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Anorectal function in the solitary rectal ulcer syndrome
Diseases of the Colon and Rectum
|May 1, 1987
Summary
Solitary rectal ulcer syndrome (SRUS) is caused by high intrarectal pressure and rectal prolapse during defecation. These patients exhibit abnormal anal sphincter relaxation and require increased pressure to void.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Physiology
Background:
- Solitary rectal ulcer syndrome (SRUS) is a rare condition affecting anorectal function.
- Understanding the underlying mechanisms of SRUS is crucial for effective treatment.
Purpose of the Study:
- To investigate the anorectal function in patients with SRUS.
- To identify the physiological abnormalities contributing to SRUS.
Main Methods:
- Utilized a novel technique combining radiological visualization of the anorectum during defecation with simultaneous intrarectal pressure and anal sphincter electromyography (EMG) measurements.
- Compared anorectal function in nine SRUS patients with nine healthy control subjects.
Main Results:
- Eight SRUS patients demonstrated rectal prolapse, with six being clinically occult.
- Seven SRUS patients exhibited abnormal failure of the anal sphincter to relax during defecation.
- SRUS patients required significantly higher intrarectal pressure (median, 100 cm water) to void compared to controls (median, 65 cm water).
Conclusions:
- The combination of high intrarectal pressure and rectal prolapse during defecation appears to be the primary cause of SRUS.
- Abnormal anal sphincter function plays a significant role in the pathophysiology of SRUS.