Proctalgia fugax
From Wikipedia, the free encyclopedia
| Proctalgia fugax Classification and external resources |
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| ICD-10 | K59.4 |
|---|---|
| ICD-9 | 564.6 |
Proctalgia fugax is a severe, episodic, anal pain. It can be caused by cramp of the pubococcygeus or levator ani muscles.[1]
Contents |
[edit] Presentation
It most often occurs in the middle of the night[2] and lasts approximately 20 minutes, occasionally 30 minutes or longer. Because pain threshold drops during sleep, the pain intensifies as the sufferer goes to sleep[citation needed] and wakes up the sufferer again. Most sufferers encounter it fewer than six times a year and can go for many months without an episode. Onset can be in childhood. One study showed that women were affected more commonly than men.[3] The pain is sometimes described as an "anal charlie horse," an anal cramp, an anal spasm, or repeated spasms of the anus.
During an episode, the patient feels spasm-like pain in the anus, often misinterpreted as a need to defecate. Simultaneous stimulation of the local autonomic system can cause erection in males. It is a disorder of skeletal muscle, it is recurrent and there is also no known cure. It is not known to be linked to any disease process and data on the number of people afflicted varies, but is more prevalent than usually thought.
Like all ordinary muscle cramps, it is a severe, deep rooted pain.
In males, it has been reported to occur immediately following ejaculation.[citation needed] There seems to be some indication that prolonged and tense sexual arousal may lead to an episode later that night.[citation needed]
Episodes happen almost always with an empty colon[citation needed]. Defecation of any feces present can to worsen the spasm, but may relieve it, or provide a measure of comfort[citation needed]. The pain might subside by itself as the spasm disappears on its own, or may persist or reoccur during the same night. At the time it can seem like "it will never go away."
[edit] Treatment and prevention
Traditional remedies have ranged from warm baths (if the pain lasts long enough to draw a bath), warm to hot enemas,[4] relaxation techniques,gentle massage of the anus, and various medications.
One method of quickly alleviating the pain is to stretch the area by touching one's toes, followed by taking the anti-inflammatory ibuprofen (e.g. Advil) with a glass of water.[5] Alternatively, it has been suggested that one takes acetaminophen / paracetamol (e.g. Tylenol) with a hot drink (or simply a glass of water).[6]
In patients who suffer frequent, severe, prolonged attacks, inhaled salbutamol has been shown to reduce their duration.[7]
One of the most common ways to reduce the symptoms is by pushing on the anal area, especially on the perineum or "taint."[8] One can either do this manually or by straddling the edge of a bathtub.[9]
The use of botulinum toxin has been proposed,[10] as has diazepam.[11]
An episode may sometimes be avoided by making sure not to engage in sexual activity within a close time proximity to defecation.[citation needed] Those afflicted can usually tell after either sex or after defecation whether they would be in danger of an episode if they were to engage in the other activity, the potential onset of an episode being usually preceded by a very slight version of the pain that will eventually become much more intense.[citation needed]
Several people have experienced relief by cold water enema.[citation needed] Also, moist heat, for example a warm wet towel has been reported to have more or less effect.[citation needed]
Keeping one's body well hydrated and having a high fiber diet may help reduce the frequency of these onsets.[12]
[edit] References
- ^ Olden, Kevin W. (1996). Handbook of functional gastrointestinal disorders. New York: M. Dekker, 369. ISBN 0-8247-9409-5.
- ^ Takano M (2005). "Proctalgia fugax: caused by pudendal neuropathy?". Dis. Colon Rectum 48 (1): 114–20. PMID 15690667.
- ^ de Parades V, Etienney I, Bauer P, Taouk M, Atienza P (2007). "Proctalgia fugax: demographic and clinical characteristics. What every doctor should know from a prospective study of 54 patients". Dis. Colon Rectum 50 (6): 893–8. doi:. PMID 17164968.
- ^ Olsen B (2007). "Proctalgia fugax - a nightmare drowned in enema". doi:. PMID 17949444.
- ^ Charlie Horse : KOLAAP
- ^ Anal problems - anal pain
- ^ "Treatment of proctalgia fugax with salbutamol inhalation. journal=The American journal of gastroenterology" (1996). PMID 8677929.
- ^ Charlie Horse : KOLAAP
- ^ Rectal Pain
- ^ Wollina U, Konrad H, Petersen S (2005). "Botulinum toxin in dermatology - beyond wrinkles and sweat". Journal of cosmetic dermatology 4 (4): 223–7. doi:. PMID 17168867.
- ^ Common Anorectal Conditions: Part I. Symptoms and Complaints - June 15, 2001 - American Family Physician. Retrieved on 2007-11-17.
- ^ Rectal Pain
