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therapy solitary rectal ulcer

Victor E Pricolo
Solitary rectal ulcer syndrome is a well-known clinical entity, likely secondary to a defecatory dysfunction. In patients who have undergone restorative proctocolectomy with ileoanal reservoir, it is conceivable that a similar pathophysiology may lead to "solitary pouch ulcer," but such a syndrome has not been reported to date. This article reports 2 such cases and clinical success with lasting symptomatic relief through local therapy and behavior modification rather than anti-inflammatory.
July 2016: Journal of Clinical Gastroenterology
Benjamin Sahn, Samuel Bitton
This article provides an overview of the evaluation and management of lower gastrointestinal bleeding (LGIB) in children. The common etiologies at different ages are reviewed. Conditions with endoscopic importance for diagnosis or therapy include solitary rectal ulcer syndrome, polyps, vascular lesions, and colonic inflammation and ulceration. Diagnostic modalities for identifying causes of LGIB in children include endoscopy and colonoscopy, cross-sectional and nuclear medicine imaging, video capsule endoscopy, and enteroscopy...
January 2016: Gastrointestinal Endoscopy Clinics of North America
S S C Rao, M A Benninga, A E Bharucha, G Chiarioni, C Di Lorenzo, W E Whitehead
BACKGROUND: Anorectal disorders such as dyssynergic defecation, fecal incontinence, levator ani syndrome, and solitary rectal ulcer syndrome are common, and affect both the adult and pediatric populations. Although they are treated with several treatment approaches, over the last two decades, biofeedback therapy using visual and verbal feedback techniques has emerged as an useful option. Because it is safe, it is commonly recommended. However, the clinical efficacy of biofeedback therapy in adults and children is not clearly known, and there is a lack of critical appraisal of the techniques used and the outcomes of biofeedback therapy for these disorders...
May 2015: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Dariusz Waniczek, Jerzy Rdes, Marek K Rudzki, Jerzy Piecuch, Nina Rubicz, Jerzy Arendt
Solitary rectal ulcer syndrome (SRUS) is a chronic, multiform, non-cancerous disorder of the rectum, the final diagnosis of which is based upon histopathological criteria. This disorder is often accompanied by latent proctoptosis. We present a patient who (in 1996) was the first case in which argon plasma coagulation (APC) was used for SRUS treatment. In the years 2004-2005 the same patient underwent 15 APC sessions (at monthly intervals) obtaining full recovery from SRUS, although she had been treated unsuccessfully for 17 years prior to that...
2014: Przegla̜d Gastroenterologiczny
Jonathan Randall, Hugh Gallagher, Bruce Jaffray
PURPOSE: This study reports the results of laparoscopic rectopexy in children. METHODS: Results were obtained from a prospective database for all laparoscopic rectopexy procedures performed for external prolapse in a tertiary referral centre from 2006 to 2013. Outcomes included recurrence of symptoms and/or visible prolapse as well as the need for further surgery RESULTS: Eighteen procedures including both suture and mesh rectopexy were performed in 11 patients...
September 2014: Journal of Pediatric Surgery
Shawn Hancock, Erik Bowman, Jyothiprashanth Prabakaran, Mark Benson, Rashmi Agni, Patrick Pfau, Mark Reichelderfer, Jennifer Weiss, Deepak Gopal
Background. i-scan is a software-driven technology that allows modifications of sharpness, hue, and contrast to enhance mucosal imaging. It uses postimage acquisition software with real-time mapping technology embedded in the endoscopic processor. Aims. To review applications of i-scan technology in clinical endoscopic practice. Methods. This is a case series of 20 consecutive patients who underwent endoscopic procedures where i-scan image enhancement algorithms were applied. The main outcome measures were to compare mucosal lesions with high-definition white light endoscopy (HD-WLE) and i-scan image enhancement for the application of diagnostic sampling and therapy...
2012: Diagnostic and Therapeutic Endoscopy
Ron Schey, John Cromwell, Satish S C Rao
Pelvic floor disorders that affect stool evacuation include structural (for example, rectocele) and functional disorders (for example, dyssynergic defecation (DD)). Meticulous history, digital rectal examination (DRE), and physiological tests such as anorectal manometry, colonic transit study, balloon expulsion, and imaging studies such as anal ultrasound, defecography, and static and dynamic magnetic resonance imaging (MRI) can facilitate an objective diagnosis and optimal treatment. Management consists of education and counseling regarding bowel function, diet, laxatives, most importantly behavioral and biofeedback therapies, and finally surgery...
