007.03.002 ◽

2007 ◽

Vol 4 (3) ◽

pp. 179-183 ◽

Cited By ~ 6

Author(s):

Wojciech Latos ◽

Aleksandra Kawczyk-Krupka ◽

Aleksandra Ledwoń ◽

Karolina Sieroń-Stołtny ◽

Aleksander Sieroń

Keyword(s):

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome

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Rigid Sigmoidoscopic Examination, an Investigation Down but Not Out: A 5-Year Single-Center Experience on 9418 Patients

Journal of Digestive Endoscopy ◽

10.4103/jde.jde_55_18 ◽

2019 ◽

Vol 10 (01) ◽

pp. 044-048 ◽

Cited By ~ 1

Author(s):

Sandeep V. Nair ◽

Thazhath Mavali Ramachandran ◽

Prajob Prasad Geevarghese ◽

N. Sunil Kumar ◽

Shine J Pakalomattom

Keyword(s):

Predictive Value ◽

Diagnostic Yield ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome ◽

Sigmoidoscopic Examination ◽

Medical College ◽

Single Center Experience ◽

Bleeding Per Rectum ◽

Inflammatory Bowel ◽

Sensitivity Specificity

ABSTRACT Background: Rigid sigmoidoscopy (RS) in the present era of flexible sigmoidoscopies is falling out of favor although it continues to be used in some centers as an outpatient (OP) department procedure. Aims: This study aims to determine the utility of RS for diagnosis of rectosigmoidal pathologies in the OP setting with emphasis on neoplastic lesions. Methods: We retrospectively studied the RS records and histopathology reports (HPRs) of 5 years (July 2013–June 2018) done in the Department of Gastroenterology at Medical College Calicut. Results: During the study period, 9418 RS examinations were done, and a total of 6921 abnormalities were picked up, giving a diagnostic yield of 73.5%. Most common indication was bleeding per rectum (PR) (51%), followed by constipation (29%). The most common lesion found was hemorrhoids 39.8% followed by proctitis 13.7%, neoplasms 9.7%, and others 10.3% while 26.5% studies were normal. HPRs showed 7.7% to be malignant, 5.8% were adenoma, 12.2% were inflammatory bowel disease ulcerative colitis (IBD UC), 2.2% were solitary rectal ulcer syndrome, 1.2% nonspecific colitis, 1.7% nonneoplastic polyps, 2.7% were normal, and 1.4% were inconclusive. Of the 4812 patients with complaints of bleeding PR, 4739 (98.5%) had a diagnosis after RS, of which hemorrhoids (72.7%) was the most common cause followed by proctitis (14.2%), neoplasm (9%), and others (4.1%). The sensitivity, specificity, positive predictive value, and negative predictive value of RS in detecting neoplasia was 98.2%, 96.8%, 66.1%, and 99.9%, respectively, when HPR was gold standard. RS was found to be effective for assessing activity in IBD UC. Conclusion: RS is a simple, cheap, and effective tool for diagnosing various rectosigmoid pathologies. RS can be used as an effective screening test for rectosigmoid pathologies, especially neoplasia and IBD UC.

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A report of 112 cases of solitary rectal ulcer syndrome from Iran

Open Medicine ◽

10.2478/s11536-009-0006-9 ◽

2009 ◽

Vol 4 (1) ◽

pp. 49-53 ◽

Cited By ~ 2

Author(s):

Saeed Derakhshani ◽

Mohsen Pakzad ◽

Mohammad Vafaie ◽

Shirin Tehrani-Tarighat ◽

Mohammad Abdollahi

Keyword(s):

Rectal Bleeding ◽

Obstructed Defecation ◽

Final Diagnosis ◽

Rectal Polyp ◽

Common Symptom ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome ◽

Clinical Presentations ◽

Rectal Polyps

AbstractSolitary rectal ulcer syndrome (SRUS) is a syndrome with symptoms such as rectal bleeding, obstructed defecation, straining at stool and incomplete evacuation, and rectal polyps. In the present study, the clinical features of SRUS among Iranian patients is reviewed. Records of 112 patients diagnosed with SRUS between 1997 and 2007 admitted to a special coloproctology clinic have been analyzed retrospectively. Of 112 patients with SRUS, 61 were male (54.4%) and 51 female (45.6%) with a mean age of 32.2 years (range, 16–64 years). The mean interval between onset of symptoms and final diagnosis of SRUS was 3.8 years (range, 1–14 years). Rectal bleeding (67%) was the most common symptom in both genders, while a feeling of fullness was the least common symptom, observed only in one woman (2%). Incontinence was observed in 4 women (7.8%) and 3 men (4.9%), comprising 6.25% of the total clinical presentations. There were 38 patients (33.9%) with mucosal prolapse and 2 patients (1.8%) with total rectal prolapse. In conclusion, rectal bleeding in the presence of constipation or diarrhea is the main sign for diagnosis of SRUS. This syndrome is usually misdiagnosed; it is frequently confused with inflammatory bowel disease (IBD) because the rectal macroscopic and microscopic lesions and true polyps of rectum are similar. We suggest that most of patients who are treating for IBD and true polyps without any response are suffering from SRUS. Regarding misdiagnosis between SRUS and IBD or rectal polyp, the exact prevalence of SRUS has been mistakenly underestimated.

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