Home Digestive systemDiseases of the anus Proctalgia fugax: causes and treatment

Proctalgia fugax: causes and treatment

by Alivia Nyhan
Published: Last Updated on

The fugax fugax is one of the three disorders that are part of the so – called “functional anorectal pain” . It is characterized by being a pain, as its name indicates, fleeting, of very short duration, of a stabbing and spasmodic type and of very high intensity, some even describe it as “extremely intense” [1] .

It most often occurs during the night and wakes the person from their sleep. Furthermore, it is typical of fleeting proctalgia that after the episode of pain, the person is completely asymptomatic (although exhausted) and without any alteration on physical examination [1] .

Experts estimate that it occurs in up to 14% of the healthy population [2] . Probably, at some point in your life you have felt this painful pang in your perineal region that leaves you breathless for a brief moment and until now you did not know that this was its name. In this FastlyHealarticle, we explain the causes, treatment, and diagnosis of proctalgia fugax.

Proctalgia shy, causes

There is no conclusive theory that supports and clearly explains the causes of proctalgia fleeting. Several theories have been postulated to try to explain its origin: neuralgia, neurosis, infection, allergy, vasospasm, venous stasis, mechanical factors, among others. None of them have been reliably sustained.

What has made its study the most difficult is the briefness of the pain crisis after which there are no symptoms and no physical findings to explain what happened. Clinical studies with anorectal manometry and endoanal ultrasound show results similar to those of healthy controls who have never had this pain.

Some researchers have attributed it to different causes:

  • Spasm of the rectosigmoid (the last portion of the large intestine, which ends at the anus).
  • Spasm of the pubococcygeus muscle (one of the levator ani).
  • Increased pressures of the anal canal.
  • Increase in the frequency of slow waves in the anal canal.
  • Constipation (constipation) and straining when having a bowel movement.
  • Sexual intercourse
  • Menstruation (and the picture in men would not be explained).
  • Stress.

Proctalgia fugax confirms once again the medical adage that says that “when there are several theories about the etiology of a disease, the reality is that it is not defined.”

Diagnosis of proctalgia fugax

Because the symptoms of proctalgia fugax vary from person to person and are similar to those seen in other medical conditions, similar conditions should be ruled out before making a definitive diagnosis.

The diagnosis involves a complete medical examination, including the genital region. Your doctor will likely order blood tests and an endoscopy (colonoscopy) test to look at the lining of the intestine.

Other possible causes must be ruled out. What we doctors call making a “differential diagnosis” with:

  • Anal fissure , which is a small tear in the lining of the anal canal.
  • Anal abscess , which occurs when a collection of pus forms located near the anus or rectum.
  • Fungal infection or sexually transmitted diseases.
  • Chronic constipation
  • Diarrhea.
  • Ulcerative colitis , which is a type of inflammatory bowel disease.
  • Fecal impaction, which occurs when a mass of hardened stool builds up in the rectum due to chronic constipation.
  • Thrombosed external hemorrhoid , which occurs when a blood clot forms in an external hemorrhoid on the skin of the anus that can cause pain when walking, sitting, or having a bowel movement.

After studying all of the above, the diagnosis of proctalgia fugax is confirmed by ruling out, also excluding the other two components of “functional anorectal pain”: coccydynia and levator ani syndrome .

Treatment of proctalgia fugax

Just as it is not known what causes it and the time of appearance and duration of pain is unknown, there is no specific medical treatment, especially due to the very short duration of pain.

What is contemplated are recommendations to prevent the appearance of throbbing pain in the anus. In this sense, it is indicated:

  • Natural plant powder or Psyllium . A natural product whose consumption would help produce softer bowel movements, helping to stretch the perianal muscles and prevent spasms.
  • Pelvic muscle retraining . If the voluntary muscles spasm, a person can train his muscles to relax by doing special exercises, these are called Kegel exercises.
  • Sitz baths with warm water . They would help keep the anal sphincter relaxed and reduce spasms and pain associated with proctalgia fugax.
  • Potassium rich foods . Potassium deficiency is believed to be associated with proctalgia fugax. Bananas, bananas, raisins, and avocados are rich in potassium and natural fiber.
  • Relaxation techniques . Pain relievers, meditation and deep breathing exercises, and yoga can help relieve anxiety and stress.

Medications for proctalgia fleeting

Longer-lasting episodes can be treated with short-acting benzodiazepines, antispasmodics (sublingual hyoscyamine), sublingual nitroglycerin, or topical (perianal) nitroglycerin.

A prospective double-blind study showed that an inhaled beta-agonist, salbutamol (a medicine used for asthma), shortened the duration of each episode in patients with a high frequency of pain attacks.

Patients with frequent episodes may benefit from the use of a calcium channel blocker, long-acting nitrates, or even botulinum toxin injection from the anal canal.

The truth is that it will be your doctor who will have the last word in establishing this diagnosis and indicating the treatment that is most necessary and appropriate for you.

This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.

If you want to read more articles similar to Proctalgia fugax: causes and treatment , we recommend that you enter our Digestive System category .




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