Not true regarding solitary rectal ulcer -

Causes of solitary rectal ulcer syndrome Due to a combination of Internal intussusception Anterior rectal wall prolapse Increase in intrarectal pressure Symptoms → pain, bleeding, mucus discharge or outlet obstruction. Treatment Nonoperative therapy (high fibre diet, defecation training to avoid straining, and laxatives or enemas) is effective in the majority of patients. Surgery (either abdominal or perineal repair of prolapse) is reserved for highly symptomatic patients, who have failed all medical intervention e.g. rectopexy.