Solitary rectal ulcer syndrome--clinical, endoscopic, and histological spectrum

Nineteen patients with solitary rectal ulcer syndrome are presented. The diagnosis was established on sigmoidoscopic and histopathological grounds; the clinical, endoscopic, and histological states were assessed at presentation and on last follow-up. Most of the patients suffered from rectal bleeding, abdominal and anorectal pains, constipation, and straining at defecation. Thirteen patients had macroscopic ulcerations on presentation and six patients did not. These six patients did not develop ulcer during the follow-up period. Four patients entered clinical and endoscopic remission with no histological improvement. Three of them managed conservatively and one underwent suturing of the ulcer and internal anal sphincter dilatation. They remained in remission for a mean follow-up of 1 yr.