Introduction:
Solitary rectal ulcer syndrome (SRUS) is a rare benign rectal disorder, with an estimated prevalence of one in 100,000 individuals annually, which does not differ in terms of gender and can occur at any age, mostly in young adults. Despite its name, it is not limited to ulcers and can affect different parts of the rectum and gastrointestinal tract to the extent that some patients do not even have ulcers. It is characterized by painful and difficult defecation, a sense of incomplete evacuation, perineal pain, tenesmus, chronic constipation, mucus discharge, fresh lower gastrointestinal bleeding, and rarely rectal prolapse.1-4
The pathogenesis and etiology of SRUS are not well understood; several factors may be involved, and the most important discussed factors include direct trauma and causes of local ischemia such as straining, rectal prolapse, self-induced trauma, and paradoxical contraction of Puborectalis muscle.1-3
Due to its rare occurrence, it is not properly diagnosed and is often misdiagnosed with other diseases such as inflammatory bowel disease (IBD), constipation, and malignancies; so, it is necessary to have knowledge about the diagnostic features and also treatment of this disorder.1-3 Diagnosis is mostly based on clinical symptoms, endoscopy, histological, and also imaging findings.1,4 Treatment is based on the severity of the disease and symptoms such as the presence of rectal prolapse. Behavioral modification, conservative treatment, biofeedback therapy, topical therapy, and surgery are options for treatment.1-4
In this report, we present a case of a 19-year-old man with a polypoid solitary rectal ulcer presented by rectal bleeding and chronic constipation.