II. Pathophysiology

  1. No clear etiology
  2. May be related to spasm of anal sphincter

III. 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

IV. Associated Conditions

  1. More common in those with Irritable Bowel Syndrome
  2. Potential food associations
    1. Artificial Sweeteners
    2. Caffeine

V. 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. Procedures that have been studied with varying success
    1. Sacral nerve stimulation
    2. Pudendal Nerve Block
  4. 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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Ontology: Levator syndrome (C0423738)

Definition (NCI) Recurrent episodes of pain localized to the anus or lower rectum which lasts seconds to minutes. There is no pain between episodes.(NICHD)
Concepts Disease or Syndrome (T047)
MSH C535890
ICD10 K59.4
SnomedCT 155788009, 270534003, 279087002, 62647006
English proctalgia fugax, proctalgia fugax (diagnosis), Levator ani syndrome, Levator syndrome, Levator ani spasm syndrome, fugax proctalgia, levator syndrome, Proctalgia fugax (& anal spasm): disorder or observation, Proctalgia fugax (& anal spasm): disorder or observation (disorder), Anal spasm/pain, Painful spasm of anus (finding), Proctalgia fugax - anal spasm, Proctalgia Fugax, Anorectal spasm, Paroxysmal proctalgia, Proctalgia fugax, Painful spasm of anus, Painful spasm of anus (disorder), fugax; proctalgia, proctalgia; fugax, proctalgia; spasmodic, spasmodic; proctalgia
Spanish Síndrome del elevador del ano, Proctalgia fugaz, espasmo anorrectal, espasmo doloroso del ano (trastorno), espasmo doloroso del ano, proctalgia fugaz (trastorno), proctalgia fugaz, proctalgia paroxística, síndrome del elevador
Dutch levator-syndroom, proctalgia fugax, fugax; proctalgie, proctalgie; fugax, proctalgie; spasmodisch, spasmodisch; proctalgie
Italian Proctalgia fugace, Sindrome di Levator
German Levatorsyndrom, Proctalgia fugax
French Coccydynie, Proctalgie fugace
Portuguese Síndrome do Elevador, Proctalgia fugaz
Czech Bolest konečníku přechodná, Syndrom zdvihače
Japanese コウモンキョキンショウコウグン, イッカセイチョクチョウツウ, 一過性直腸痛, 肛門挙筋症候群
Hungarian Levator syndroma, Proctalgia fugax