Solitary rectal ulcer syndrome

Br J Surg. 1998 Dec;85(12):1617-23. doi: 10.1046/j.1365-2168.1998.00935.x.


Background: Solitary rectal ulcer syndrome is a rare disorder characterized by erythema or ulceration of the rectal wall, associated with typical histological features, and disturbed defaecatory behaviour with the passage of blood and mucus.

Methods: This is a review based on a literature search using a computer database (Medline) and manual cross-referencing.

Results: The pathogenesis is likely to vary in different patients; it includes trauma from straining, direct digital trauma and possibly primary neuromuscular pathology. The histological findings of extension of the muscularis mucosa between crypts and muscularis propria disorganization on full-thickness specimens are characteristic. Biofeedback defaecation retraining, including habit training, can lead to symptom improvement and return to work in a majority of patients. Abdominal rectopexy offers long-term symptom improvement in approximately 50 per cent of patients. Rectal ulceration may persist after any treatment, even if symptoms improve.

Conclusion: Behavioural therapy and carefully considered operations offer the best treatment results. Further work on psychological factors and neuromuscular and vascular pathology is required.

Publication types

  • Review

MeSH terms

  • Humans
  • Rectal Diseases* / diagnosis
  • Rectal Diseases* / etiology
  • Rectal Diseases* / therapy
  • Syndrome
  • Ulcer* / diagnosis
  • Ulcer* / etiology
  • Ulcer* / therapy