First AD

Second AD

A 27-year-old man presents to the emergency room after experiencing several episodes of hematochezia. He has a history of constipation and occasionally uses a laxative to have a bowel movement. On colonoscopy, he is noted to have internal hemorrhoids and an ulcer along the anterior wall of the rectum.

This patient presents with solitary rectal ulcer syndrome (SRUS), a condition that occurs in young adults. The pathogenesis is not completely understood, however constant straining during bowel movements may lead to rectal prolapse and mucosal ischemia. Because of the limited controlled studies for SRUS, there are no definitive treatment recommendations. Management is usually aimed at behavioral modifications, such as biofeedback sessions to correct abnormal pelvic-floor behavior and reduce straining. The other medications do not have a role in the treatment of SRUS.

Gastrointestinal Disorders

AIBD

Conference

Constipation-related straining may be the cause of the lesion. How would you proceed? 

What Treatment for Rectal Ulcer in a Young Man?