Proctalgia fugax is an anorectal disorder characterized by severe, intermittent episodes of rectal pain. This disorder is estimated to affect 4-18 percent of the general population. Though the condition can affect people of all ages, it is more common in people between 46 and 58 years. Statistics show that the disorder is more prevalent in women than in men.
Though the condition can occur without a trigger, there are numerous triggers, including anal sex, stress, constipation, and menstruation in women. This article offers an insight into the causes, symptoms, treatment, and prevention of proctalgia fugax.
Causes of proctalgia fugax
Proctalgia fugax means “anal pain of unknown cause” the anal canal is surrounded by various organs. The organs include the prostate in men and the uterus in women. The pelvic floor muscles support it.
Proctalgia fugax is caused by muscle spamming, which can occur without a trigger in some cases. The common cause of the spamming is damage or entrapment of the nerve that supplies the anal canal muscles.
According to the health line, proctalgia fugax isn’t known to have a specific trigger. Studies have, however, shown that an issue with the pudendal nerves can cause it. This can happen after injection when treating hemorrhoids or after a vaginal hysterectomy.
Other known triggers of this condition will include the following:
1. Stress
Emotional stress is one of the common triggers of proctalgia fugax. Continued emotional stress causes the body to react in certain ways. The internal organs of the digestive system are acute receptors of stress. That explains why your stomach is likely to feel sick during emotionally stressful events.
When the anal spasm is accompanied by gastric pain an over the counter medication can be used to alleviate the symptoms. Stress medication and adopting relaxation techniques like yoga and meditation can also be used.
2. Rough anal sex
Complications from anal sex, such as internal injuries, can also trigger episodes of proctalgia fugax.
3. Menstruation
Though not clear, menstruation is also believed to be a common trigger of proctalgia fugax in women. In such cases, it is accompanied by severe pain and arching during a bowel movement.
4. Anal fissures
Anal fissures are small tears on the mucosa lining your anus. This is a common cause of anal pain that could trigger proctalgia fugax.
5. Hemorrhoids
Hemorrhoids, also known as piles, are swollen veins in the region of the anus. Some conditions can cause the swelling. Common causes include straining during a bowel movement and increased pressure during pregnancy.
6. Chronic constipation
Mayo Clinic defines chronic constipation as infrequent bowel movements or difficulties passage of stool that persists for some weeks. This causes severe straining during a bowel movement that can lead to proctalgia fugax.
Treatment for this condition will depend on the underlying cause. In some cases, the cause is never identified.
Symptoms
Though proctalgia fugax is not life-threatening, it can cause more discomfort than anything. Different conditions might cause proctalgia fugax and anal pain. Most of these causes are easily treatable once identifies.
The symptoms of proctalgia fugax are slightly similar to those of levator ani syndrome. These symptoms occur when the muscles in the anal canal and pelvic floor suddenly tightens. You are likely to experience the following symptoms:
- Sudden, severe muscle cramps
- Episodes of anal pain
- Muscles spasm in or around the lower rectum
- The pain or spasms are common during the night
Most symptoms are not dangerous; it is, however, important to know when to see a doctor in cases of severe and serious symptoms. You need to seek medical assistance if the symptoms persist for more than 48 hours, or you start experiencing other symptoms such as the following:
- You experience a large amount of rectal bleeding
- An anal pain that does not get better with treatment
- Anal pain start to spread
- Additional symptoms such as fever, chills, and anal discharge
- Unbearable pain
Proctalgia fugax during periods
Period or menstruation cycle is believed to be the main trigger of proctalgia fugax in women. Currently, the relation between your period and the anal spasms is unclear. Generally, this explains why proctalgia fugax is common in females than it is in males.
Women are likely to experience chronic proctalgia during their periods. This may be marked with pain that lasts for more than twenty minutes. In rare cases, the pain may even last continuously throughout the day.
Other symptoms may include:
- Arching and pressure after sitting or standing for long
- Mild to severe pain during bowel movement
Proctalgia fugax treatment
Before treating proctalgia fugax, medical diagnosis is required to rule out all the other possible causes that might lead to the symptoms exhibited by the patient. This is because the symptoms of this condition vary from person to person and may be similar to those exhibited by other conditions. Some of the conditions that might have the same symptoms as proctalgia fugax include hemorrhoids, rectal abscesses, and fissures.
