Solitary rectal ulcer syndrome

Both pages describe sores or other changes in the rectal lining, not a swollen vein. ahem has not examined anyone and does not sell a treatment. How the hemorrhoid pages separate an internal hemorrhoid from an external one is on internal and external hemorrhoids.

Mayo Clinic dates its page September 20, 2025. Opened October 30, 2026, it says one or more ulcers form in the rectum, the muscular tube at the end of the colon. It calls the condition rare and poorly understood. It can happen in people with long-lasting constipation, and it can cause rectal bleeding, pain, and straining. Despite the name, sometimes more than one rectal ulcer develops. Some people have no symptoms.

The Merck Manual professional page lists a full review of January 2025. Opened October 30, 2026, it says the syndrome is poorly named because the lesions may be solitary or multiple, and ulcerated or not. They can range from redness of the lining to ulcers to small mass lesions. Lesions are typically on the anterior rectal wall within 10 centimeters of the anal verge. That distance is the Merck Manual's. Mayo Clinic does not print it.

Mayo Clinic's symptom list is constipation, rectal bleeding, straining during bowel movements, pain or a feeling of fullness in the pelvis or rectum, a feeling of incomplete passing of stool, passing mucus from the rectum, and fecal incontinence, which it describes as not being able to control bowel movements. The Merck Manual's symptom line is straining during defecation, a sense of incomplete evacuation or pelvic fullness, and sometimes passage of blood and mucus by rectum.

Both pages include straining and a sense that the bowel has not emptied. Both include blood, and both include mucus, with the Merck Manual saying "sometimes." Fecal incontinence is written out on Mayo Clinic's list. The leakage pages, including the hemorrhoid and prolapse sentences, are on fecal incontinence, hemorrhoids, and rectal prolapse. Mayo Clinic says several other conditions can cause similar symptoms, and that a visit may include tests to identify or rule out causes other than this syndrome.

Mayo Clinic says it is not always clear what causes the syndrome. Researchers believe stress or injury to the rectum may lead to the ulcers. The injuries it names are constipation or hardened stool that is difficult to pass, which it calls impacted stool; straining; a stretched rectum that comes out of the anus, known as rectal prolapse; tightening of the pelvic floor muscles that slows blood flow to the rectum; attempts to remove impacted stool by hand; and one part of the intestine sliding inside another, known as intussusception.

The Merck Manual says the syndrome is caused by mucosal ischemia of the distal rectal lining from trauma. Its cause list is rectal prolapse, paradoxical contraction of the puborectalis muscle, chronic constipation, and attempts at manual disimpaction of hard stools. The opening summary also says the cause is localized ischemic injury or prolapse of the distal rectal mucosa. Rectal prolapse is on both lists. What the prolapse pages say about pushing a prolapse back, and when NIDDK calls that an emergency, is on a prolapsed hemorrhoid and rectal prolapse.

Mayo Clinic says that although anyone can have solitary rectal ulcer syndrome, adults between the ages of 30 and 40 are most affected. That age range is Mayo Clinic's, dated September 20, 2025 and opened October 30, 2026. The Merck Manual does not print it.

Mayo Clinic says the syndrome may improve with simple strategies such as changing the diet and drinking more fluids, and that surgery may be needed in severe cases. It does not print a gram target for fiber on this page. The hemorrhoid fiber figure is a different guide, fiber, fluids, and hemorrhoid symptoms, and it was not copied here.

The Merck Manual says diagnosis is typically made from the history and a flexible sigmoidoscopy, sometimes with a biopsy. It says to assess for internal or full-thickness rectal prolapse. Mild cases are treated with reassurance and a bowel regimen that uses bulk laxatives to relieve chronic constipation. If rectal prolapse is the cause, surgery may be needed. The bulk-laxative sentence is the Merck Manual's. Mayo Clinic's diet-and-fluids sentence was not rewritten as a laxative dose. What a flexible sigmoidoscopy reaches, compared with a colonoscopy, is on colonoscopy and flexible sigmoidoscopy.