"PROCTALGIA FUGAX"...Sudden,Sharp Rectal pains? PART II

I have had this every few months for a couple of years now. Mostly at night but twice during the day - once at work which wasn't pleasant. I've wondered if it is due to a fall I had some years ago. I fell on the stairs and snapped an inch or so off the end of my sacrum. I was told it was best to leave it to heal by itself. The broken piece had twisted out of place but I was told that the broken ends eventually round off and the pain would lessen. It did - took about three months but afterwards I was fine. However, in the last few years I've had problems with nerve pain down my legs when I walk down hill. On the flat and uphill is fine - just down hill. I also now occasionally get very low back pain. I have a feeling I may have caused some damage when I had the fall which wasn't noticed at the time but as I have approached (and now pasty) 50, it's starting to cause me grief. I'm wondering if this could be the reason why I'm getting the dreaded PF now.

also, i've never felt the desire to poop during one of these-- like i said, even if i'm sitting on the toilet with my pants down, i make a point not to poo cuz it hurts too much to. i also don't know if it'd be sex related cuz i'm a virgin (yeah, on purpose) but now that i've read these threads and know that can trigger it, gosh i've just got my fingers crossed it won't. that'll definitely be something to spoil a honeymoon.

Hi everybody from Spain (sorry for my English).

I've been suffering proctalgia fugax since around 2005. Two years before I had an anal fissure and my proctologist operated me from lateral internal sphincterotomy, which stopped the problem with the fissure.

As proctalgia incidents only happened twice or thrice a year, never thought of asking opinion from a doctor, but when I started to be tired of them, in 2010, I told about them to several doctors, including two proctologists. None of them knew what I was speaking about. At the end of 2010 I visitted an urologist which stated that my problem arose from a bacterial prostatitis, so I was treated with ciprofloxacin (antibiotic) and I was free from anal spasms until a month ago, so I haven't had proctalgia for 16 months.

I came again to see the same urologist and this time no bacterial prostatitis was found, but he stated that the problem was in relation to dammage that has been caused in the prostate due to previous prostatitis. He asked me to have Serenoa repens pills (in Spain the commercial name is Permixon 160 mg) for a month, and wait another month to see if the problem stopped.

As I wasn't sure that the urologist was to be precise about the problem, I visitted a proctologist and after putting one finger in my rectum and touching the prostate, I felt the same pain that when I have a night proctalgia attack, so he stated again that the problem was a prostatitis.

Finally I visitted another urologist and after putting one finger in my rectum (again!) he told me that the problem was not of prostate, but of my pelvic floor muscles, which were too much hypertonic. So he stated that I should visitted a physioterapy clinic for dealing pelvic floor problems, and next Thursday I have an appointment in this clinic which he recommended me. By the way, this doctor was the first one in 7 years that put name to the problem: PROCTALGIA FUGAX!! I felt so happy when I read the symptons in wikipedia... Now I know what is the name of my enemy!

I have read the two threads about proctalgia, and have write down a lot of the main ideas just to try if proctalgia comes again, but anyway, I would like to ask two questions and to share with you one more thing.

The first question is if anyone having proctalgia fugax o levator anus syndrome has tried physioterapy for the pelvic floor muscles and which were the results.

The second question is if you have experienced worsening with cycling. I used to ride a lot when I was younger (5,000 to 6,000 miles a year), but now (I'm 36 years old) I only ride 1,000-2,000 miles a year and only by flat road.

And finally (and sorry for my speech), since the last proctalgia fugax attack visitted me two weeks ago, I feel very uncomfortable when I am sitting on a soft chair or in the car (of course I've stopped riding my bike). I suppose that the muscles around the anus must be affected by some kind of contracture, which I don't know how to alleviate. Hope that next week physioterapy solve this issue.

Thank you for your information and for your time.

Best regards.

Post Edited (vxon_kitt) : 5/4/2012 10:48:16 AM (GMT-6)

Wow! It is amazing how many people are also dealing with this same "pain in the butt" I have been dealing with for years. I am a 50 yr old female who has had symptoms for at least 10 years. I got my 1st colonoscopy shortly after and found out that my colon was fine and the Dr. said I just had harmless spasms.

 I did develop ulceritive colitis about 4 yrs ago but I do not think these things are related at all from what I have read. I eat a very healthy high fiber diet, exercise regularly and try to drink enough water, but sometimes know some days are not enough. I think I am basically symptom free from my UC as long as I eat healthy and stay away from spicy foods.

