Proctalgia fugax is pain in the anus or rectum that occurs suddenly and goes away quickly. Anal pain due to proctalgia fugax occurs for a few seconds or minutes and does not last more than 30 minutes. Although generally harmless, this condition can cause discomfort to the sufferer.
Approximately 8–18% of people worldwide have experienced proctalgia fugax. However, this condition rarely recurs and generally only occurs less than five times in 1 year. Although it can happen to anyone, proctalgia fugax is more often experienced by women aged 30–60 years.
Causes of Proctalgia Fugax
The exact cause of proctalgia fugax is not known. However, this pain is thought to occur due to a sudden tension or contraction (spasm) in the anal sphincter muscle, which is the muscle at the end of the anus that functions to regulate bowel movements.
According to several studies, proctalgia fugax can also occur due to pressure on the pudendal nerves, which are the main nerves in the anal and genital areas. This pressure can be triggered by hysterectomy or sclerotherapy procedures.
In addition to the conditions above, there are several factors that are thought to trigger proctalgia fugax, namely:
- Sexual activity
- Irritable bowel syndrome ( irritable bowel syndrome )
- Abnormal bowel movements
- Constipation ( constipation )
Symptoms of Proctalgia Fugax
Proctalgia fugax is one of the causes of anal pain . Symptoms that appear include pain, cramps, prickling, or burning, in the anus. The pain appears suddenly and lasts for a few seconds or minutes, but lasts no longer than 30 minutes and often stops on its own.
Most people with proctalgia fugax rarely experience recurrent pain. This condition generally only occurs less than 5 times in 1 year. Sufferers also usually do not feel any complaints before pain occurs.
Patients with proctalgia fugax can feel pain at night, but pain can also be felt during the day. The pain that is felt can be severe enough to interfere with daily activities, for example causing sufferers to wake up from sleep.
When to see a doctor
Check with your doctor if you experience pain in the anus or rectum. The pain in proctalgia fugax can mimic the symptoms of other conditions or diseases. Therefore, a doctor's examination is needed to determine the cause of the complaint that is being experienced.
Immediately see a doctor if anal pain does not stop or is accompanied by some of the following symptoms:
- Bleeding from the anus
Diagnosis of Proctalgia Fugax
In the early stages, the doctor will conduct questions and answers regarding the patient's complaints, including the severity of the pain in the anus and how long the patient has experienced this pain, as well as the patient's medical history.
Next, the doctor will perform a physical examination to detect lumps, lacerations , rashes, or abscesses around the anus. The doctor will also examine the inside of the anus by hand to check for lumps, bleeding, or certain abnormalities.
After that, the doctor may also use a tool called a proctoscope to see the condition of the anus to the end of the large intestine (rectum).
If needed, the doctor can carry out further tests in the form of:
- Scans, such as ultrasound and MRI, to look inside the anus
- Sigmoidoscopy, using a small tube equipped with a camera, to see conditions deep into the intestine
- Anorectal manometry test, to measure anal muscle contractions
Examination of the patient's mental condition may also need to be done if the complaint is suspected to be related to a psychiatric or psychological condition. The diagnosis of proctalgia fugax can be confirmed if other causes of anal pain, such as hemorrhoids, anal abscesses , and anal cancer , are not found during examination.
Treatment of Proctalgia Fugax
Generally, anal pain that occurs in proctalgia fugax does not require special treatment because it can recover on its own. However, if the pain gets worse to the point where it interferes with daily activities, the following treatment methods can be used:
- Administration of topical medications, such as diltiazem cream and glyceryl trinitrate cream , to relax the muscles around the anus by dilating blood vessels
- Giving botox injections , to reduce muscle tension around the anus
- Electrical stimulation therapy, to relax the muscles around the anus by conducting electrical signals
In addition to some of the treatments above, patients are also encouraged to do the things below to relieve pain and help the healing process:
- Soaking the anus in warm water ( sitz bath )
- Clean the anus gently after defecation (BAB)
- Do not use soap that contains fragrance
- Don't wear clothes that are too tight
- Don't sit too long
If anal pain is related to psychological problems, consultation with a psychologist or psychiatrist can also be done to treat mental disorders.
If after a complete examination no problems or other causes are found, proctalgia fugax is generally not a serious condition and does not cause long-term problems.
Fugax proctalgia complications
If it gets worse, proctalgia fugax can cause several complications, such as:
- Sleep disturbance if it occurs at night
- Uncomfortable feeling
- Anxiety disorder
Prevention of Proctalgia Fugax
Considering that the cause of proctalgia fugax is unknown, this condition is also difficult to prevent. The best effort that can be done is to follow the doctor's treatment recommendations if you suffer from a disease that can cause proctalgia fugax.
Prevention can also be done by avoiding factors that can trigger proctalgia fugax. Some things that can be done are:
- Avoid or manage stress well
- Overcoming depression and anxiety, for example by consulting a psychiatrist or psychologist and following the advice and therapy given
- Eat high-fiber foods to avoid constipation or constipation