A thorough examination of the genital region is often done when diagnosing the condition. In some cases, a blood test and an endoscopy test may be required. The test is done not to confirm a diagnosis of proctalgia fugax but to rule out more serious conditions that might be causing the symptoms.
Treatment for this condition acts by relaxing the anal sphincter spasm. There are different treatment options one can use to get relief from this condition; the options will, however, vary from one person to the other.
Since there is no specific cause of this condition, treatment mainly involves managing the symptoms when the trigger of the condition has been identified, managing the trigger will also be included in treating proctalgia fugax.
Here are some of the treatment options that may help to relax the anal muscles and to prevent them from spamming:
- Topical glyceryl nitrate to relieve the pain accompanying the anal muscles spasms
- Nerve block, these are medication use t numb the nerves
- Muscles relaxers may also be used
- Oral diltiazem can be used to treat high blood pressure
- Over the counter creams and pain relievers
- Topical and oral antibiotics may be used to fight infections
- Electric stimulation may also be used to relax the muscle
- In cases of hemorrhoids, over the counter creams and pain relievers can help manage the symptoms of proctalgia fugax.
In most cases, no treatment is required as the episodes of proctalgia fugax can occur without warning, and last a short amount of time.
Proctalgia fugax natural treatment
In most of the cases, proctalgia fugax does not cause any lasting damage. It can, however, be painful and annoying, especially when in public. Apart from treating and avoiding the triggers of this condition, there are some effective natural remedies that can help relieve the symptoms.
1. Sitz bath
A warm sitz bath may help to relax the anal sphincter and reduce the spasm and pain associated with this condition. Add some warm water in a basin or a bath and immerse yourself in for some minutes to relieve the pain caused by proctalgia fugax.
You can also install a home sitz bath on your toilet:
- Soothic Sitz Bath for Over The Toilet Postpartum Care, for hemorrhoid and perineal treatment
- Sitz Baths Install on Toilet for Hemorrhoids Patients with Flush Hose
- Sitz Bath Over-The-Toilet Perineal Soaking Bath
2. Yoga and other relaxation techniques
Emotional stress is a common trigger of proctalgia fugax. Yoga, meditation, and other related techniques can help relieve anxiety and stress in general.
3. High fiber diet
Maintain a proper diet, vegetables, whole grain, and fruits may help with bowel movements. This is because they help prevent you from getting constipated. This means reduced strain and eases the pain during a bowel movement.
4. Potassium-rich foods
A deficiency in potassium is also believed to be associated with proctalgia fugax. Increasing your consumption of food rich in potassium can, therefore, help prevent this condition from occurring. Avocado, banana, and raisins are just some of the foods rich in potassium.
5. Pelvic muscle retraining
Proctalgia fugax is caused by spasm of the pelvic floor muscles, anal sphincter, and rectal muscles. If voluntary muscles are in spasm, then you can train your muscles to relax by doing special exercises.
How to prevent proctalgia fugax
Preventing proctalgia fugax involves avoiding all the possible triggers of the condition. For stress yoga, antidepressants and meditation can be used to prevent this condition.
For other causes such as hemorrhoids, chronic constipation, and anal fissures, treating this condition will help prevent anal spasms from occurring.
Maintain a balanced diet, increasing your consumption of fiber and drinking plenty of water to remain hydrated can all help prevent proctalgia fugax.
References:
- Proctalgia fugax: https://en.wikipedia.org/wiki/Proctalgia_fugax
- What is proctalgia fugax, causes, and diagnosis: http://www.healthline.com/health/proctalgia-fugax
- Proctalgia fugax and anal pain: https://patient.info/doctor/proctalgia-fugax-and-anal-pain
- Causes and treatment of proctalgia fugax: http://www.medicalnewstoday.com/articles/317254.php
- Chronic proctalgia fugax: http://ddc.musc.edu/public/symptoms/proctalgia.html
