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It is a long-term condition that results in inflammation and ulcers of the colon and rectum. [1] [7] The primary symptoms of active disease are abdominal pain and diarrhea mixed with blood (hematochezia). [1] Weight loss, fever, and anemia may also occur. [1] Often, symptoms come on slowly and can range from mild to severe. [1]
Solitary rectal ulcer syndrome (SRUS) is a rare benign disease characterized by symptoms, clinical findings, and histological abnormalities. [9] Only 40% of patients have ulcers; 20% of patients have a single ulcer, and the remaining lesions range in size and form from broad-based polypoid to hyperemic mucosa. [10]
These hard lumps irritate the rectum and lead to the formation of these ulcers. It results in fresh bleeding per rectum (i.e. hematochezia). These ulcers may be seen on imaging, such as a CT scan but are more commonly identified using endoscopy, usually a colonoscopy. [1] Treatment modalities can include both surgical and non-surgical techniques.
A nasogastric aspirate can help determine the location (source) of bleeding and help understand the best initial diagnostic and treatment plan. Nasogastric aspirate has a sensitivity of 42%, specificity 91%, negative predictive value 64%, positive predictive value 92% and overall accuracy of 66% in differentiating upper gastrointestinal ...
A final option of treatment is available in the form of colorectal surgery. Generally, this option is reserved for only the cases in which cancer development is highly suspected or major internal bleeding from ulcers occurs. In this case the entire colon and rectum are removed which both cures the pancolitis and prevents any chance of colon ...
A lower gastrointestinal bleed is defined as bleeding originating distal to the ileocecal valve, which includes the colon, rectum, and anus. [2] LGIB was previously defined as any bleed that occurs distal to the ligament of Treitz, which included the aforementioned parts of the intestine and also included the last 1/4 of the duodenum and the entire area of the jejunum and ileum. [1]
Bleeding peptic ulcers require endoscopic treatment if they show evidence of high risk stigmata of re-bleeding, such as evidence of active bleeding or oozing on endoscopy or the presence of a visible blood vessel around the ulcer.
Despite treatment, re-bleeding occurs in about 7–16% of those with upper GI bleeding. [3] In those with esophageal varices, bleeding occurs in about 5–15% a year and if they have bled once, there is a higher risk of further bleeding within six weeks. [13] Testing and treating H. pylori if found can prevent re-bleeding in those with peptic ...
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