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

I am 36, married and have two children. I had my first episode in 2000 but never thought anything of it as it never happend again until 2002 (on my honeymoon!) and thereafter it has been very intermitent until 2010 which was the time the attacks ocurred frequently. Finally in March 2010 I decided to visit the doctor and asked for a referral (through my private medical insurance). I visited the BUPA hospital on a number of ocassion and saw various specialists to try and work out what the problem was, this was followed by a colonoscopy. The results of the colonoscopy showed polyps which were removed during the colonoscopy (later tests showed that 5 of the 8 were high graded and as the doctor told me "not nice ones to have"). I am due to go back in August 2012 for a further colonoscopy to see how things are doing however this was not the reason for my attacks and the doctor has not confirmed what I have he only suggested it was something to do with "Vasogal Neverve" and then told me "there is nothing you can do about it (that helps!!!)"....great I thought.

So on to my attacks, initially the attacks were very irregular night mostly but also in the day time. The night attacks woke me up (generally around 2am), very painful and also made me feel as though I needed the toilet so I got up every time and went into the bathroom where I would sit on the toilet (this relieved some of the pain) and then I would go all fuzzy, hot, wet through and pass out. This sent me into a blind panic every time as I knew what was happening and I couldn't stop it. I have explained to the children exactly what happens as my husband works shifts and is not always there to help me. A few months ago however, was the worst attack ever, this time it was around 6pm, husband at work and only our youngest son in the house. The attack started - What do I do, I asked myself, I quietly walked into the bathroom and the next minute I came round and my youngest son was bent over me with a cold flannel on my head saying "mum, mum are you ok" then I realised I was naked and had been to the toilet (BM) and still had the toilet paper in my hand!! I was gutted....What a thing for him to see - this really upset me. My son told me I had shouted, well grunted from the bathroom and he came straight in to find me out on the bathroom floor.

Early this year a pattern has formed with the attacks, they occur monthly, 2 days before my period starts and have been during the night rather than in a day. After researching on the internet I found this site which gave me a sigh of relief to read some of the postings on here as you always think you are the only one suffering. I am visiting the doctors next week to ask for the inhaler. Fingers crossed this will help and I will post later in the month and let you know how I am getting on.

I know Novice Runner, I fill up everytime I think about it. I do generally wake my husband up (although I don't like to because he works shifts he tells me off if I don't!) unfortunatley on that dreadful ocassion my son was my hero . I must admit, when I was telling my mum the day after I cried my eyes out!!

Thursday last week was the last episode (again 2 days before my period) and my husband did the duty this time (bless) it's so embarassing!! I was wet through laid on the bathroom floor with my feet propped up on the toilet or wall or headboard - I have found doing this stops the fainting.

Fingers crossed ehh will post after the next episode is due. Thanks again, such support means a lot x

Desperate Housewife said...
The night attacks woke me up (generally around 2am), very painful and also made me feel as though I needed the toilet so I got up every time and went into the bathroom where I would sit on the toilet (this relieved some of the pain) and then I would go all fuzzy, hot, wet through and pass out. This sent me into a blind panic every time as I knew what was happening and I couldn't stop it.

Hello DH, I joined this forum because of your posts! I have suffered the same "blind panic" as you, including the "fuzzyhotwetpassoutinthetoiletwakeuponthefloor"!!! I have had this happen only maybe a half dozen times in my life, but each time the episode was precipitated by severe-and-mysterious-pain-exacerbated-by-fear. It starts with exceptional and unusual pain, which then morphs into panic, and suddenly you get lightheaded with cold sweats and your ears ring and the next thing you know you wake-up on the floor. Awful.

THIS aspect of your problem (not the pain per se, but the panic-passout after) is most likely a vasovagal reaction. A panic attack if you will, that causes your blood pressure to drop and you rather quickly pass out. I'm a retired male, "disgustingly healthy" according to my GP, and have been around the world many times but must admit that I've suffered these attacks, most embarrassingly on the toilet owing in my case to constipation. But that's a different story...

Fixing your vasovagal attacks can start with recognizing that your PF pain is not going to kill you! Hopefully you'll see your doctor and he/she will prescribe something that lessens your pain, but in addition to this you have to try to convince yourself when you DO have these PF attacks that they will end "soon enough" and you must not panic and vasovagal yourself into unconsciousness! It starts with the PF, but then you worry about passing out, don't you! You gotta relax, don't panic, deep breaths, you'll get thru it, its-not-what-you-think, whatever works for you. I still have the occasional "when's this pain gonna end and am I gonna freak-out and pass-out and bleah" anxieties but I've got my own problem mostly under control--you can do it too.

