SYSTEMATIC REVIEW/META ANALYSIS
Year : 2020 | Volume
: 26 | Issue : 1 | Page : 4--12
A systematic review and meta-analysis of the efficacy of medical treatments for the management of solitary rectal ulcer syndrome
Yousef Qari, Mahmoud Mosli
Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Background/Aim: Solitary rectal ulcer syndrome (SRUS) is a benign, poorly understood disorder that is difficult to manage. Medical interventions such as sucralfate, sulfasalzine, human fibrin, and a high fibre diet are reported as the first line of treatment. The aim of this study is to perform a systematic review and meta-analysis of the efficacy of medical treatments for SRUS.
Materials and Methods: Databases including PubMed, Cochrane, and Embase were searched for randomised clinical trials (RCT) and observational studies that evaluated medical treatments for SRUS. Two authors independently performed selection of eligible studies based on eligiblity criteria. Data extraction from potentially eligible studies was carried out according to predefined data collection methods. Medical treatments, including sucralfate, sulfasalzine, human fibrin, a high fibre diet, and psyllium powder as a single or combination therapy were compared to placebo alone or combined with other treatments. The primary outcome was the proportion of patients with ulcer remission; this was presented as pooled prevalence (PP) with a 95% confidence interval (CI). The I2 value and Q statistic test were used to test for heterogeneity. In the presence of heterogeneity, a random-effects model was applied.
Results: A total of 9 studies with 216 patients (males = 118, females = 98) diagnosed with SRUS were analysed in the final meta-analysis. The pooled effect estimate of treatment efficacy revealed that, of the patients receiving medical treatment, 57% had resolution of their ulcers (PP 0.57; 95% CI; 0.41 to 0.73). Statistically significant heterogeneity was observed (I2 = 63%; τ2 = 0.64, P= <0.01). The scarcity of RCTs comparing medical treatments with other interventions was a major limitation.
Conclusions: The majority of patients receiving medical treatment for the management of SRUS experience resolution of their ulcers.
Dr. Mahmoud Mosli
Department of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah
|How to cite this article:|
Qari Y, Mosli M. A systematic review and meta-analysis of the efficacy of medical treatments for the management of solitary rectal ulcer syndrome.Saudi J Gastroenterol 2020;26:4-12
|How to cite this URL:|
Qari Y, Mosli M. A systematic review and meta-analysis of the efficacy of medical treatments for the management of solitary rectal ulcer syndrome. Saudi J Gastroenterol [serial online] 2020 [cited 2020 Mar 30 ];26:4-12
Available from: http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2020;volume=26;issue=1;spage=4;epage=12;aulast=Qari;type=0