November 2012: American Journal of Gastroenterology
Carol Blackburn, Michael McDermott, Billy Bourke
BACKGROUND AND AIMS: Solitary rectal ulcer syndrome (SRUS) is an uncommon but troublesome and easily misdiagnosed condition of childhood. We have reviewed the presentation and outcome following conservative management of a group of children with SRUS attending a single national paediatric gastrointesinal referral unit. METHODS: Eight children were identified with histology-proven SRUS. Chart review was conducted for relevant history and examination at diagnosis...
February 2012: Journal of Pediatric Gastroenterology and Nutrition
Saeed Kargar, Hassan Salmanroughani, Fariba Binesh, Shokoh Taghipoor, Shady Kargar
Patients with Solitary Rectal Ulcer Syndrome (SRUS) come to a physician with passage of mucus and bloody liquid within defecation. The treatment for SRUS is depended to the severity of symptoms and the existance of rectal prolapse. This study is a report of the assessing of rectopexy as surgical modalities for 62 medical treatment resistant SRUS patients who were referred to the gastrointestinal department of Shahid Sadoughi Medical University and Mojibian hospital. The present non-randomized clinical trial was carried out in 62 SRUS patients from 1991 till 2005...
2011: Acta Medica Iranica
Abdulkerim Temiz, Burak Tander, Muhyittin Temiz, Sancar Barış, Ender Arıtürk
Solitary rectal ulcer causing lower gastrointestinal bleeding is extremely rare in children. Rare presentation, non-specific symptoms, insufficient experience, and characteristics mimicking other rectal diseases may cause misdiagnosis or delay of diagnosis in some pediatric patients. Here, we report a 10-year-old boy with solitary rectal ulcer diagnosed two years after onset of the symptoms who responded well to the conservative therapy, including high-fiber diet, laxatives, defecation training, and sucralfate enema...
March 2011: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
S B Umar, J E Efron, R I Heigh
Solitary rectal ulcer syndrome (SRUS) is an uncommon disorder which can present in patients being evaluated for defecatory disorders or which can present as a primary process often involving hematochezia, rectal pain and tenesmus. Unfortunately the diagnosis of this disorder is often delayed due to misdiagnosis and/or physician unfamiliarity with the condition. We present a 24-year-old female who presented with 6 months of bloody diarrhea and weight loss. She had been receiving treatment for a presumed diagnosis of inflammatory bowel disease (IBD) due to an endoscopic picture of rectal thickening, edema and ulceration and had been on prednisone for 2 months prior to presentation without relief of her symptoms...
2008: Case Reports in Gastroenterology
Sanjay Kumar Somani, Arindam Ghosh, Gurcharan Avasthi, Richa Goyal, Puneet Gupta
BACKGROUND: Solitary rectal ulcer syndrome (SRUS) is an uncommon disorder of evacuation. Management of bleeding ulcers is usually unsatisfactory with conventional treatment. Argon plasma coagulation (APC) has been reported to control bleeding; however, it has not been shown to result in ulcer healing. The aim of the present study was to: (i) to investigate the efficacy and safety of APC in controlling bleeding from SRUS; and (ii) to study its efficacy in the healing of ulcer/s. METHODS: Twenty-four patients with bleeding SRUS diagnosed on clinical, colonoscopic, and histological findings were randomized to receive either standard care alone (12 patients) or to undergo multiple sessions of APC in addition (12 patients)...
April 2010: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Sanjay Kumar Somani, Arindam Ghosh, Gurcharan Avasthi, Richa Goyal, Puneet Gupta
BACKGROUND: Solitary rectal ulcer syndrome (SRUS) is an uncommon disorder of evacuation. Management of bleeding ulcers is usually unsatisfactory with conventional treatments. Argon plasma coagulation (APC) has been reported in case reports to control bleeding; however, it has not been shown to result in ulcer healing. OBJECTIVE: To investigate the efficacy and safety of APC in controlling bleeding from SRUS and to study its efficacy in eventual healing of ulcers...
