Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2019; 7(15): 2058-2064
Published online Aug 6, 2019. doi: 10.12998/wjcc.v7.i15.2058
Modified Tong Xie Yao Fang relieves solitary rectal ulcer syndrome: A case report
Li-Li Zhang, Wan-Shan Hao, Meng Xu, Chang Li, Yuan-Yuan Shi
Li-Li Zhang, Meng Xu, Yuan-Yuan Shi, School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, China
Wan-Shan Hao, Teaching and Research Section of Shanghan, Beijing University of Chinese Medicine, Beijing 100029, China
Chang Li, Traditional Chinese Medicine Department, Beijing Baicaoyuan Hospital of Traditional Chinese Medicine, Beijing 100107, China
Author contributions: Zhang LL, Hao WS and Xu M contributed equally to this work; Hao WS and Shi YY designed the research; Zhang LL, Xu M and Li C performed the research; Zhang LL, Hao WS, Xu M and Shi YY wrote the paper; All authors have read and approved the final version to be published.
Supported by the Start-up Fund from Beijing University of Chinese Medicine, No. 1000061020044.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Institutional review board statement: The Institutional Review Board of Beijing University of Chinese Medicine provided approval for this study.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Yuan-Yuan Shi, PhD, Professor, School of Life Sciences, Beijing University of Chinese Medicine, No. 11 East road, North 3rd Ring Road, Beijing 100029, China.
Telephone: +86-10-53912150Fax: +86-10-64286651
Received: April 16, 2019
Peer-review started: April 16, 2019
First decision: May 9,2019
Revised: June 17, 2019
Accepted: June 27, 2019
Article in press: June 27,2019
Published online: August 6, 2019

Solitary rectal ulcer syndrome (SRUS) is a rare rectal disorder characterized by bloody mucus in the stool, difficulty in defecation, pain, and anal swelling. To date, the etiology of this syndrome remains not well understood and the diagnosis is frequently confused with other disorders, making treatment a clinical challenge.


A 50-year-old woman presented to our hospital with a 40-d history of bloody mucus in the stool and anal swelling. SRUS was suspected. Rectoscopy revealed a large, severe ulcerous lesion. Histologically, the lesion was characterized as chronic ulcer without clear tumor cells, and the final diagnosis of SRUS was made. The patient was treated with Chinese medicine therapy, with administration of Tong Xie Yao Fang. After 3 wk of treatment, the symptoms improved significantly. At 2-mo follow-up, rectoscopy in a local hospital showed healed ulcer scars without obvious protrusion 3 cm from the anal verge.


Chinese medicine therapy represents a potential treatment of SRUS with predominant rectal bleeding, mucinous discharge, and anal swelling pain.

Keywords: Solitary rectal ulcer syndrome, Chinese formulas, Tong Xie Yao Fang, Er Shen Wan, Ding Zhi Xiao Wan, Chinese medicine therapy, Case report

Core tip: Solitary rectal ulcer syndrome (SRUS) is a benign but uncommon rectal disorder. We present the case of a 50-year-old woman who suffered from SRUS for 40 d, with the symptoms of bloody mucous in the stools and anal swelling. Following our success of treatment with modified Tong Xie Yao Fang, we discuss how this traditional Chinese medicine prescription might be an effective treatment strategy for SRUS with this symptom profile.