Proctalgia Fugax

What is proctalgia fugax?

Proctalgia fugax is a Latin term for "fleeting rectal pain", and the medical condition is essentially just that - a brief attack of rectal pain.

What causes proctalgia fugax?

The cause of proctalgia fugax is not known. Just like the "charlie horse", proctalgia fugax is a sudden uncontrolled spasm or contraction of the muscles in the rectal area and pelvis. Hemorrhoids, fissures, polyps, or other rectal conditions do not cause it. It is not felt to be psychosomatic in origin, but some patients report more attacks during times of emotional stress.

What are the symptoms of proctalgia fugax?

Patients with proctalgia fugax often describe waking up from sleep with a sharp pain, often described as stabbing pain "like a knife sticking deep in the rectum". Most pain attacks last less than 20 minutes and disappear spontaneously. Although many patients with proctalgia fugax never mention their symptoms to their doctor, the condition is not uncommon, with some health surveys suggesting that approximately 5% of the general population experience the symptoms occasionally. Most report less than 6 attacks per year.

How is proctalgia fugax diagnosed?

There are no blood tests, x-rays, or procedures that can diagnose Proctalgia Fugax. Even in rare circumstances when patients have been examined during an attack, no consistent abnormality has been found. Unlike the pain of a hemorrhoid or anal fissure, this pain does not occur during a bowel movement. Indeed, passing some gas or a bowel movement often ends the attack. Your doctor bases his diagnosis on typical symptoms and the lack of any other cause. This means that often a flexible sigmoidoscopy or colonoscopy test is done to be sure that no serious problem is present in the rectal area.

What are complications of proctalgia fugax?

Proctalgia fugax does not lead to any complications. Sufferers should be confident that the pain is not an indication of something serious. Also, this condition does not increase the risk of colon cancer, colitis, hemorrhoids, anal fissures or other bowel disorders. It is simply a muscle cramp in the wrong place at the wrong time.

How is proctalgia fugax treated?

There is no cure for proctalgia fugax and the attacks are too short for any medical therapy to be effective. While there have been a few reported successes using an asthma inhaler called salbutamol to abort prolonged episodes, this has not been studied in great detail. There is no surgical procedure that has been shown to be effective. The most common therapy is simply pushing on the anal area. This may be done manually or by straddling the edge of a bathtub. Soaking in a warm bath may help, but usually the pain begins to subside before the bathtub is filled.

Can proctalgia fugax be prevented?

There is no proven way to reliably prevent further attacks. Some doctors feel that a high fiber diet and plenty of fluids helps keep the stools soft and prevents spasm. Often a fiber supplement such as Metamucil or Citrucel is recommended. The best plan is to let your doctor rule out any other serious disorders and be happy that nothing more important was found.