March 2010: Gastrointestinal Endoscopy
Anna Swatton
Solitary rectal ulcer syndrome (SRUS) is a rare condition that can lead to pain, rectal bleeding and mucus. It is associated with chronic straining and abnormal defaecatory behaviour, including digitating and several unsuccessful visits to the toilet daily. Other symptoms can include tenesmus, altered bowel habit and incontinence. It can also be accompanied with a rectal prolapse, which may involve protrusion of either the rectal mucosa or the entire wall of the rectum. SRUS is known for its chronicity and can be difficult to treat...
November 26, 2009: British Journal of Nursing: BJN
Satish S C Rao, Jorge T Go
Pelvic floor disorders that affect defecation consist of structural disorders (eg, rectocele) and functional disorders (eg, dyssynergic defecation). Evaluation includes a thorough history and physical examination, a careful digital rectal examination, and physiologic tests such as anorectal manometry, colonic transit study, and balloon expulsion test. Defecography and dynamic MRI may facilitate detection of structural defects. Management consists of education and counseling regarding bowel function, diet, laxatives, and behavioral therapies...
August 2009: Current Gastroenterology Reports
Richelle J F Felt-Bersma, E Stella M Tiersma, M Tiersma E Stella, Miguel A Cuesta
Rectal prolapse is best diagnosed by physical examination and by having the patient strain as if to defecate; a laparoscopic rectopexy is the preferred treatment approach. Intussusception is more an epiphenomena than a defecatory disorder and should be managed conservatively. Solitary rectal ulcer syndrome is a consequence of chronic straining and therapy should be aimed at restoring a normal bowel habit with behavioral approaches including biofeedback therapy. Rectocele correction may be considered if it can be definitively established that it is a cause of defecation disorder and only after conservative measures have failed...
September 2008: Gastroenterology Clinics of North America
G Meurette, L Siproudhis, N Regenet, E Frampas, M Proux, P A Lehur
BACKGROUND: Solitary rectal ulcer syndrome (SRUS) is a chronic disabling condition. Several therapeutic options have been advocated including conservative approaches and surgery, bringing into question their functional outcomes. This study aimed to assess treatment procedures on both anorectal complaints and quality of life (QoL) using standardised self-administered questionnaires. MATERIALS AND METHODS: Forty-one patients who underwent treatments for SRUS in two referral centres were reviewed...
May 2008: International Journal of Colorectal Disease
Paolo Boccasanta, Marco Venturi, Giuseppe Calabro, Marco Maciocco, Gian Carlo Roviaro
PURPOSE: At present, none of the conventional surgical treatments of solitary rectal ulcer associated with internal rectal prolapse seems to be satisfactory because of the high incidence of recurrence. The stapled transanal rectal resection has been demonstrated to successfully cure patients with internal rectal prolapse associated with rectocele, or prolapsed hemorrhoids. This prospective study was designed to evaluate the short-term and long-term results of stapled transanal rectal resection in patients affected by solitary rectal ulcer associated with internal rectal prolapse and nonresponders to biofeedback therapy...
March 2008: Diseases of the Colon and Rectum
Alireza S Keshtgar
SRUS is a rare condition in children, which usually presents with a symptom complex of rectal bleeding, passage of mucus and straining on defecation, tenesmus, perineal and abdominal pain, sensation of incomplete defecation, constipation and rectal prolapse. The underlying etiology of SRUS is not fully understood but it is likely to be secondary to ischemic changes in the rectum associated with paradoxical contraction of pelvic floor and external anal sphincter muscles and rectal prolapse. Conservative measures like high intake of fluids and fibers, laxatives, biofeedback and behavior modification therapy may be beneficial for treatment of constipation...
February 2008: European Journal of Gastroenterology & Hepatology
Ramazan Oztürk, Satish S
Functional defecation disorders are common and affect approximately 50% of patients with chronic constipation. The etiology of functional defecation disorders is not well known, but several pathophysiologic mechanisms have been described, including failure of rectoanal coordination, paradoxical anal contraction or insufficient relaxation of anal sphincter during defecation and impairment of rectal sensation as well as secondary slowing of colonic transit. Symptoms alone are inadequate to distinguish patients with defecation disorders from those with other types of constipation...
September 2007: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
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