SOLITARY RECTAL ULCER SYNDROME AND ITS RELATION TO SPECIFIC FOOD

2021 ◽  
pp. 14-15
Author(s):  
Syed Mohammed Akbar Hassan ◽  
Purushottam Padmanabhan ◽  
Nagendran Deenakaran
Keyword(s):  
Fast Food ◽  
Rectal Wall ◽  
Occult Blood ◽  
Food Type ◽  
Rectal Ulcer ◽  
Anterior Rectal Wall ◽  
Solitary Rectal Ulcer Syndrome ◽  
Rectal Polyps ◽  
Bleeding Per Rectum

Introduction: SRUS was rst identied as clinical identity in 1969. But the etiology is not known. Anal ssure, IBD, proctagia fugax and malignancy, rectal polyps, hemorrhoids, and infections. Rarely ischemia, trauma and cystic profunda colitis and Stercoral ulcers have to be excluded. Hence a careful history is important. Material and methods: Patients presenting with C/O constipation or straining at stools with difculty in passing motion with associated minimal bleeding per rectum on and off period less than a month were included in the study. All patients were investigated for stool for occult blood, Us abdomen, BMFT, CBP and exible sigmoidoscopy. Results:100 patients presenting with constipation and bleeding PR were investigated. Flexible sigmoidoscopy showed multiple pin point supercial ulcers on the anterior rectal wall without involvement of sigmoid colon. The incidence age group wise was seen very high between 20 to 60 years. M: F ratio 47:53. All were positive for stool for occult blood, negative for IBD and malignancy by biopsy. They responded to dietary changes i.e; veg, non spicy, non fried diet with antibiotic, mesalamine (400mg BD) and lactulose 15ml at bed time. 10 days after the test follow up sigmoidoscopy was found normal and patient asymptomatic even after 3 months. Discussion: The incidence of SRUS has become common irrespective of age and sex. The type of food used by all these patients was found to be more or less similar with majority of them using fast food, fried food, and spicy food. Stoppage of the above mentioned food with specic treatment for 10 days resulted in recovery with normal sigmoidoscopy. Conclusion: SRUS incidence is high in general population due to specic food type and evacuation behavior.

Solitary rectal ulcer syndrome: a series of 13 patients operated with a mean follow-up of 4.5 years

2001 ◽  
Vol 16 (4) ◽  
pp. 228-233 ◽  
Author(s):  
Frederic Marchal ◽  
Laurent Bresler ◽  
Laurent Brunaud ◽  
Stephane Collinet Adler ◽  
Hugues Sebbag ◽  
...  
Keyword(s):  
Rectal Ulcer ◽  
Solitary Rectal Ulcer ◽  
Solitary Rectal Ulcer Syndrome

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

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

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

2019 ◽  
Vol 10 (01) ◽  
pp. 044-048 ◽  
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.

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

Open Medicine ◽  
2009 ◽  
Vol 4 (1) ◽  
pp. 49-53 ◽  
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.

scholarly journals Role of colonoscopy in haemorrhoids with other colorectal disorders

2019 ◽  
Vol 7 (4) ◽  
pp. 1212
Author(s):  
Tariq Ahmed Mala ◽  
Syeed Rayees Ahmad ◽  
Shahid Amin Malla
Keyword(s):  
Rectal Bleeding ◽  
Rectal Wall ◽  
Digital Rectal Examination ◽  
Rectal Mucosa ◽  
Rectal Ulcer ◽  
Solitary Rectal Ulcer ◽  
Bleeding Per Rectum ◽  
Inflammatory Bowel ◽  
Time Of Presentation

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.

Abstract P138: Lifestyle Goals in Pediatric Preventive Cardiology: Practical Clinical Application

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Justin P Zachariah ◽  
Michael M Mendelson ◽  
Suzanne Griggs ◽  
Heather H Ryan ◽  
Annette L Baker ◽  
...  
Keyword(s):  
Real World ◽  
Fast Food ◽  
Lipid Level ◽  
Laboratory Data ◽  
Management Plan ◽  
Trans Fat ◽  
Lipid Management ◽  
Preventive Cardiology ◽  
Low Hdl

