scholarly journals Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome

2018 ◽  
Vol 28 (1) ◽  
Author(s):  
Mojgan Forootan ◽  
Masood Shekarchizadeh ◽  
Hamedreza Farmanara ◽  
Ahmad Reza Shekarchizadeh Esfahani ◽  
Mansooreh Shekarchizadeh Esfahani
Keyword(s):  
Clinical Symptoms ◽  
Response To Treatment ◽  
Rectal Ulcer ◽  
Solitary Rectal Ulcer ◽  
Solitary Rectal Ulcer Syndrome ◽  
Duration Of Symptoms ◽  
Dyssynergic Defecation ◽  
Incomplete Evacuation ◽  
Anorectal Pain ◽  
The Difference

Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9±45.74 months in non-responder group (P=0.22). There were more ulcers in non-responder group than responder group (1.50±0.71 versus 1.33±-0.71 before and 1.30 ± 0.95 versus 0.67±0.50 after biofeedback), although the difference was not significant (P=0.604, 0.10 respectively). The most prevalent symptoms were constipation (79%), rectal bleeding (68%) and anorectal pain (53%). The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.

scholarly journals Solitary Rectal Ulcer Syndrome: A Narrative Review

2019 ◽  
Vol 11 (3) ◽  
pp. 129-134 ◽  
Author(s):  
Anahita Sadeghi ◽  
Mohammad Biglari ◽  
Mojgan Forootan ◽  
Peyman Adibi
Keyword(s):  
Health Anxiety ◽  
Rectal Ulcer ◽  
Obsessive Compulsive ◽  
Solitary Rectal Ulcer ◽  
Diagnostic Dilemma ◽  
Solitary Rectal Ulcer Syndrome ◽  
Surgical Interventions ◽  
Dyssynergic Defecation ◽  
Compulsive Disorder ◽  
Bowel Diseases

Solitary rectal ulcer syndrome is a multifactorial pathology, which entails a variety of clinical, histologic and endoscopic aspects that needs step-wise logical approach for management especially in relapsing refractory cases. Apart from the diagnostic dilemma that may be faced due to similarities of presentation with inflammatory bowel diseases or colorectal neoplastic lesions, the syndrome also overlaps with dyssynergic defecation syndrome, health anxiety disorder, obsessive compulsive disorder, and latent mucosal rectal prolapse, a systematic composite treatment modality including psychological, pharmacological, physiological and possibly surgical interventions are sometimes essential. Selecting appropriate treatment in this condition not only affects clinical outcome but also patients’ experience and further stigma of SRUS life-long. In this review, we will discuss the detailed pathophysiology, diagnostic and therapeutic approaches in dealing with solitary rectal ulcer syndrome.

scholarly journals Solitary Rectal Ulcer Syndrome in Children

2021 ◽  
pp. 22-26
Author(s):  
Duran Arslan ◽  
Buket Daldaban Sarıca
Keyword(s):  
Abdominal Pain ◽  
Rectal Bleeding ◽  
Demographic Data ◽  
Endoscopic Examination ◽  
Response To Treatment ◽  
Common Symptom ◽  
Rectal Ulcer ◽  
Solitary Rectal Ulcer ◽  
Chi Square ◽  
Solitary Rectal Ulcer Syndrome

To describe clinical features, demographic data, and complications of the patients with SRUS, which is a rare cause of rectal bleeding in children. Eleven patients diagnosed with Solitary Rectal Ulcer Syndrome (SRUS) were evaluated. The patients assessed by colonoscopy and the biopsies were investigated. The data evaluated in SPSS Program. The exact Method of the Chi-square test was used to compare groups according to qualitative variables. P <0.05 value was considered statistically significant. The most common symptom of the patients was rectal bleeding followed by abdominal pain and constipation. Lesions were mostly ulcerative in the endoscopic examination. There was a statistically significant relationship between the admission symptom and the response to treatment. Patients with abdominal pain and rectal bleeding had poor responses to treatment. In conclusion, SRUS is not uncommon than is thought in pediatric patients with the symptoms of rectal bleeding and constipation. SRUS should be considered in patients with or without rectal prolapse, with any complaints of any lesions in the rectum, hematochezia, and tenesmus.

scholarly journals Prospective evaluation of the treatment of solitary rectal ulcer syndrome with biofeedback

Gut ◽  
1997 ◽  
Vol 41 (6) ◽  
pp. 817-820 ◽  
Author(s):  
C J Vaizey ◽  
A J Roy ◽  
M A Kamm
Keyword(s):  
Surgical Treatment ◽  
Symptom Improvement ◽  
Rectal Ulcer ◽  
Solitary Rectal Ulcer ◽  
Solitary Rectal Ulcer Syndrome ◽  
Duration Of Symptoms ◽  
Macroscopic Appearance ◽  
Laxative Use ◽  
Before And After

Background—Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment.Aim—To determine whether biofeedback retraining is a useful treatment for this condition.Patients—Thirteen consecutive patients with SRUS (three men, median age 34 years, median duration of symptoms three years) underwent treatment. Previous surgical treatment had failed in five.Methods—Patients were evaluated prospectively. Anorectal physiological studies were performed in 11 patients before treatment. A standardised questionnaire was used before and after treatment, and all but two patients were examined after treatment.Results—Median follow up was nine months (range 3–22 months). After treatment four patients were asymptomatic, and four felt improved. Symptom improvement or elimination occurred in: need to strain (7/13 patients), digitation (7/11), laxative use (5/9). Time in the toilet (median 30 v 10 minutes, beforev after treatment) and number of visits to toilet (6v 3/day) were also improved. Three patients were able to maintain employment before treatment compared with eight after treatment. The solitary ulcer did not heal completely in any of the nine patients examined after treatment, but improved in four. Previous surgery, the macroscopic appearance of the ulcer, the presence of pelvic floor paradox, and other physiological parameters did not predict outcome.Conclusion—Biofeedback retraining is a useful treatment for this condition. Long term studies are now required.

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 Modified Tong Xie Yao Fang relieves solitary rectal ulcer syndrome: A case report

2019 ◽  
Vol 7 (15) ◽  
pp. 2058-2064 ◽  
Author(s):  
Li-Li Zhang ◽  
Wan-Shan Hao ◽  
Meng Xu ◽  
Chang Li ◽  
Yuan-Yuan Shi
Keyword(s):  
Case Report ◽  
Rectal Ulcer ◽  
Solitary Rectal Ulcer ◽  
Solitary Rectal Ulcer Syndrome

Solitary ‘rectal’ ulcer syndrome in the sigmoid colon

2009 ◽  
Vol 12 (11) ◽  
pp. 1163-1164 ◽  
Author(s):  
A. Ignjatovic ◽  
B. P. Saunders ◽  
L. Harbin ◽  
S. Clark
Keyword(s):  
Sigmoid Colon ◽  
Rectal Ulcer ◽  
Solitary Rectal Ulcer ◽  
Solitary Rectal Ulcer Syndrome
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