I found this site cuz I've had this bizarre anal pain once or twice a year (! yes that's all) and the last several years I've had some prostate problems (under control now) and thought this might be a prostate thing but how 'bout that, no it's not, it's simple Prostalgia Fugax (did I spel it rite?) and it's not (at least for me, and probably you) not something to worry myself to death over.

Thanks all for the info here--I will discuss my own few bouts with my GP and prolly also my Urologist but it seems I don't have to fret that it's "the one"! As you get older, you start to wonder which pain you get is the Beginning of the End, especially if you're a natural worrier like myself!

Desperate Housewife said...
we certainly need someone to research this as I firmly believe there is a reason for this and surely something can be done about it with the medical studies that are available today

Well, it seems there is no clear explanation for PF as we've seen thru our Googling (and this thread) and a limited number of treatments for it (the inhaler appearing to be the likeliest remedy). So "talk to your doctor". But given it's apparently not life- or even health-threatening in any way I doubt we'll see a drug for sale on the Evening News with Brian Williams anytime soon! ;)

As for your panic attacks, and vasovagal reactions, be sure you press your Dr. about these as well, and separately, because IMO the fact that you are susceptible means that this can happen under other circumstances as well, not just PF pain (or in my case severe abdominal cramping from constipation).

Obviously, if you could eliminate the PF pain then the VV oughta go away as well. But if not, your VV weakness might be treatable also--though myself, I never got to the point of pressing my internist on it e.g. hypnosis or some such. He only told me that some people were susceptible to VV and we focussed instead on fixing the pain-leading-up-to-it.

P.S. We've been talking about PF of course, but I forget yours seems to be brought-on by premenstrual cramping (which I know nothing about, and probably didn't even spel rite). That's no doubt where you need to start with your Doctor: PMC --> PF --> VV --> EUOTFPO

EUOTFPO - "End-Up On The Floor Passed-Out!!!

Post Edited (FeelinFine) : 7/1/2011 7:25:03 AM (GMT-6)

To whoever reads this and suffers from this horrible thing, I know how you feel. I have been suffering with this random attack, usually at night and/or after orgasm and rarely during the day since early childhood. I am now 24. I am also a male. The pain is really really bad. I usually feel like I have to use the restroom when I get the attack, so I go to the restroom when I do get an attack every time. Then the horrible, sometimes horribly excruciating pain usually last for about 20 minutes or less. It usually leaves me faint, and I feel like I am going to faint when I am having the attack. I am surprised I haven't fainted to date during an attack.

I have never told anyone about this and keep it private, and will probably never tell a doctor, mainly because I don't go to one, but when I start going I am going to ask if there is anything he can do for me about it.

I typed this because for someone who may have it might read it and know they aren't alone.

I suffer from PF and my spasms come in the first 90 minutes of sleep.  I have found that sitting on a tennis ball works well.  I take the ball, sit it on the toilet seat lid and sit (with underware on) so the tennis ball is pressing on the rectum and the perineum area.  Somehow, the pressure from the tennis ball relaxes that spasm and it goes away very quickly.  Before using the tennis ball, I would suffer for 20 to 30 minutes.  Now, it is over in less than five minutes.  I hope this helps someone. 

Hi
Responding to NeilfromEssex's Q re the lack of bladder functions during a PF attack, i can confirm that this is the case for me also. In fact the whole area down there seems to be none functional. The PF itself seems to make you feel like a BM is coming yet you can try but nothing happens likewise you cant pee either..
As for me i actually had two in consecutive nights a few weeks ago, can't figure out why but it's never happened before..

I am a 35 yr old, healthy, active mother to 3 teenage sons. I have been dealing with PF for about 3 years. Typically I have about 4-6 attacks per year, always occurring in the night to wake me from a deep sleep. This past year they started to increase, gradually decreased and came back with a vengeance. The other night I had an episode so severe, that I was certain I was going to pass out. I have cold sweats and severe pain. My attacks generally last about 20 minutes, although I've had some last longer and some last less. Like most, I find the need to 'bear down' as if I'm giving birth. Sometimes I can have a BM, but usually I am empty and have nothing to give. I've found that getting on all 4's and breathing helps alleviate the pain. Also as someone else mentioned, lying on the cold bathroom floor. My attacks have always brought me to tears as the pain is always severe. With my last episode, I laid on my living room floor on my back, legs up on the sofa and breathed slowly. Although my husband is aware of my condition, I try to not startle him throughout the night, as I am ashamed and embarrassed. I've discussed my symptoms with both my family physician and my gynecologist who both were way off on their guesswork. about 6 mons ago, I stumbled upon this condition while researching my symptoms online and knew immediately, this was me! I am praying for a cure. I am shocked to learn that some of you have been dealing with this for years!! This scares me to death. If we can do heart transplants, surely they can get our 'butts' to calm down (so to speak...no pun intended!)

