Rectal Ulcer Diagnosis

Unfortunately physical examination of solitary rectal ulcer syndrome is generally unremarkable; when current signs are limited to the perineum and rectum. The most familiar sign of solitary rectal ulcer syndrome is rectal bleeding. However, after a careful examination, physicians may diagnose the source of the bleeding. It is important to remember that not all the rectal bleeding conditions are linked with the SRUS. More serious disease conditions like lower gastrointestinal tract including anal or colorectal cancer may also be the reason for bleeding.

Refer to your doctor immediately if your symptoms start with the below conditions:

• Significant change in bowel habits
• Passing black, tarry, bloody maroon stools

Do not forget that the above mentioned stools may indicate an extensive bleeding within the digestive tract. And do not loose any time to refer to your doctor if you observe enormous rectal bleeding, dizziness, lightheadedness or faintness.

After your physician takes your patient history, he/she may employ the following tests whether you have rectal ulcers.

The foundation of diagnosing of solitary rectal ulcer syndrome is based on the synthesis of both histologic and endoscopic results and conclusions. History taking has an important role for screening and diagnosing solitary rectal ulcer syndrome for the first time. It is crucial to make differential diagnosis of solitary rectal ulcer syndrome from other severe, chronic and potentially destructive disorders.

Differential diagnosis of the solitary rectal ulcer syndrome include:

• IBD ( Inflammatory Bowel Disease)
• CCP (Colitis cystica profunda)
• Endometriosis
• Malignancy
• Infectious (amebiasis, venereum, lymphogranuloma, secondary syphilis)
• Stercoral (pressure) ulcer
• Trauma
• Chronic vascular insufficiency (chronic ischemic colitis)
• Drug-induced (e.g., ergotamine tartrate-containing suppositories) Idiopathic

Endoscopy is a critical diagnosis tool for solitary rectal ulcer syndrome, together with the common appearance being a small, shallow ulcer usually positioned on the anterior rectal wall approximately 5 to 10 cm from the anus. The endoscopic coverage of solitary rectal ulcer syndrome may change from basic hyperemic mucosa to little or giant ulcers to broad based polypoid lesions in various sizes and quantity. It is critical to take biopsy from the subject location to make a confirmation of the diagnosis of SRUS, and differentiating it from other potential diseases including cancer. Do not forget that wide endoscopic spectrum of solitary rectal ulcer syndrome prevents to make a proper diagnosis. Thus it is usually unrecognized or, more commonly, misdiagnosed.

Diagnosing the presence of internal or external mucosal prolapse or intussusception in solitary rectal ulcer syndrome is critical. Thus defecography is being employed to identify this. It is also being used to validate a hidden prolapse, non-relaxing puborectalis muscle and incomplete or delayed rectal emptying. The term solitary rectal ulcer syndrome is a misnomer, because not all lesions are ulcers, and multiple lesions may be present.