 I have been having these acute pains in my rectum area with increasing frequency for over 10 yrs. I would estimate I get them 4-6 times a month now. The one difference for me that others have not mentioned as much is that about 50% or more of the time mine occur during the day, usually when I am on a walk. They are not as debilitating as others have shared and I can always continue my walk and they usually go away in about 10 minutes or so. They feel kind of like labor pains in the way that they come on slowly, intensify for several minutes, then they are completly gone usually within 15 min or so. It feels like someone has shoved a rock up my anus and like others have shared, I feel the urge to have a BM but it is usually the wrong time of day for that as I usually have one every morning upon rising. I see no corelation to having sex or an orgasm or being stressed or not, but I do think that maybe dehydration may be a consideration. I would like to try taking magnessium like others have suggested and see if that helps.

Does anyone else experience these painful episodes when they are walking as well or am I alone there? (we heard from a few runners)

 

Thank god for this website. I've clearly been suffering from this for decades, calling it "tenesmus cramping". Years and years of doctors thinking I am crazy, sending me to shrinks, telling me to learn to relax ... when I tell them it usually wakes me up at 2:00 or 3:00 am, so I couldn't be more relaxed, they sort of say "oh" but they still didn't believe me.

For the record: i'm male. Starting about 17 or 18, about once a month I'd be awakened by mild rectal cramping that just got worse and worse, until I would be writhing in bed (or on the toilet) with the sort of pain that makes you twist your fingers into claws. Lasted about a half hour.

For a while, the once a month regularity made me wonder if men could have a sort of cycle -- there are mentions in medical lit. of men with a bit of uterus-like patches in their abdomens... But it was never that regular.

After a few years, I reasoned that aspirin delivered quickly would relieve some pain, so now my routine is: I crunch a couple of aspirin between my teeth, hoping it will be absorbed in the cheek membranes faster than swallowing them as pills. Seems to help; certainly cuts the pain shorter. I wonder if aspirin has some smooth muscle relaxant quality? Once read that it did.

Incidently, in my mid-40's its frequency diminished to about 3 or 4 times per year, although intensity is still just as bad.

I will now ask my M.D. to try me on Ventalin inhaler, suggested in previous thread.

All that effort keeping a journal to help me find some food or activity that correlated to the episodes! Just could not find any clear correlation, although for a while I thought it was triggered by particularly intense or drawn out orgasms. Or red wine. Over the years, I have had such a varied lifestyle that I can state with great cinfidence the following are NOT factors:
Coffee or alcohol -- have gone a decade without either, still had the pains.
Good or bad shape -- have been incredibly trim karate enthusiast, then after a bad hernia repair completely sedentary and 40 lbs overweight, no difference in the pain.
Sexually active, or not, no difference (i am hetero.) pre-marriage vs now married, no difference.
Diet has changed a lot; when younger and poorer, ate lots of pasta and carbs. Tried Atkins for a while. Lots of salad or almost never salad -- i have been through it all, the pain persisted.

And yes, I certainly have /had IBS as did a sibling, my dad, and 2 of my children.

Hope this posting helps others. In a half year or so I will try to report back on any Ventalin trial.

All the best!

1beachlover, sorry I hadn't read your post when i posted my previous comment but I see u also get it when exercising. Putting pressure on my behind seems to relieve the pain a little but kind of hard when u are in public! It is really putting me off jogging at the moment which I really need to keep up because of my sedentary job. I have no other health issues, am on the contraceptive pill and within the healthy weight range. I'm 36.

I am so incredibly relieved to have found this (and its previous) thread after all these years of confusion and pain. I'm a 28 year old male and I've been suffering from PF for the last ten years. My doctor ruled out constipation years ago but didn't have an explanation for what I was going through at the time. I suffer from attacks about once a month and the pain has had me close to passing out on a few occasions. The most recent lasted 45 minutes, which is about 15 minutes longer than my usual episodes.

I'm relieved to find out that it isn't a serious issue, but what is even more surprising is the Salbutamol relief aspect. As an asthma sufferer I've used Ventolin for as long as I can remember. I cannot believe that this potential remedy has been right next to my bed all of these years. I will definitely try it out the next time this happens.

