• Aqsa Shahid, Rashk-E Hinna, Ehtesham Haider, Rao Saad Ali Khan, Fuad Ahmad Siddiqi, and Zoya Ali Khan.
• From the Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi, Punjab, Pakistan.
• Ann Saudi Med. 2024 Jan 1; 44 (1): 263026-30.

BackgroundSolitary 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.ObjectivesDetermine the efficacy of APC treatment for patients suffering from SRUS.DesignProspective, single center.SettingsGastroenterology department at a military hospital in Pakistan.Patients And MethodsThis 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 MeasuresEffectiveness of APC for resistant SRUS.Sample Size99 patients.ResultsThe 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.ConclusionAPC 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.LimitationsSingle centered.

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