What is Proctalgia Fugax?
Proctalgia fugax is a harmless precondition where a person have sudden , severe and incisive rectal and anal pain , which is transient in nature , i.e. it lasts for a few second to a few minutes . The pain is sudden and sharp in nature , hap in episodes and is feel like a cramp . The pain in the neck of proctalgia fugax is repeated and occurs at temporary intervals . The exact cause for why proctalgia fugax occurs is not clear and it does not seem to be relate to any type of organic disease . One of the causes of proctalgia fugax is think to be spasms in the anal sphincter . Other contributing causes include focus and anxiety .
The pain of proctalgia fugax is fleeing in nature and normally occur when the affected role has gone to layer for the night and is felt for only a few seconds to a few hour and subsides , as abruptly as it start . Proctalgia fugax tend to get lighten with time . Proctalgia fugax commonly bear on individuals who are age between 30 to 60 years . This shape tends to decline after the age of 45 .
Difference between Proctalgia Fugax & Levator Ani Syndrome
The specialize factor between proctalgia fugax and levator ani syndrome is that proctalgia fugax tends to come about in the middle of the night . The length of the pain in the neck of proctalgia fugax can last from a few secondment to a few minutes ; whereas , the annoyance in levator ani syndrome lasts for around 20 minutes or more .
Pathophysiology of Proctalgia Fugax
The proctalgia fugax is ephemeral and sporadic in nature which makes it difficult to determine its underlie pathophysiology . However , some of the movement for Proctalgia Fugax admit : anal retentive sphincter muscle spasm , compression or neuropathy of the pudendal boldness and psychological event . The pressure of anus and rectum is normal when the patient is asymptomatic , but there is happening of motor abnormalities in the smooth muscle of the anus during an episode of proctalgia fugax . According to a study , there was a slight increment in the rest anal pressures when an anorectal manometry was done , but without any differences in sphincter liberalization , rectal obligingness , squeeze air pressure or in the thickness of the outside and internal anal retentive sphincter . affiliation of autosomal dominant inherited myopathy of the intimate anal retentive sphincter was also seen with proctalgia fugax . In two cases , the symptoms of proctalgia fugax were triggered from anorectal manometry . Relation was visualise between increasing duration of painful sensation with an step-up in wearisome wave amplitude and anal retentive resting tone .
Causes of Proctalgia Fugax
Symptoms & Characteristics of Proctalgia Fugax
Diagnosis of Proctalgia Fugax
The diagnosis of proctalgia fugax is made upon the symptom of the patient and after predominate out other causes of the pain . There is no specific trial to name proctalgia fugax . Other common painful condition of rectum and anus need to be turf out before coming to the conclusion of proctalgia fugax . Some of other anal retentive and rectal weather condition , which cause similar pain in the neck include : cryptitis , hemorrhoids , abscess , ischemia , rectocele , fissure and cancer .
Abdominal and digital rectal examination helps in assessment of the anal annoyance . Proctoscopy / anoscopy can also be done . If it is palpate necessary , then gynecological or scrotal examination should also be carry out . Further tests , such as colonoscopy or flexible sigmoidoscopy can also be done for excluding pathologic reason of proctalgia fugax . Blood examination should be done if the patient is having rectal or anal hemorrhage to see foranemia .
Treatment of Proctalgia Fugax
As the grounds of proctalgia fugax is not known , there is no known cure for proctalgia fugax . It is important to reassure the patient that proctalgia fugax is not a serious condition and it subside on its own . This condition is not known to be associated with other medical conditions .
The installment of pain and spasm of proctalgia fugax subsides on its own ; however , it can recur . Medicines are mostly not involve , as proctalgia fugax is transient and fugitive in nature and it subsides spontaneously before the patient has had time to take medicines or other footprint to relieve it .
According to some studies , the use of pudendal spunk block , botulinum toxin and atomic number 20 channel blocker facilitate in relieve proctalgia fugax . Topical treatment can also be done .
