Argon plasma coagulation: an effective treatment for solitary rectal ulcer syndrome

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 sho...

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Main Authors: Aqsa Shahid, Rashk-e Hinna, Ehtesham Haider, Rao Saad Ali Khan, Fuad Ahmad Siddiqi, Zoya Ali Khan
Format: Article
Language:English
Published: King Faisal Specialist Hospital and Research Centre 2024-01-01
Series:Annals of Saudi Medicine
Online Access:http://www.annsaudimed.net/doi/10.5144/0256-4947.2024.26
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author Aqsa Shahid
Rashk-e Hinna
Ehtesham Haider
Rao Saad Ali Khan
Fuad Ahmad Siddiqi
Zoya Ali Khan
author_facet Aqsa Shahid
Rashk-e Hinna
Ehtesham Haider
Rao Saad Ali Khan
Fuad Ahmad Siddiqi
Zoya Ali Khan
author_sort Aqsa Shahid
collection DOAJ
description 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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spelling doaj.art-5b721fd0a9d54883b704f01005f7b7732024-02-05T06:40:49ZengKing Faisal Specialist Hospital and Research CentreAnnals of Saudi Medicine0256-49470975-44662024-01-01441263010.5144/0256-4947.2024.26Argon plasma coagulation: an effective treatment for solitary rectal ulcer syndromeAqsa Shahid0Rashk-e Hinna1Ehtesham Haider2Rao Saad Ali Khan3Fuad Ahmad Siddiqi4Zoya Ali Khan5From the Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi, Punjab, PakistanFrom the Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi, Punjab, PakistanFrom the Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi, Punjab, PakistanFrom the Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi, Punjab, PakistanFrom the Department of Medicine, Armed Forces Postgraduate Medical Institute, Rawalpindi, Punjab, PakistanFrom the Lahore Grammar School International, Lahore, Punjab, PakistanBACKGROUND: 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 centeredhttp://www.annsaudimed.net/doi/10.5144/0256-4947.2024.26
spellingShingle Aqsa Shahid
Rashk-e Hinna
Ehtesham Haider
Rao Saad Ali Khan
Fuad Ahmad Siddiqi
Zoya Ali Khan
Argon plasma coagulation: an effective treatment for solitary rectal ulcer syndrome
Annals of Saudi Medicine
title Argon plasma coagulation: an effective treatment for solitary rectal ulcer syndrome
title_full Argon plasma coagulation: an effective treatment for solitary rectal ulcer syndrome
title_fullStr Argon plasma coagulation: an effective treatment for solitary rectal ulcer syndrome
title_full_unstemmed Argon plasma coagulation: an effective treatment for solitary rectal ulcer syndrome
title_short Argon plasma coagulation: an effective treatment for solitary rectal ulcer syndrome
title_sort argon plasma coagulation an effective treatment for solitary rectal ulcer syndrome
url http://www.annsaudimed.net/doi/10.5144/0256-4947.2024.26
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