BACKGROUND: Lifestyle change is recommended by the 2011 NHLBI Expert Panel Integrated Guidelines as the cornerstone of pediatric lipid management. Using a Standardized Clinical Assessment and Management Plan (SCAMP)© (IRCDA Inc, Boston MA) as an implementation tool, we examined in a real-world setting the effect of making 3 lifestyle goals on lipid levels in youth referred to a pediatric Preventive Cardiology clinic. METHODS: Prospectively collected anthropometric, clinical, and laboratory data were analyzed on youth referred for lipid abnormalities between September 2010 and March 2014. Percent change in lipid fractions from baseline to last follow-up was calculated. Lifestyle recommendations given at initial visit were predictors of interest considered individually and as groups of 3. Multivariable adjusted linear regression was used to identify lifestyle combination trios that were associated with dyslipidemia change. RESULTS: Among 325 patients (55% female, median follow-up time 17 [IQR 10,28] months; mean age 13±4yrs], high LDL (>130 mg/dL) was present in 62%, high TG (> 150 mg/dL) in 35%, and low HDL (<40 mg/dL) in 28%. In those with the relevant lipid abnormality, LDL decreased by 11±17%, TG declined by 22±35% and HDL improved by 15±35%. Overall, BMI percentile declined by 2 points. The most common lifestyle goals given were ‘decrease saturated/trans fat’ (63%), ‘increase vegetables/fruit’ (61%), ‘increase exercise’ (55%), ‘continue exercise’ (35%), and ‘decrease glycemic index’ (30%). In those with HDL<40 adjusted for age and sex, ‘increase fish and nuts’ was associated with HDL improvement (6.52mg/dL[ 2.38,10.66];p=0.002) but, unexpectedly, ‘increase vegetables/fruit’ was associated with worse HDL (-3.87mg/dL[95%CI-6.75,-0.99]; p=0.01). In those with TG>150 as expected, ‘decrease fast food/eating out’ was associated with lower TG (37%[13,54]; p=0.006). After adjustment for age, sex, baseline lipid level, and BMI percentile change, the trio of ‘increasing vegetables/fruit’, ‘decreasing saturated/trans fat’, and ‘continue exercise’ was associated with lower LDL (-17.64mg/dL[-3.62,-31.56];p=0.01). Intriguingly, substituting ‘increase exercise’ instead of ‘continue exercise’ in this trio was not associated with lipid change. CONCLUSIONS: In a real-world cohort of dyslipidemic youth, providing lifestyle goals was associated with favorable lipid changes, with some combinations showing particular benefits. More data is warranted to explore the effect of specific lifestyle goal combinations in youth.

Initial participation as a predictor for continuous participation in population-based colorectal cancer screening

2017 ◽  
Vol 25 (3) ◽  
pp. 126-133 ◽  
Author(s):  
Deborah Saraste ◽  
Daniel J Öhman ◽  
Marika Sventelius ◽  
K Miriam Elfström ◽  
Johannes Blom ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Strong Predictor ◽  
Participation Rate ◽  
Occult Blood ◽  
Population Based ◽  
Faecal Occult Blood Testing ◽  
Faecal Occult

Objectives To assess patterns and probabilities of participation in multiple rounds of colorectal cancer screening. Methods All individuals who were invited to participate in population-based colorectal cancer screening in the Stockholm-Gotland region in Sweden between 1 January 2008 and 30 September 2015 were included in the study. Guaiac-based faecal occult blood testing was used. All individuals invited to the three first consecutive screening rounds were included in the analysis. Results There were 346,168 individuals eligible for invitation to screening. The average participation rate during the follow-up period was 60%. Eligible individuals could be invited 1–4 times, depending on age at first invitation. Of 48,959 individuals invited to the three first consecutive rounds of screening, 71% participated at least once, and 50% participated in all three rounds. Participation at first invitation was a predictor for participation in subsequent rounds, and the likelihood of continuous participation following participation in the first round was 84%. Of those who attended the first and second rounds, 93% also participated in the third round. Similar patterns of consistency were seen among non-participants. For individuals not participating in the first screening round, the likelihood of consistent non-participation was 71. Conclusions Participation in the first round of screening is a strong predictor for participation in subsequent rounds. Therefore, reducing barriers for initial participation is a key for achieving consistent participation over several rounds in organized colorectal cancer screening programmes.

scholarly journals Radiobiological Evaluation of Dosimetric Plans for Stereotactic Radiotherapy for Prostate Cancer According to Fractionation Regimen

2019 ◽  
Vol 100 (5) ◽  
pp. 263-269
Author(s):  
E. S. Sukhikh ◽  
I. N. Sheyno ◽  
L. G. Sukhikh ◽  
A. V. Taletskiy ◽  
A. V. Vertinskiy ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Total Dose ◽  
Rectal Wall ◽  
Tumor Control ◽  
Anterior Rectal Wall ◽  
Tumor Control Probability ◽  
Equivalent Uniform Dose ◽  
Dose Volume Histograms ◽  
Dose Volume ◽  
Fractionation Regimen

Objective. To determine the most effective irradiation regimen (total dose and dose per fraction) for hypofractionated treatment for prostate carcinomas according the TCP/NTCP radiobiological criteria.Material and methods. Using the tomographic information of five patients with low-risk prostate adenocarcinoma as an example, the authors devised dosimetric radiation therapy plans using the volumetric modulated arc therapy (VMAT) procedure. They considered the range of total doses of 33.5 to 38 Gy administered in 4 and 5 fractions. Based on the equivalent uniform dose concept proposed by A. Niemierko and on the computed differential dose volume histograms, the investigators modeled local tumor control probability (TCP) values, by taking into account the uncertainties of main radiobiological parameters, and estimated normal tissue complication probabilities (NTCP) for the anterior rectal wall as the organ most at risk of irradiation. An effective dosimetric plan was selected according to the UTCP criterion and the probability of complication-free tumor control, i.e. TCP (1 – NTCP).Results. The results of modeling the UTCP criterion show that with a higher total dose, the TCP value increases and so does the NTCP value, therefore the optimal radiation therapy plans are to irradiate with a total dose of 34 Gy over 4 fractions or with a dose of 36–37 Gy over 5 fractions. The difference between the fractionation regimens is that the UTCP value is achieved with a higher TCP value over 4 fractions and with a lower load on the rectal wall over 5 fractions.Conclusion. The choice of a specific fractionation regimen should be determined from the calculated values of differential dose volume histograms for each patient, as well as from radiobiological criteria, such as TCP, NTCP and UTCP.

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