Behavioural therapy (biofeedback) for solitary rectal ulcer syndrome improves symptoms and mucosal blood flow

Aims: The aim of the study was to determine if there is a permanent disorder of mucosal blood flow in patients with solitary rectal ulcer syndrome (SRUS) or a disorder related to autonomic gut innervation and physiological function that is reversible concomitant with successful treatment. Rectal muc...

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Bibliographic Details
Published in:Gut 2004-03, Vol.53 (3), p.368-370
Main Authors: Jarrett, M E D, Emmanuel, A V, Vaizey, C J, Kamm, M A
Format: Article
Language:English
Subjects:
Adult
Biofeedback
Biofeedback, Psychology - methods
Biological and medical sciences
Colon
Defecation
Female
flux units
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Intestinal Mucosa - blood supply
laser Doppler
Laser-Doppler Flowmetry
Lasers
Laxatives
Male
Medical sciences
Middle Aged
Patients
Physiology
Prospective Studies
Rectal Diseases - physiopathology
Rectal Diseases - therapy
rectal mucosal blood flow
Rectum
Rectum - blood supply
Regional Blood Flow
solitary rectal ulcer syndrome
SRUS
Surveys and Questionnaires
Syndrome
Therapists
Therapy
Treatment Outcome
Ulcer - physiopathology
Ulcer - therapy
Ulcers
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Summary:Aims: The aim of the study was to determine if there is a permanent disorder of mucosal blood flow in patients with solitary rectal ulcer syndrome (SRUS) or a disorder related to autonomic gut innervation and physiological function that is reversible concomitant with successful treatment. Rectal mucosal blood flow was used as a validated measure of extrinsic autonomic nerve function. Methods: Sixteen consecutive patients with SRUS (12 women; mean age 35 years) and 26 healthy controls (17 women; mean age 36 years) were studied. Laser Doppler mucosal flowmetry was performed before and after biofeedback treatment. Symptoms were documented before and after biofeedback treatment using a standardised prospectively applied questionnaire. Results: Twelve of 16 patients (75%) reported subjective symptomatic improvement after treatment. Five of the 16 patients (31%) had sigmoidoscopic ulcer resolution. Pretreatment rectal mucosal blood flow was significantly lower in patients with SRUS compared with controls (163 (27) v 186 (14) flux units (FU) (mean (SD)); p
ISSN:0017-5749
1468-3288
1458-3288
DOI:10.1136/gut.2003.025643