Rectal Ulcer Clinical Features

It is important to understand the clinical features of solitary rectal ulcer syndrome. We observe that people generally confuse this disease because of its name. Considering that patients may present lesions that are neither solitary nor ulcerated, the name "solitary rectal ulcer syndrome" is misguiding the general population. Among the vast majority of patient population, when we talk about the lesions we should not forget that it is detected in the anterior rectal wall 10 cm of the anal borderline. The clinical results of endoscopic examination change and may involve mucosal ulcerations, mass lesions, polypoid or erythma. As a consequence misdiagnosis is true for general patient population. The onset of symptoms to diagnosis may take from 3 months to 30 years. (This data is derived from a single clinical study). The most common seen lesion in solitary rectal ulcer syndrome is an ulcer (approximately 75%), preceded by polypoid lesions (25%) and little patches of hyperemic or nodular mucosa (18%) and small patches of when ulcers are present, the majority are solitary (70%), with multiple lesions being common (30%).

What is the epidemiology of rectal ulcer syndrome?

Solitary rectal ulcer syndrome is not a very common disease. However, Typically presenting in the third decade of life, more than 80% of reported individuals with SRUS are younger than 50 years. Although there is a lack of exact data, current estimations reflect that, solitary rectal ulcer syndrome is rare and under-diagnosed disease where annually 1 in 100 000 prevalent patient population. The source of this information is a 10-year study. Various reports emphasize the gender differences. Although it is being asserted that there is a small predominance of women among the general patient population; according to a clinical study, women and men appear to be affected similarly. This means men and women are affected equally. According to the several reports solitary rectal ulcer syndrome is a disease of young adult population.

Solitary rectal ulcer syndrome is present frequently in the third decade in men and in the fourth decade in women. However, SRUS has been also defined in children (very rare) and in the geriatric population.

What is the incidence of Solitary rectal ulcer syndrome among children?

SRUS is not very common among children. It can be said that solitary rectal ulcer syndrome is an unusual disorder in childhood. Although SRUS is well recognized among adult population, the pediatric experience with SRUS is limited. Thus solitary rectal ulcer syndrome is usually unrecognized or misdiagnosed. There are some few reported cases where the documentation was so weak. It has been observed that in these cases children had different macroscopic pathology. In most of the cases the diagnosis was delayed. The diagnosis and management of solitary rectal ulcer syndrome among children deserves wider recognition.