8%-18% of people have it. And of those people, only 20-30% seek a professional diagnosis for it. Patients suffer from episodes of severe pain that can make it difficult to function in their daily lives. What is this mysterious ailment?
Proctalgia fugax is the answer. Proctalgia fugax, fugax meaning “fleeting” in Latin, is a condition that causes severe episodic pain in the anorectal area caused by cramps in the levator ani, the main pelvic floor muscle. Attacks typically occur at night and are often mistaken as an urge to defecate. When the levator ani spasms, the result is anorectal pain lasting anywhere from a few seconds to 30 minutes. Men may even get an involuntary erection! This condition typically starts around the age of 45. While it does not cause physical damage to the body, proctalgia fugax can be very painful and debilitating.
Proctalgia fugax cannot be cured, but its symptoms can be managed. Here’s a list of some of the many treatments that can help ease the pain during an attack:
1. Warm baths
2. Warm enemas
3. Cold packs
4. Relaxation techniques
5. Salbutamol inhaler – Usually used for bronchitis, salbutamol inexplicably seems to shorten episodes of pain
6. Botox – Inhibits acetylcholine, the neurotransmitter that controls muscle, which reduces contractions
7. Topical calcium channel blockers – Vasodilates blood vessels, reduces muscle contractions
8. Counseling – Stress can be a major trigger of proctalgia fugax. Eliminating stress may reduce the frequency of attacks.
9. Galvanic stimulation – High voltage stimulation has been shown to reduce frequency of attacks
10. Treatments of the underlying diseases, such as hemorrhoids and anal fissures.
Overall, proctalgia fugax can be a real nuisance. The 8%-18% figure above may be even greater in reality because so few people seek treatment. And it’s understandable why people don’t- it’s an uncomfortable and embarrassing thing to talk about. Many will just try to ride it out. Proctalgia fugax can be a struggle. It’s not worth the loss in quality of life. If you feel that proctalgia fugax is making your life worse, it might be time to see your doctor.