Solitary Rectal Ulcer Syndrome: Addition of Rectal Therapies to Biofeedback Is More Effective Than Biofeedback Alone



Abdi S¹ ; Tavakolikia N² ; Yamini M¹ ; Bagheri M¹ ; Sadeghi A¹ ; Pourhoseingholi MA¹ ; Shahrokh S¹ ; Pasha MA¹ Show Affiliations
Source: Gastroenterology and Hepatology from Bed to Bench Published:2019

Abstract

Aim: We designed this study to evaluate the effectiveness of the combination of topical rectal therapy with biofeedback in treatment of solitary rectal ulcer compared to single biofeedback therapy. Background: Biofeedback therapy is an appropriate treatment for patients with solitary rectal ulcer syndrome (SRUS) but it seems that it is not effective alone. Topical medical therapies are supposed to have an additive role to biofeedback. Methods: This randomized, controlled trial was conducted on 63 patients with SRUS. Patients were randomly enrolled into two groups of combination and single therapy. The patients in combination group (n=31) received biofeedback plus a topical therapy (an enema contained dexamethasone, sulfasalazine and bismuth) and the patients in single therapy group (n=32) were treated with biofeedback alone. Results: Endoscopic responses to treatment in the combination and single groups were 80% and 50%, respectively (P<0.05). Clinical improvement in symptoms such as difficulty to evacuate, digitation to evacuate, feeling of incomplete evacuation, time to need to evacuation and life style alternation were significantly better in treated group by combination therapy than single therapy. Regarding to the mean total score based on all subjective parameters, the results were also significantly better in the treated group by combination therapy. Conclusion: Topical anti-inflammatory therapies in combination with biofeedback is an efficient treatment for patients with SRUS. © 2019 RIGLD, Research Institute for Gastroenterology and Liver Diseases.