Proctalgia fugax: it hurts even to say it!
“A red hot poker up the bum” is the classic description patients give me in proctalgia fugax.
It is usually a sharp, strong, sudden pain in the rectum that can come upon you at any time. However, a common time to get it is at night. It is terrible enough to be woken with a calf or foot cramp at night. Imagine being woken instead with an excruciating pain in the rectum! This sharp, sudden pain differentiates proctalgia fugax from chronic ache in the rectum and perineum, often called chronic proctalgia or levator ani syndrome. Rather than constant rectal pain, proctalgia fugax comes in “attacks” lasting between 5 seconds and 90 minutes.
Proctalgia fugax has a bit in common with interstitial cystitis/painful bladder syndrome and (in men) chronic prostatitis/chronic pelvic pain syndrome. Men and women with these conditions have troubles emptying their bowels and/or bladder, distressing levels of pain, and a huge impact on their lifestyle. They often have other health problems too, and depression is more common. Proctalgia fugax is more common in women – but this is small comfort to the men I’ve seen who experience it!
Proctalgia fugax is usually related to a muscle spasm of the muscles in the anus.
In fact, pelvic floor muscle tension is the most important thing to address with this condition. For this, you need a pelvic floor physiotherapist – not the same physio who treats your knee! I have also seen visceral mobilisation (a very gentle form of abdominal massage) help.
Medications are often offered for this condition, but don’t always work. A safe supplement to try is magnesium. I have seen this work wonders in many people. Unless you only have one working kidney, magnesium is very safe to try. However, the form of magnesium is important. Some work much better than others. Some just give you an unwanted laxative effect!