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.