Overview

Solitary rectal ulcer syndrome is a condition that occurs when one or more open sores (ulcers) develop in the rectum. The rectum is a muscular tube connected to the end of your colon. Stool passes through the rectum on its way out of the body.

Solitary rectal ulcer syndrome is a rare and poorly understood disorder that often occurs in people with chronic constipation. Solitary rectal ulcer syndrome can cause rectal bleeding and straining during bowel movements. Despite the name, sometimes more than one rectal ulcer occurs in solitary rectal ulcer syndrome.

Solitary rectal ulcer syndrome may improve with simple lifestyle strategies, such as changing your diet and drinking more fluids. In severe cases, however, surgery may be needed.

Symptoms

Signs and symptoms of solitary rectal ulcer syndrome include:

  • Constipation
  • Rectal bleeding
  • Straining during bowel movements
  • Pain or a feeling of fullness in your pelvis
  • A feeling of incomplete passing of stool
  • Passing mucus from your rectum
  • Fecal incontinence
  • Rectal pain

However, some people with solitary rectal ulcer syndrome may experience no symptoms.

When to see a doctor

Make an appointment with your doctor if you notice any signs or symptoms that worry you.

Several other conditions may cause signs and symptoms similar to those of solitary rectal ulcer syndrome. At your appointment, your doctor may recommend tests and procedures to identify or rule out causes other than solitary rectal ulcer syndrome.

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Causes

It's not always clear what causes solitary rectal ulcer syndrome. Doctors believe stress or injury to the rectum may cause rectal ulcers to form.

Among the things that could injure the rectum are:

  • Constipation or hardened stool in the rectum that's difficult to pass (impacted stool)
  • Straining during bowel movements
  • A stretched rectum that comes out of the anus (rectal prolapse)
  • Uncoordinated tightening of the pelvic floor muscles that slows blood flow to the rectum
  • Attempts to manually remove impacted stool
  • When one part of the intestine slides inside another part (intussusception)

April 25, 2020
  1. Zhu QC, et al. Solitary rectal ulcer syndrome: Clinical features, pathophysiology, diagnosis and treatment strategies. World Journal of Gastroenterology. 2014;20:738. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921483/. Accessed July 26, 2018.
  2. Solitary rectal ulcer syndrome. Merck Manual Professional Version. https://www.merckmanuals.com/professional/gastrointestinal-disorders/anorectal-disorders/solitary-rectal-ulcer-syndrome. Accessed July 26, 2018.
  3. Kim DJ, et al. Solitary rectal ulcer syndrome. https://www.uptodate.com/contents/search. Accessed July 26, 2018.
  4. Fazio VW, et al., eds. Solitary rectal ulcer syndrome. In: Current Therapy in Colon and Rectal Surgery. 3rd ed. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed July 26, 2018.
  5. Constipation. National Digestive Diseases Information Clearinghouse. https://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/constipation/Pages/overview.aspx. Accessed July 26, 2018.
  6. Cameron JL, et al. The management of solitary rectal ulcer syndrome. In: Current Surgical Therapy. 12th ed. Philadelphia, Pa.: Saunders Elsevier; 2017. https://www.clinicalkey.com. Accessed July 26, 2018.

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