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The exact treatment depends on the severity of the symptoms, the severity/type of SRUS and whether rectal prolapse is present or absent. [ 5 ] Conservative measures are the first line treatment for patients with no symptoms, or only mild to moderate symptoms, and who have no significant anatomical defect. [ 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]
However, when the opening is obstructed due to inflammation, polyps, mucosal thickening, anatomical abnormalities, or other lesions, pressure equilibration is impossible. Squeeze is produced on descent when trapped air in the sinuses contracts and produces negative pressure.
Vitamin D treatment may be associated with less inflammatory bowel disease reoccurrence of symptoms (relapse). It is not clear if this treatment improves the person's quality of life or what the clinical response to vitamin D treatment. The ideal treatment regime and dose of vitamin D therapy has not been well enough studied. [90]
Most polyps are benign and do not need to be removed. Surgical removal of the gallbladder (cholecystectomy) is recommended when a gallbladder polyp larger than 1 cm is found, even if the person has no symptoms clearly related to the polyp. Laparoscopic surgery is an option for small or solitary polyps. [citation needed]
The first line of treatment for nasal polyps is topical steroids. [12] Steroids decrease the inflammation of the sinus mucosa to decrease the size of the polyps and improve symptoms. [12] Topical preparations are preferred in the form of a nasal spray but are often ineffective for people with many polyps.
Computed tomography of the abdomen is not routinely necessary, but may show thickening or inflammation in the distal colon (sigmoid colon) with associated diverticulosis. Treatment may consist of antibiotics, aminosalicylates (mesalamine), or prednisone. In rare cases, surgery with segmental resection may be considered.
The colonoscopy is normal but histology of the mucosal biopsy reveals an accumulation of lymphocytes in the colonic epithelium and connective tissue (lamina propria). Collagenous colitis shares this feature but additionally shows a distinctive thickening of the subepithelial collagen table.