Shahid A, Hinna RE, Haider E, Khan RSA, Siddiqi FA, Khan ZA. Argon plasma coagulation: an effective treatment for solitary rectal ulcer syndrome.
Ann Saudi Med 2024;
44:26-30. [PMID:
38311871 PMCID:
PMC10839455 DOI:
10.5144/0256-4947.2024.26]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/21/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND
Solitary rectal ulcer syndrome (SRUS) is a very rare benign defecation disorder characterized by distinct clinical features and histological findings. Conventional measures are often shown to be ineffective for the treatment of ulcers. Argon plasma coagulation (APC) has recently been shown to be an effective treatment method for SRUS that is refractory to conventional therapy.
OBJECTIVES
Determine the efficacy of APC treatment for patients suffering from SRUS.
DESIGN
Prospective, single center.
SETTINGS
Gastroenterology department at a military hospital in Pakistan.
PATIENTS AND METHODS
This prospective study included patients with symptoms of rectal bleeding diagnosed with SRUS. Patients were recruited on the basis of clinical, sigmoidoscopic, and histological findings from September 2022 to March 2023. All patients had received conventional treatment initially and were assessed for persistence of symptoms. APC was performed only for those patients who were refractory to standard treatment.
MAIN OUTCOME MEASURES
Effectiveness of APC for resistant SRUS.
SAMPLE SIZE
99 patients.
RESULTS
The 99 patients diagnosed with SRUS had a median (minimum-maximum) age of patients was 20 (9-41) years. All the patients had undergone conventional treatment, which included the use of laxatives, drinking plenty of water and practicing biofeedback. After this standard treatment, 19 patients (19.19%) recovered fully. However, the remaining 80 patients did not show improvement and underwent APC sessions, out of which 61 patients (76.3%) achieved complete healing of ulcers, while the remaining 19 (23.8%) had no improvement at all. None of the patients reported post session complications.
CONCLUSION
APC is an effective therapy with very promising results for rectal ulcer hemorrhage. It also helps with ulcer healing and alleviates clinical symptoms. However, further controlled investigations are required to consolidate the use of APC in SRUS patients.
LIMITATIONS
Single centered.
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