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Solitary Rectal Ulcer Syndrome

Experience expert care for Solitary Rectal Ulcer Syndrome (SRUS) with Dr. Rishi Chadha at GastroDoxs in Houston. Dr. Chadha offers personalized diagnosis, lifestyle and dietary guidance, minimally invasive therapies and advanced procedures to alleviate pain, stop bleeding, restore bowel function.

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Rishi Chadha

About the Expert

Dr. Rishi Chadha, MD is a board‑certified gastroenterologist who specializes in preventive gastroenterology, colorectal cancer screening, and minimally invasive endoscopic procedures. He completed his fellowship at Sunrise Health GME in Las Vegas and previously trained in internal medicine at St. Vincent’s Medical Center in Connecticut.

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.

Dr. Rishi Chadha
Treatment

Treatment Options at GastroDoxs for Solitary Rectal Ulcer Syndrome

1. Lifestyle and Diet Changes

  • Eat more fiber-whole grains, fruits, and vegetables
  • Drink plenty of water daily
  • Avoid straining during bowel movements
  • Try pelvic floor therapy or biofeedback to retrain muscles

2. Medications

  • Stool softeners or fiber supplements
  • Sucralfate enemas or anti-inflammatory creams
  • Safe pain relief options if needed

3. Minimally Invasive or Advanced Procedures

  • Endoscopic therapy to treat small ulcers
  • Botox injections to relax pelvic muscles
  • Surgery (e.g., rectopexy or ulcer removal) for severe cases
Rishi Chadha

About the Author

Dr. Rishi Chadha, MD is a board‑certified gastroenterologist who specializes in preventive gastroenterology, colorectal cancer screening, and minimally invasive endoscopic procedures. He completed his fellowship at Sunrise Health GME in Las Vegas and previously trained in internal medicine at St. Vincent’s Medical Center in Connecticut.

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.

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