Thank goodness for the internet!! We would all be walking around wondering what the hell was wrong with us, too scared or embarrassed to talk about this with our doctor or anyone else if we didn't have it. I thought for sure I had colon cancer when this first started but after all of the tests and researching I know that I have this somewhat harmless but painful condition.
As far as pain is concerned I found that squeezing my anal area in and out continuously for maybe 30 seconds to a minute helps minimize the pain time. I could lay in bed for up to 45 minutes, getting up occasionally thinking I had to do a BM but the squeezing motion(as if you are trying not to poop your pants,sorry about this)helps me more than anything else i have tried.

I am a 50-year old female.  I've had PF for 30 years. Usually for 20 - 60 minutes.  I used to take 3 tylenol right when it hit, but now it usually is gone in 20 minutes, so I figure why bother.  Isn't the first time an eye-opener?  And it's embarassing to try to get help or describe the condition.  I was so relieved when a doctor was finally able to give me a name! (I'd even been to a proctologist who didn't know what I was talking about)

But here's my solution.  The only time it has NOT happened at night was during a soccer game (I was playing).  Which got me to thinking.  It's a butt cramp.  What else causes cramps?  Dehydration, right?  I can be almost guaranteed to get PF during the night if I am dehydrated (drank more than my usual coffee or alcohol, and not enough water).  Try it!  Try drinking more water and see if you get it less frequently, or if you notice the PF might be from being dehydrated. 

I've read that this gets less painful as you get older, and I must say, while it's still painful, I no longer writhe on the floor. 

I have NEVER seen dehydration suggested, which is why I wanted to share.  It makes a lot of sense.  I avoid anything that might dehydrate me (hot tub, excess coffee, etc. . .), and try to drink more water.  I still get PF.  But if I look back on my day, I know it's, "dang, I forgot to drink water."

I always thought mine was menstrual related too, well it actually is but why do men get it too? Maybe is is just something with our periods that make us more susceptible at that particular time.

Hello - I'm a 45 year old male who has been having these episodes 6-8 times a year for 28 years. I mentioned it to a few doctors before one informed me of proctalgia fugax. Very few people know about this - how can someone understand something that you can't see unless they've had it happen to them? I have never passed out from the pain but I have gone very fuzzy, the first time enough so that in the morning I wondered if it really happened. Lying on the cold floor of the bathroom has helped as well as pressure on my lower abdomen and/or anal area. I once read someplace using a clove of garlic as a suppository would help and the handful of times I've tried it, it has. I've also applied cold and hot washcloths to some effect. The baseball/tennis ball idea sounds worth a try. The dehydration angle is interesting - I had an episode tonight (the strongest in some time) and earlier tonight I had a very large cup of coffee and two beers. I think the worst most painful episodes I had were during the first ten years, and they may have been more frequent then, too. I must repeat what others have said: this is an *awful* pain to have to deal with and it's a shame that nothing can be pinpointed as a cause nor a quick dependable relief found. (This statement may be modified by whatever method you've found that works for you. : ) Reading all the ways tried here encourages me that human ingenuity will eventually find a solution.) Good luck to everyone.

lilken said...
What else causes cramps? Dehydration, right? I can be almost guaranteed to get PF during the night if I am dehydrated (drank more than my usual coffee or alcohol, and not enough water). Try it! Try drinking more water and see if you get it less frequently, or if you notice the PF might be from being dehydrated.

I have NEVER seen dehydration suggested, which is why I wanted to share...

I like your theory. A lot. A WHOLE lot. I've had all sorts of problems associated with dehydration, including constipation (which is a correlation I make with my own PF attacks), excess alcohol, etc. Don't do the horizontal mambo thing much these days but I can see getting dehydrated from that activity too, as one young man here said he's had PF after orgasms.

These days I tend to take my prescription drugs, with a couple long drinks of water, right before bedtime so I've not usually been dehydrated overnight, but then I only have a couple of PF attacks a year anyway.

Thanks for your theory--I'm going to pay much closer attention to it now.