Solitary Rectal Ulcer Syndrome

Your healthcare provider will ask about your symptoms and bathroom habits that may have caused your symptoms (like frequently straining to poop). To check for rectal ulcers, providers use digital rectal exams and imaging tests.

The most common test is an:

• Endoscopy: Your provider may insert a scope inside you to check for ulcers. Most scopes have cameras on the end that allow your provider to see inside your lower digestive tract. An anoscopy examines your anus. A flexible sigmoidoscopy examines your rectum and the lower part of your colon. A colonoscopy examines your entire colon.

You may need additional tests so your provider can rule out conditions that cause symptoms similar to solitary rectal ulcer syndrome, like inflammatory bowel disease (IBD) and colon cancer. Tests include:

• Transrectal ultrasound: During a transrectal ultrasound, a provider inserts a small probe into your rectum. The probe uses sound waves to show images of the inside of your rectum so your provider can see ulcers and other growths.
• Defecography: This test can show if a condition like rectal prolapse or intussusception is likely causing your ulcer. During a defecography test, X-rays or an MRI (magnetic resonance imaging) machine will record how your muscles work in real-time to help you poop.
• Anorectal manometry: Anorectal manometry shows how your pelvic floor muscles are coordinating to help you poop. During the test, a provider inserts a flexible tube with sensors (transducer) inside your rectum. It records how your muscles respond to pressure.
• Biopsy: During the endoscopy, your provider may take a biopsy (sample) of the tissue surrounding the ulcer and send it to a lab. Lab tests can show if the cells are benign (as with SRUS) or cancerous.