Sadeghi Anahita, Biglari Mohammad, Forootan Mojgan, Adibi Peyman
Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Middle East J Dig Dis. 2019 Jul;11(3):129-134. doi: 10.15171/mejdd.2019.138. Epub 2019 Jun 28.
Solitary rectal ulcer syndrome is a multifactorial pathology, which entails a variety of clinical, histologic and endoscopic aspects that needs step-wise logical approach for management especially in relapsing refractory cases. Apart from the diagnostic dilemma that may be faced due to similarities of presentation with inflammatory bowel diseases or colorectal neoplastic lesions, the syndrome also overlaps with dyssynergic defecation syndrome, health anxiety disorder, obsessive compulsive disorder, and latent mucosal rectal prolapse, a systematic composite treatment modality including psychological, pharmacological, physiological and possibly surgical interventions are sometimes essential. Selecting appropriate treatment in this condition not only affects clinical outcome but also patients' experience and further stigma of SRUS life-long. In this review, we will discuss the detailed pathophysiology, diagnostic and therapeutic approaches in dealing with solitary rectal ulcer syndrome.
孤立性直肠溃疡综合征是一种多因素病理状况，它涉及多种临床、组织学和内镜方面的表现，对于其管理，尤其是复发性难治性病例，需要采取逐步的逻辑方法。除了因临床表现与炎症性肠病或结直肠肿瘤性病变相似而可能面临诊断困境外，该综合征还与排便协同失调综合征、健康焦虑症、强迫症以及潜在的黏膜性直肠脱垂重叠，因此有时系统性的综合治疗模式（包括心理、药物、生理以及可能的手术干预）至关重要。在这种情况下选择合适的治疗方法不仅会影响临床结果，还会影响患者的体验以及孤立性直肠溃疡综合征患者一生的进一步污名化。在本综述中，我们将讨论处理孤立性直肠溃疡综合征的详细病理生理学、诊断和治疗方法。
