Research Information System
Turkish Journal of Gastroenterology, vol.9, no.2, pp.179-182, 1998 (SCI-Expanded)
Eleven patients (six men and five women), mean age 24.45 (21-29) with a history of rectal bleeding, difficulty in defecation and incomplete rectal evacuation, were diagnosed by rectosigmoidoscopic and histologic work-up with solitary rectal ulcer. In all cases the ulcer was located 4-8 cm above the pectinate line. The rectal ulcer was located on the front wall in nine cases, on the back wall in one and on the front-side wall in one. All patients were told to avoid manual rectal evacuation and they were put on a high fiber diet. In addition, they received 40 g of lactulose each evening, and Trimebutin, 100 mg tid. before meals. They also a kortos suppositury., which is composed of 5 mg hydrocortisone acetateta and 27 mg pistocain, qd, every night. Patients were seen on months one and three after starting treatment, and had a physical examination, endoscopy and rectosigmoidoscopy. After three months of treatment, the symptoms of rectal bleeding and pelvic pain had totally subsided in all patients. The patients'complaints of constipation and diffuculty in defecating had also improved. In six patients, ulcer size had decreased by 70% on month one; in four of the tehm the ulcer healed with a band scar and some granulation tissue by month 3 and in the other two the ulcer size had decreased by 90% on month three. In the other 5 patients, the ulcer size decreased by 50% at month 1 and by 70-80% at month 3. The results of this study suggests that the above mentioned management of solitary rectal ulcer consisting of diet regulation, laxatives, anticholinergics and local anti-inflamatory drugs may be at least partially effective. The long term effects of such treatement have to be explored as well and controlled studies are required to verify our results.