<prompt> Not true regarding solitary rectal ulcer -20 are multipleRecurrent rectal prolapse is a causeInvolves Posterior wall.Managed by digital reposition  <response>: Causes of solitary rectal ulcer syndromeDue to a combination ofInternal intussusceptionAnterior rectal wall prolapseIncrease in intrarectal pressureSymptoms pain, bleeding, mucus discharge or outlet obstruction.TreatmentNonoperative 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. 