The rectum attaches to the bottom of the colon, or large intestine, and when individuals have a bowel movement, the waste travels through the rectum before it is expelled from the body. Solitary rectal ulcer syndrome is a condition that occurs when individuals have sores or ulcers inside their rectum.
Although the exact cause is not known, some physicians theorize that the ulcers appear due to an injury to the rectum. These injuries are often caused by straining while having a bowel movement, constipation and a prolapse of the rectum.
Solitary rectal ulcer syndrome can cause various symptoms including pain in the rectum, bleeding from the rectum and a discharge of mucus from the rectum. Some people have a full feeling in their pelvic area or they feel as if they did not have a complete bowel movement after going to the bathroom.
Fecal matter may exit the rectum uncontrollably or it may seep out while an individual passes gas. Other symptoms include bowel movements that are infrequent and difficulties passing stool. Some individuals who have solitary rectal ulcer syndrome do not experience any symptoms at all.
Solitary rectal ulcer syndrome (SRUS) tends to be caused by injury to the rectum. One of the most common ways to develop an injury is during rectal prolapse, which is where the end of the rectum begins to protrude through the anus. This leaves it highly susceptible to injury.
However, there are many other potential causes of injury to the rectum. It is thought that straining can cause rectal ulcers, which means that people with chronic constipation and impacted stools are at a higher risk. Similarly, attempts to manually remove impacted stools could cause the ulcers.
In some cases, unusual tightening of the pelvic floor muscles is thought to cause rectal ulcers. This is because it could restrict blood flow to the rectum which can result in damage to the tissues. A condition called intussusception, which is where part of the intestine slides into another part, might also cause injury to the rectum and lead to ulcers.
Sometimes it is the insertion of a foreign body into the anus or anal intercourse which causes injury to the rectum. It’s also known that abnormal toileting behaviors, which could be exhibited by people with psychological disorders like OCD, can lead to injury and SRUS.
The types of treatments depend on the magnitude of the injuries to the rectum and the symptoms that a person is experiencing. Those who have slight symptoms can often prevent them from getting worse by eating healthy meals and getting regular exercise. Medications that can also help to reduce the symptoms include botulinum toxin, steroids and sulfasalazine enemas.
If the condition is advanced, individuals may need surgery to repair a rectal prolapse. If treating the condition is not effective, individuals may be required to have a proctectomy, which is a surgical procedure for removing the rectum. If necessary, a colostomy procedure may be performed to reroute the colon to the abdominal wall. After this procedure is completed, individuals will have a bag attached to an opening in the abdomen to collect their waste.
Preventing SRUS may be possible by preventing the underlying injuries or conditions which can cause ulcers to develop. Rectal prolapse tends to occur due to the weakening of the muscles surrounding the rectum, which often occurs as a result of excessive straining.
By increasing the amount of fiber and liquids in the diet, it may be possible to keep stools soft enough for more regular, comfortable bowel movements. This will both reduce the risk of prolapse and of injury to the rectum. It’s also important to avoid trying to manually remove impacted stools.
Those who frequently have anal intercourse should take great care to avoid injuring the rectum. Use of a body-friendly lubricant will help with this.