Heterotopic gastric mucosa of the rectum with a review of the literature.

Heterotopic gastric mucosa has been identified in all levels of the gastrointestinal tract but is a rare finding in the rectum. We describe a patient with heterotopia found during a routine evaluation of persistent symptoms, possibly due to an irritable bowel syndrome, and provide a complete review of the literature through 1992. Of the 29 reported cases, the most common presentation was painless rectal bleeding, with the heterotopia usually identified on pathologic examination of a rectal polyp. The heterotopic tissue was frequently located in the posterolateral region of the rectum between 5 and 8 cm from the anal verge. The definitive treatment was excision, either by endoscopy or surgery, although H2 may also provide symptom relief. Our patient was treated with H2 with resolution of symptoms.