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Proctalgia Fugax

Pathophysiology
1. No clear etiology
Symptoms
1. Anorectal Pain
  1. Sudden onset
  2. Variable character: Sharp, gripping, or cramp-like
  3. No radiation
2. Spontaneous relief
  1. Seconds to minutes
  2. Rarely lasts hours
3. Recurs several times each year
  1. Often occurs at night
  2. May occur as often as 3 to 4 times weekly
4. Associated Symptoms
  1. Urge to defecate but no stool passed
  2. Onset with orgasm
Associated Conditions
1. More common in those with Irritable Bowel Syndrome
2. Potential food associations
  1. Artificial Sweeteners
  2. Caffeine
Management
1. No proven Management
2. Medications with Anecdotal success
  1. Albuterol MDI
  2. Catapres 0.15 mg bid
  3. Cardizem 80 mg PO bid
  4. Diazepam (Valium) at bedtime
3. Maneuvers that anecdotally interrupt spasm
  1. Sit in tub of hot water
  2. Apply ice to peri-anal area
  3. Finger placed inside rectum
  4. Rectal suppository (e.g. Preparation H)

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.