Solitary rectal ulcer syndrome (SRUS) is an uncommon, chronic disorder of rectal mucosal prolapse that typically presents with rectal bleeding, mucus discharge, and straining, and can occasionally present as a polypoid mass rather than a discrete ulcer. Acute incarceration of SRUS through the anal canal, requiring emergency surgery, does not appear to have been previously reported. We describe an adolescent boy with a two-year history of biopsy-confirmed SRUS, managed conservatively with only partial symptomatic response, who presented with acute, irreducible incarceration of a large, actively bleeding polypoidal mass protruding through the anal canal. He underwent emergency examination under anaesthesia with complete transanal excision, achieving simultaneous diagnostic and therapeutic control, and histopathology confirmed SRUS without dysplasia or malignancy. He remained completely asymptomatic with no recurrence at long-term follow-up extending to nearly six years postoperatively. This case illustrates an apparently novel presentation of SRUS as an anorectal surgical emergency, supports complete transanal excision as effective definitive treatment, and is placed in the context of the wider published literature on polypoid and prolapse-related SRUS.
This study aimed to produce sourdough bread using an encapsulated kombucha sourdough starter culture without the addition of baker's yeast. The bioactive metabolites of kombucha sourdough starter and sourdough starter without kombucha were identified using 1 H-NMR analysis with multivariate analysis. The physical properties, including loaf volume, specific loaf volume, firmness, and water activity were determined following standard methods. The shelf life and consumer acceptability of the bread were also being evaluated. The principal component analyses showed the presence of 15 metabolites in kombucha sourdough starter. The major compounds that contributed to the differences from sourdough starter without kombucha were alpha-aminobutyric acid, alanine, acetic acid, riboflavin, pyridoxine, anserine, tryptophan, gluconic acid, and trehalose. The encapsulated kombucha sourdough starter increased the loaf volume (976.7 ± 25.2 mL) and specific loaf volume (4.38 ± 0.12 mL/g) compared to yeast bread. Thus, significant (P