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.
20% are multiple
Recurrent rectal prolapse is a cause
Involves Posterior wall.
Managed by digital reposition