Evaluation of Prognosis and Related Factors in Children with Solitary Rectal Ulcer Syndrome

Abstract

Background: Solitary Rectal Ulcer Syndrome (SRUS) is a rare disease that commonly manifests in children. Its diagnosis is often delayed due to misdiagnosis with other diseases. Objectives: The aim of this study is to evaluate prognosis and related factors in children. Methods: In this retrospective cohort study, medical records of 101 children with histologically confirmed SRUS were reviewed over a 12-year period (2012 - 2024). Demographic data, clinical presentations, colonoscopic and histopathological findings, treatment modalities, and therapeutic responses were analyzed. Statistical analysis was performed using SPSS, and a P-value ≤0.05 was considered significant. Results: The mean age at diagnosis was 10.46 ± 2.94 years (range: 2.75 - 16.7), and 77.2% were male. The most common presenting symptom was rectal bleeding (89.1%), followed by constipation (73.3%) and abdominal pain (67.3%). Endoscopic findings revealed single ulcers in 53.5% and multiple ulcers in 28.7% of cases. The most frequently prescribed treatments were polyethylene glycol (PEG) (88.1%) and mesalazine (70.3%). After a median follow-up of three years, 68% of patients achieved complete remission with medical management, while 32% experienced recurrence. Rectal bleeding, constipation, digital manipulation, and chronic constipation were significantly associated with relapse (P Conclusions: Findings from colonoscopy and histopathology were helpful in confirming the underlying etiology. Also, multiple follow-ups are required to confirm remission.