For me, my episodes always occur at night and build up gradually from the feeling of discomfort in a very specific spot that feels like it is just inside my anus, to an incredible amount of sharp pain in the same spot that leaves me with cold sweats and feeling faint. Nine times out of ten I will be asleep when it hits me, without warning, although I once felt the onset in the early evening that passed after an hour, only to return after I'd fallen asleep that evening.

I can empathise with what you are all going through, especially if you're unsure what it is and its severity. I'm glad there is this resource to fall back on...

Tinlou said...
It is the strangest phenomenon ever.

And apparently one of the least well diagnosed. No, no one knows why mostly "dead of night".

I'm a sixty-something with the usual "old man" problems, including constipation which I feel I may finally have under control, i.e. I have a new morning routine of fiber cereal with fruit that's helped a lot, and part/parcel of keeping traffic flowing on the Hershey highway is water, and lots of it.

It's been mentioned here several times (though maybe in the older thread) that LOTS OF WATER may help some people, just as dehydration (after drinking? after sex? hey doesn't drinking cause sex? ;-) clearly hurts. I think it's helped me as I haven't had any PF attacks since posting here (a year? two? old fart like me can't remember!). Water before bedtime, water when I get up to pee, water throughout the day, cool, clear, water...can only be good for you.

I am a 27 year old male and I have been dealing with this for about 7 years now on and off. Seemingly unlike most people I have only ever suffered it once at night and every other time I experience it is after I use the toilet. It normally comes on so fast I do not have a chance to wipe or anything and it is the most intense pain I have ever felt. I am very active and have broken a dozen bones, blown out both my knees and ankles, fractured my spine and suffered many other injuries and none of them have ever come close to being as painful as this is for the short period of time that it lasts. My only way of coping with this (as juvenile as it sounds) is to punch myself in the leg. I am just not sure how else to deal with that kind of pain. I just try and divert my brain to another part of my body. But this is not really any kind of a solution. Just kind of something that makes me laugh slightly and wonder what my house mates must think of the noise.
At first I thought it might have been IBS or something else like that but I do not suffer from anything like that.
The attacks used to be far worse years ago and I have been reading through this whole thread and I have noticed a few people mention their diets. I have always eaten pretty healthy but about 4 years ago I went vego and then for the last 3 years I have been vegan. I used to suffer these attacks about once a week but since I have been vegan I only deal with them a few times a year now. And I find it is normally when I get really lazy with my diet. I am not saying anyone needs to do anything as extreme as going vegan but the main reason I am vegan is because of the personal health aspects. But from my own personal experience I have found that the change in my diet in a healthy direction has seemed to dramatically reduced the amount of attacks I suffer from this.

I have never actually been diagnosed but from everything I have read it sounds to me that this is what I have.

Post Edited (Deanosc) : 6/29/2012 8:34:41 AM (GMT-6)

Tinlou said...
Other than my morning coffee, water is all that I drink. I gave up soda/pop a while ago. Maybe I am not drinking as much water as i think i am. The other logical scenario I have heard before is weak pelvic wall in relation to this. I guess that could be possible but for now we are all perplexed but definitely not alone.

Interestingly, I also only drink water. Lots of it. I don't touch soda, coffee, tea etc...

Processed foods are the devil..even certain chewing gum/candy that contains sorbitol can leave me in the bathroom for quite a while. I never put the two together but eventually, after a lot of searching and pain i correlated the two. My gastroenterologist didn't ever even ask me about my diet and now I know that it has a great deal to do with all of this.

Thanks for the vegan information. It does sound like something I could do since I am not a big red meat person anyway so giving up all meat and cheese is definitely something i could do. Eggs may be a different story but do egg beaters count?

When you first started this did your system take a while to get use to it? I don't know if you are IBS c or d so I would think if you were c this would be great but IBS d, i would think would take a bit to get use to since your body is flushing out a lot of toxins and is just not use to it and one may be in the bathroom for a bit while the digestive system adapts.

I have been having these pains for several years now. I am so glad I found this thread! I was never quite sure if it was from hemorrhoids because the pain is so severe. I keep plenty of the Preparation H wipes handy. They also come in individual travel packs. These are the best thing I have found that helps relieve the pain fairly quickly. Just fold it and place it at the anal opening. I can then go back to bed and lay on my side or stomach. Even if it happens during the day when it is not convienent to lay down. I don't remove it until I am sure the pain has completely subsided...just watch out, they are wet and can soak thru underwear and thin pants, but the relief is worth it!