Proctalgia fugax refers to the sudden onset of severe pain in the rectal area, which can last from seconds to minutes. The pain is sporadic, can be without warning, and occurs due to muscle spasms in the anal canal.
Proctalgia fugax is a benign, or non-serious, condition that does not present with any abnormality on examination of the rectum or anus. The condition does not have any effect on how the stomach or intestines work.
In many cases, the condition is self-remedying and is typically not a cause for concern. However, if the pain does not go away in a few days, or accompanies other gastrointestinal symptoms, it is advisable to contact a doctor.
People with proctalgia fugax may experience sudden and severe muscle cramps in their anal canal that can cause sharp, stabbing pains.
These bouts of pain may last only a few seconds but can last for up to 30 minutes.
The exact cause of proctalgia fugax is unclear, but the pain is due to muscles in the anal canal and pelvic floor tightening suddenly.
This muscle tightening is called spasming. Spasms often occur in the smooth muscles of the anal canal and the anal sphincter.
Though proctalgia can occur without warning, the condition does have many triggers. These triggers can include:
Proctalgia fugax may be more likely to occur after treatments for certain other conditions. These treatments include sclerotherapy for hemorrhoids and vaginal hysterectomy.
To diagnose proctalgia fugax, a doctor will primarily assess the severity and duration of a person’s symptoms. Proctalgia fugax causes sharp, stabbing pain for 30 minutes or less.
Previous diagnostic criteria included chronic proctalgia, which refers to duller pain for a longer duration. However, healthcare providers no longer use this term.
As symptoms of proctalgia fugax can vary from person to person and are similar to other medical conditions, doctors will also
Diagnosis of anal pain will typically involve an anorectal exam, which can include a rectal exam, colonoscopy, and fecal blood testing.
Other causes of anorectal pain include:
- anal fissures, a small rip or tear in the lining of the anal canal
- anal abscesses
- fungal infections or sexually transmitted infections
- chronic constipation
- ulcerative colitis, a type of inflammatory bowel disease
- fecal impaction, a mass of hardened stool in the rectum due to chronic constipation
Levator ani syndrome is a type of functional anorectal pain similar to proctalgia fugax.
The levator ani muscle is a complex structure in the lower pelvis. A person may experience pain in this muscle due to spasmodic contractions. These can result from injury in or around the pelvis, torso, or back.
Pain from levator ani syndrome is typically more constant than proctalgia fugax pain. For a doctor to diagnose functional anorectal pain, a person must experience pain for
Proctalgia fugax does not cause any lasting damage to people, but it is painful. Treatment focuses mostly on pain relief.
There are treatment options that may help to relax the anal muscles and keep them from spasming. These include:
- topical diltiazem, a drug that treats high blood pressure
- topical glyceryl nitrate, a pain-relieving drug
- nerve blocks, substances that numb nerves
- electrical stimulation
- muscle relaxers
The effectiveness of these treatments can vary greatly.
Topical treatments are preferable to oral formulations, as oral medications will likely not take effect in time due to episodes of proctalgia fugax occurring without warning and lasting a short time.
There are some natural treatment remedies that people can try to help relieve the pain:
- Diet: Staying adequately hydrated and consuming a balanced diet rich in fiber can help to keep stools soft and pass regularly. This can reduce stress on the anal passage.
- Stool softeners: These can assist in the easy passing of stools.
- Pelvic muscle retraining: If voluntary muscles are in spasm, a person may be able to train their muscles to relax by doing certain exercises.
- Warm baths: May help relax the anal sphincter and reduce the spasms and pain associated with proctalgia fugax.
- Relaxation techniques: Stress relievers such as meditation, deep-breathing exercises, and yoga may help to relieve anxiety and stress.
Treatment for anorectal pain syndromes varies depending on the type. Many conditions heal on their own over time. Over-the-counter creams and pain relievers work for many people.
Proctalgia fugax is not life threatening, but people should seek immediate treatment if their anal pain does not go away within a few days or if they experience any of the following symptoms:
- a large amount of continuous rectal bleeding that may be accompanied by lightheadedness or dizziness
- anal pain that does not get better after several days or seems to worsen
- anal pain that spreads in addition to fever, chills, or anal discharge
- severe pain
People should also pay attention to any changes in bowel movements to identify potential triggers or stressors. Rectal bleeding is especially dangerous as it can be a sign of colon cancer.
Some FAQs about proctalgia fugax may include:
What causes proctalgia fugax?
Currently, the exact cause of proctalgia fugax is unclear. It occurs due to muscle spasms in the anal canal and pelvic floor. Potential triggers can include passing stools, constipation, menstruation, and sexual activity.
How do you relieve proctalgia fugax?
In most cases, initial management of proctalgia fugx will involve home remedies such as stool softeners, warm baths, and relaxation techniques to help manage pain. Some people may also find relief with over-the-counter pain relief creams.
If these methods do not work, a healthcare provider may recommend oral medications that help the anal muscles to relax, or other options such as biofeedback.
Why does proctalgia fugax happen at night?
Proctalgia fugax can occur at any time of the day, but often occurs at night. It is currently unknown why proctalgia fugax is more frequent at night.
Can ibuprofen help proctalgia fugax?
Currently, there is no evidence to support that over-the-counter pain relievers, such as ibuprofen, are helpful with proctalgia fugax. Instead, a healthcare provider may recommend topical pain relief options, such as creams.
Proctalgia fugax is sharp, stabbing pain in the rectum area with no apparent cause. It often lasts for a few seconds but can last for up to 30 minutes.
The condition is self-remedying and is typically not a cause for concern.