What Is Solitary Rectal Ulcer Syndrome?
Solitary Rectal Ulcer Syndrome (SRUS) is a rare, non-cancerous condition that causes sores (ulcers) in the lining of the rectum. Despite its name, some patients may develop multiple ulcers. SRUS often leads to pain, rectal bleeding, and the sensation of incomplete bowel movements. (ICD-10 code: K62.7)
Common Causes and Risk Factors
- Chronic constipation or excessive straining during bowel movements
- Rectal prolapse or internal intussusception (telescoping of the rectum)
- Overuse of enemas or laxatives
- Weakness of the pelvic floor muscles
- History of pelvic injury or surgery
Signs and Symptoms
- Bright red bleeding from the rectum
- Persistent pain or pressure in the rectal area
- Mucus discharge with bowel movements
- Straining and a feeling of incomplete evacuation
- Sensation of rectal fullness or a prolapse-like feeling
How Dr. Rishi Diagnoses Solitary Rectal Ulcer Syndrome?
Dr. Chadha uses a step-by-step approach:
Medical History and Physical Exam
He reviews your symptoms-bleeding, pain, mucus discharge, straining and incomplete emptying-as well as past bowel habits, constipation history, prior surgeries, and any signs of prolapse.
Endoscopic Evaluation
He performs a colonoscopy or flexible sigmoidoscopy to directly visualize the rectal lining, locate ulcers, assess their number and size, and rule out other diseases.
Biopsy
Targeted tissue samples are taken from the ulcer edges to exclude cancer and confirm the characteristic fibromuscular changes of SRUS.
Functional Testing
- Anorectal Manometry: Measures sphincter pressures, rectal sensation, and pelvic floor coordination during simulated bowel movements.
- Defecography: A dynamic X-ray study that evaluates rectal emptying, detects internal prolapse or rectocele, and shows how the rectum moves under strain.
Advanced Imaging (If Indicated)
In select cases, MRI or endoanal ultrasound provides detailed images of the pelvic floor muscles and rectal support structures to identify subtle prolapse or muscle defects.
Frequently Asked Questions
What is solitary rectal ulcer syndrome?
It's a condition that causes sores in the rectum, leading to pain and bleeding.
Can SRUS turn into cancer?
No. SRUS is not cancer, but a biopsy confirms the diagnosis.
When is surgery needed?
Surgery is only for severe cases that don-t improve with therapy or medication.
What lifestyle tips help with SRUS?
Eat fiber-rich foods, stay hydrated, avoid straining, and try pelvic floor exercises or biofeedback.
How long is recovery after surgery?
Most people return to daily activities in 2-4 weeks and heal fully by 6-8 weeks.
Is SRUS passed down in families?
No strong genetic link. It's mostly caused by mechanical and functional factors in the rectum.
Can kids get SRUS?
Yes, but it's rare. Children need specialized testing and care.
Why is it called 'solitary- if there's more than one ulcer?
The name started that way, but doctors now know multiple ulcers can appear.
Is biofeedback helpful?
Yes! It helps retrain pelvic muscles to stop straining and improve bowel movements.
What is the ICD-10 code for SRUS?
The code is K62.7-used for medical records and insurance.