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Solitary rectal ulcer

Solitary rectal ulcer is a fairly rare proctological disease. This is a chronic disease in which a single deep defect of the mucous membrane of the lower part of the rectum is formed. This pathology is always observed in the rectum. By its nature, this is a benign formation. The disease can occur in both men and women.

Main etiological factors and pathogenetic aspects:

  • chronic constipation,
  • mechanical action, in particular, an attempt to release the rectum with your fingers,
  • rectal prolapse.

 There is evidence of the occurrence of ulcerative lesions of the rectum in the form of ulcerative-necrotic rectitis after radiation therapy of malignant formations of the pelvic organs and the rectum itself.

Clinical manifestations
The clinical picture of a solitary ulcer is very nonspecific and diverse. In addition, an asymptomatic course of the disease is also possible. The most common symptoms of solitary rectal ulcer are as follows: bloody or mucous discharge during the act of defecation, pain in the rectum during defecation, a feeling of a foreign body in the rectum, a feeling of incomplete emptying, false urge to defecate.

Basic diagnostic criteria:
finger examination of the rectum,
rectoromanoscopy and colonoscopy are the most important in making a diagnosis; during studies, a biopsy is necessarily taken for the purpose of subsequent differential diagnosis,
morphological examination - important in the diagnosis of solitary rectal ulcer is morphological examination, which allows you to identify the signs typical of superficial ulceration and excludes the malignant process, as well as inflammatory diseases of the rectum (ulcerative colitis).

Basic principles of treatment:

  • conservative treatment: therapy should be directed to the causes of the ulcer; local treatment-symptomatic use of anti-inflammatory candles and enemas does not give an effect. 
  • surgical treatment is used in case of ineffectiveness of conservative and / or development of complications in the form of bleeding, perforation, obstruction or with the progression of internal intussusception (complete rectal prolapse). 
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