In this study, doctors from England assessed whether solitary rectal ulcer syndrome (SRUS) is a permanent disorder of mucosal blood flow, or whether it is related to autonomic gut innervation. The latter is a physiological function that would be reversible with successful treatment.
The team evaluated 16 consecutive patients with SRUS and 26 healthy controls.
They used rectal mucosal blood flow as a measure of extrinsic autonomic nerve function, performing laser Doppler mucosal flowmetry before and after biofeedback treatment.
|31% had sigmoidoscopic ulcer resolution.|
The patients' symptoms were documented using standardized questionnaires.
The doctors found that 75% of patients reported subjective symptomatic improvement after treatment.
Furthermore, 31% had sigmoidoscopic ulcer resolution.
The team determined that pretreatment rectal mucosal blood flow was significantly lower in patients with SRUS than in the controls.
They found that biofeedback resulted in a significant improvement in rectal mucosal blood flow in those subjects who felt subjectively better after treatment.
Dr Jarrett's team concluded, "Gut directed biofeedback is an effective behavioral treatment for the majority of patients with SRUS".
"Mucosal blood flow is reduced to a similar level seen in normal transit constipation, suggesting similar impaired extrinsic autonomic cholinergic nerve activity".
"Successful outcome following biofeedback is associated with increased rectal mucosal blood flow".
"Improved extrinsic innervation to the gut may be partially responsible for the response to treatment".