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Medically reviewed by Alana Biggers, M.D., MPH — Written by Valencia Higuera on May 2, 2017
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Proctalgia fugax refers to the sudden onset of severe pain in the rectum area, which can last from seconds to minutes. The pain is sporadic and can be without warning.
The condition is also known as functional recurrent anorectal pain. It is part of a group of disorders that affect the workings of the stomach and intestine.
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For some people with proctalgia fugax, they may experience severe muscle cramps in their anal canal.
Proctalgia fugax means “anal pain of unknown cause.” As the name suggests, the exact cause of the condition is unclear, but the pain is due to muscles in the anal canal and pelvic floor tightening suddenly.
This muscle tightening is called spasming. It is believed that spasms occur in the smooth muscles of the anal canal and the anal sphincter.
Some people may experience sudden and severe muscle cramps in their anal canal. These spasms are more likely to occur at night than at other times. Some people may experience several episodes of anal pain, and then go long periods without any problems.
Though proctalgia can occur without warning, the condition does have many triggers. These triggers can include:
Proctalgia fugax may be more likely to occur after treatments for certain other conditions. These treatments include sclerotherapy for hemorrhoids and vaginal hysterectomy.
As the symptoms vary from person to person and are similar to other medical conditions, similar conditions must be ruled out before making a definite diagnosis. These conditions can include hemorrhoids, abscesses, and fissures.
Diagnosis involves a thorough medical examination, including of the genital region. The doctor may also order blood tests and an endoscopy test to look at the lining of the bowel. An endoscopy test is when a doctor puts a small flexible tube into the body that has a light and camera.
In most cases, tests cannot confirm a diagnosis of proctalgia fugax specifically. Instead, the examinations can exclude other, more serious conditions.
Anorectal pain is pain that affects the anus or rectum.
Levator ani syndrome is similar to proctalgia fugax but has a different pattern of pain. Levator ani syndrome causes spasms in the pelvic floor muscles. This is typically a result of injury in or around the pelvis, torso, or back.
Another condition that causes anal pain is a thrombosed external hemorrhoid. Here, a blood clot forms in an outer hemorrhoid in the anal skin. Larger clots can cause pain when walking, sitting, or when having a bowel movement.
Other anorectal pain syndromes include:
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A warm bath may help to relieve the pain by relaxing the anal sphincter.
Proctalgia fugax does not cause any lasting damage to people, but it is painful. Treatment focuses mostly on pain relief.
There are treatment options that may help to relax the anal muscles and keep them from spasming. These include:
The problem is that the effectiveness of these treatments vary greatly. As the proctalgia fugax episodes can occur without warning and last a short amount of time, medicine often does not take effect in time. Most people do not worry about taking medicine and instead just let the episodes pass.
There are, however, some natural treatment remedies that people can try to help relieve the pain:
Treatment for anorectal pain syndromes varies depending on the type. Many conditions simply heal on their own, over time.
Over-the-counter creams and pain relievers work for many people. In some instances, antibiotics may be necessary to fight infections. Surgery or other procedures may also be needed.
There are some measures that people can take to try and relieve their anorectal syndromes. Eating more fruits and vegetables is a good start.
Vegetables, whole grains, exercise, and stool softeners help with bowel movements. They help to keep people from getting constipated as well as reducing strain and easing the pain. Over-the-counter hemorrhoid cream and pain relievers can also help to clear up mild cases.
Proctalgia fugax is not life-threatening and causes more discomfort than anything. There are many causes of anal pain but most are easily treatable.
Most anorectal pain syndromes are not dangerous, but it is important to understand when to contact a doctor. People should seek immediate treatment if their anal pain does not go away within 24 to 48 hours, or if they experience any of the following symptoms:
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Over-the-counter creams may help to reduce symptoms for people with proctalgia fugax.
People should also pay attention to any changes in bowel movement. A doctor will want to know exactly what has been going on so they can treat the person. Rectal bleeding is especially dangerous as it can be a sign of colon cancer.
Anorectal bleeding can be caused by hemorrhoids, fissures, polyps, or inflammatory bowel disease. Any bleeding should be carefully looked at and diagnosed. Anal cancer is also a possibility.
A colonoscopy may be needed to discover the reason for the bleeding. This procedure is a form of endoscopy, where a special tube with a light and camera is inserted into the colon through the rectum.
Most causes of anal pain are not related to cancer, but tumors can cause bleeding, pain, and changes in bowel habits. Early detection is the key to successful treatment of all anorectal pain syndromes.
Last medically reviewed on May 2, 2017
Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
Medically reviewed by Alana Biggers, M.D., MPH — Written by Valencia Higuera on May 2, 2017
Medically reviewed by Daniel Murrell, MD
Medically reviewed by University of Illinois
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© 2004-2021 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional

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Anal pain (pain in the bottom) can be distressing, but it's often just the result of a minor, treatable problem.
The medical name for pain in and around the anus or rectum is proctalgia.
An anal fissure is a small tear in the skin of the anus that can be caused by passing a large or hard poo.
Symptoms of an anal fissure include:
Anal fissures can be very painful, but many heal on their own in a few weeks.
Eating more fibre, drinking plenty of fluids and taking laxatives and over-the-counter painkillers can help.
If the pain persists, you may need special ointment that relaxes the ring of muscle around your anus.
Occasionally, you may need surgery to help the fissure heal.
Piles) are swollen blood vessels that are found inside or around your bottom (anus). They're often thought to be caused by straining on the toilet as a result of constipation.
In many cases, piles do not cause symptoms. If you do have symptoms, they may include:
The symptoms often pass after a few days. Eating more fibre, drinking plenty of fluids and taking laxatives and over-the-counter painkillers can help.
If the blood supply to the pile has been blocked by a clot, a simple procedure can be carried out to remove the clot under local anaesthetic (where the area is numbed).
An anal fistula is a small tunnel that develops between the end of the bowel and the skin near the anus. It's usually caused by an infection near the anus resulting in a collection of pus (an abscess).
Symptoms of an anal fistula or abscess can include:
Your GP may prescribe antibiotics if an abscess is picked up early on. If it persists, it may need to be drained in hospital, possibly under general anaesthetic (while you're asleep).
If a fistula develops, you'll usually need surgery because they rarely heal by themselves.
Less common causes of anal pain include:
Many common causes of anal pain improve with simple self-care treatments, so you do not always need to see your GP.
But it's a good idea to see your GP if:
Do not feel embarrassed to see your GP – anal pain is a common problem that they're used to seeing. Your GP can try to work out what the problem is and give you treatment advice.
They'll probably ask to see your bottom and may carry out a rectal examination (where they gently insert a gloved finger into your bottom) to check for any abnormalities.
If the cause is not immediately obvious, they may refer you to a specialist for advice and further tests.
Page last reviewed: 02 August 2019
Next review due: 02 August 2022

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