Overview
Solitary rectal ulcer syndrome (SUS) is a rare disorder characterized by a solitary ulcer in the rectum, often presenting with hematochezia, rectal pain, and potential anemia 12.Diagnosis
Endoscopic identification of a solitary or multiple rectal ulcers
Presence of characteristic histological changes in adjacent mucosa 2
Clinical symptoms may include hematochezia, rectal pain, and anemia 1Management
First-line treatments: Not explicitly detailed in provided abstracts; conservative management often considered 2
Adjunctive treatments: Argon plasma coagulation (APC) shows promise for bleeding ulcers, with sessions spaced 30 days apart 1Special Populations
Elderly: A case report indicates efficacy in a 64-year-old patient 1
Comorbidities: Management considerations for secondary anemia and pain management (analgesics) noted 1Key Recommendations
Consider argon plasma coagulation (APC) as a therapeutic approach for bleeding solitary rectal ulcer syndrome, particularly when medical management fails (Evidence: Weak) 1
Endoscopic evaluation is crucial for diagnosis and monitoring response to treatment (Evidence: Expert opinion) 2
Manage secondary anemia and pain aggressively, potentially reducing reliance on analgesics post-treatment (Evidence: Weak) 1References
1 Stoppino V, Cuomo R, Tonti P, Gentile M, De Francesco V, Muscatiello N et al.. Argon plasma coagulation of hemorrhagic solitary rectal ulcer syndrome. Journal of clinical gastroenterology 2003. link
2 Madigan MR, Morson BC. Solitary ulcer of the rectum. Gut 1969. link