Treatment of Solitary Rectal Ulcer Syndrome (SRUS)

Medical Management

• The American Gastroenterological Association recommends topical mesalamine for patients with rectal inflammation, similar to treatment principles for distal colitis, with a strength of evidence based on clinical trials 1, 2
• Topical corticosteroids may be considered for patients intolerant to topical mesalamine, as suggested by the European Society of Gastrointestinal Endoscopy 1, 2
• Proximal constipation, which is common in SRUS, may contribute to symptoms and poor response to therapy, similar to what is observed in refractory distal colitis, according to the National Institute of Diabetes and Digestive and Kidney Diseases 1

Treatment of Solitary Rectal Ulcer Syndrome (SRUS)

Diagnosis and Differential Diagnoses

• Differential diagnoses that must be excluded include infection, irritable bowel syndrome, Crohn's disease, ulcerative colitis, chemical colitis, and rectal prolapse, according to the American Gastroenterological Association 3

Treatment Approaches

• Biofeedback therapy works by training patients to relax pelvic floor muscles during straining and restore normal coordination, as recommended by the American Gastroenterological Association 4