Proctalgia Fugax

Proctalgia Fugax

Proctalgia Fugax (or) Levator Spasm Syndrome

Proctalgia Fugax is anal pain that doesn’t have a clear cause. This pain is generally caused by intense muscle spasms in or around the canal of the anus. It’s alike to another kind of anal pain called levator ani syndrome. The pain is slightly separate in levator ani syndrome, and may last days instead of minutes. Anyone can experience proctalgia fugax. However, it doesn’t normally affect anyone prior to the start of puberty and seems to affect more female than male. It’s not unclear why this is, or if it’s due to more female reporting the issue, as many people don’t do so.


Epidemiology

Proctalgia fugax approximately affect 4 to 18 percent of the population. However, only 17 to 20 percent of patients report their indicating factors to a physician. Although proctalgia has been reported in adult patients varying from 18 to 87 years of age, it usually affects individuals between 30 and 60 years of age. Proctalgia fugax is more common among females as compared with males


Symptoms

The indication of proctalgia fugax are muscles spasms in or around the lower part of rectum or in or around the canal of the anus. Proctalgia fugax isn’t known to have certain triggers. However, some studies Trusted Source have shown that it may be caused by an issue with the pudendal nerves. It usually happens after an injection course for hemorrhoids called sclerotherapy, or after a vaginal hysterectomy.

Other possible triggers may be:

  • sexual activity
  • menstruation
  • constipation
  • stress

The pain or spasm happens suddenly, and usually without caution. The pain can be severe and will remain for only a few seconds, although it can last up to 30 minutes in some cases. These event may be severe enough to keep you home from work. They may restrict your other activities until the event is over.


The pain will usually stop on its own. There can be long periods of time between spasms.

The pain or spasms usually starts at night and may be painful enough to wake you from sleep. They can also occur during the day


Patients with proctalgia fugax have usual anorectal pressures without symptoms, but exhibit motor abnormalities of the anal smooth muscle during an acute attack


Diagnosis

Proctalgia fugax is normally diagnosed after other causes of anal pain and spasms have been ruled out. In order to find out other conditions that may be causing the pain, your doctor may:

  • conduct a physical exam
  • ask questions about the pain severity, duration, etc.
  • check for hemorrhoids, fissures, an abscess, and other conditions that might cause anal pain

Once other conditions have been ruled out as the source of your pain and discomfort, your doctor will be able to diagnose proctalgia fugax.


Treatment

There are few treatment options that may help to relax the anal muscles and keep them from spasming. These include:

  • Oral Diltiazem
  • Glyceryl nitrate, a pain-relieving drug
  • Nerve blocks, substances that numb nerves
  • Muscle relaxers

Home remedies

Warm baths, potassium rich foods and natural vegetable powder can help in reducing pain


Physical therapy treatment

Pelvic muscle training and pelvic muscle stretching can help in reducing the pain and spasams

If the skeletal muscles are under spasam a physical therapist can train you to relax those muscle by teaching special exercises and proper stretching techniques to reduce pain


Check out these links for relevant information: Pain
management


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