ABSTRACT
Objective: To assess the demographic, clinical, endoscopic and histological spectrum of Solitary Rectal Ulcer Syndrome [SRUS]
Study Design: Cross-sectional observational study
Place and Duration of Study: Medical Unit-III, Civil Hospital Karachi [CHK] and Ward 7, Jinnah Postgraduate Medical Centre [JPMC], Karachi, from January 2009 to June 2012
Methodology: Patients with SRUS, based on characteristic endoscopic and histological findings, were enrolled. Patients were excluded if they had other causes of the rectal lesions [neoplasm, infection, inflammatory bowel disease, and trauma]. Endoscopically, lesions were divided on the basis of number [solitary or multiple] and appearance [ulcerative, polypoidal/nodular or erythematous mucosa]. Demographic, clinical and endoscopic characteristics of subjects were evaluated
Results: Forty-four patients met the inclusion criteria; 21 [47.7%] were females and 23 [52.3%] were males with overall mean age of 33.73 +/- 13.28 years. Symptom-wise 41 [93.2%] had bleeding per rectum, 39 [88.6%] had mucous discharge, 34 [77.3%] had straining, 34 [77.3%] had constipation, 32 [72.7%] had tenesmus, 5 [11.4%] had rectal prolapse and 2 [4.5%] had fecal incontinence. Twelve [27.27%] patients presented with hemoglobin less 10 gm/dl, 27 [61.36%] with 10 - 12 gm/dl and 05 [11.36%] subjects had hemoglobin more than 12 gm/dl. Endoscopically, 26 [59.1%] patients had mucosal ulceration, 11 [25.0%] had mucosal ulceration with polypoid characteristics; while only polypoid features were found in 7 [15.9%] subjects
Conclusion: Solitary rectal ulcer syndrome affects adults of both genders with diverse clinical presentation and nonspecific endoscopic features