Proctalgia fugax
From Wikipedia, the free encyclopedia
Proctalgia fugax (or levator syndrome, also known as anal cold) is a severe, episodic, rectal and sacrococcygeal pain.[1] It can be caused by cramp of the pubococcygeus or levator ani muscles.[2]
Presentation
It most often occurs in the middle of the night[3] and lasts from seconds to minutes,[4] an indicator for the differential diagnosis of levator ani syndrome, which presents as pain and aching lasting twenty minutes or longer. In a study published in 2007 involving 1809 patients, the attacks occurred in the daytime, (33 percent) as well as at night (33 percent) and the average number of attacks was 13. Onset can be in childhood, however, in multiple studies the average age of onset was 45. Many studies showed that women are affected more commonly than men.[5] This fact can be at least partly explained by men's reluctance to seek medical advice concerning such a delicate case as rectal pain.
During an episode, the patient feels spasm-like, sometimes excruciating, pain in the anus, often misinterpreted as a need to defecate. Simultaneous stimulation of the local autonomic system can cause erection in males. In men, twinges sometimes occur shortly after orgasm. Because of the high incident of internal anal sphincter thickening with the disorder, it is thought to be a disorder of the internal anal sphincter or that it is a neuralgia of pudendal nerves. It is recurrent and there is also no known cure. However, some studies show effective use of botulinum toxin, pudendal nerve block, and calcium channel blockers. 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. Again, quite few people report these symptoms, so obtaining data on more or less precise ratio of occurrence of proctalgia in human populations presents a challenge.
The pain episode subsides by itself as the spasm disappears on its own, but may reoccur.[4]
Sometimes pain is so severe that that may cause loss of consciousness and possible injury. Staying down is suggested if in bed, and lying down is recommended. However, in many cases, defecating is suggested as emptying the rectum provides relief, even though it might be extremely painful at the first seconds or minutes.
Treatment and prevention
Traditional remedies have ranged from warm baths (if the pain lasts long enough to draw a bath), warm to hot enemas,[6] relaxation techniques, and various medications.
In patients who suffer frequent, severe, prolonged attacks, inhaled salbutamol has been shown in some studies to reduce their duration.[7]
The use of botulinum toxin has been proposed as analgesic,[8] and low dose diazepam at bedtime has been suggested as preventative.[9]
The most common approach is simply reassurance and topical treatment.[10]
A fast effective treatment is to place one 0.125 Hyoscyamine lozenge under the tongue at the onset of pain, or the application of heat (warm water bottle or bath). Relief usually begins within 5 to 10 minutes.
Taking 40–80 mg Drotaverine (an antispasmodic drug, No-Spa) also gives fast relief.
Strangely i do get the 'attacks' about 13 times a year. The level of pain varies from 2 to 5 out of ten, and it usually lasts about 45 minutes. When it happens in the middle of the night the worse thing to do is stay in bed as all you can notice is the pain. Getting up and doing something distracting is the best thing.
Last time i looked this up there were no known cures. I had taken to rubbing Deep Heat stuff into the affected area, doesnt really stop the pain but it burns and stings so much that it masks the pain, and that is preferabble to the thing itself. I thought that benzos might work as a muscle relaxant but they dont. Onset often occurs after orgasms, which is quite inconvenient when that happens in the company of the opposite sex (that circumstance hasnt happened too often, for better or for worse). It's a very bizzare condition. Apart from orgasms there are no known dietary or other things that trigger it, it just happens totally randomly, out of the blue. For a while it happened on the dates of family members birthdays, how fucking weird was that

I've been having these things for about 20 years. I thought i had cancer or something at first, but it seems to be a 'harmless' condition, its not getting any worse over time, at least.
Apparently this is a very common condition, anyone else here have it ?