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| {{Infobox_Disease |
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| | {{Proctalgia fugax}} |
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| ICD10 = {{ICD10|K|59|4|k|55}} |
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| ICD9 = {{ICD9|564.6}} |
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| | ==[[Proctalgia fugax overview|Overview]]== |
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| ==Overview== | |
| '''Proctalgia fugax''' is a severe, episodic, [[anal]] pain. It can be caused by cramp of the [[pubococcygeus]] or [[levator ani]] muscles. <ref name="isbn0-8247-9409-5">{{cite book |author=Olden, Kevin W. |title=Handbook of functional gastrointestinal disorders |publisher=M. Dekker |location=New York |year=1996 |pages=369 |isbn=0-8247-9409-5 |oclc= |doi=}}</ref>
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| ==Presentation==
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| It most often occurs in the middle of the night<ref name="pmid15690667">{{cite journal |author=Takano M |title=Proctalgia fugax: caused by pudendal neuropathy? |journal=Dis. Colon Rectum |volume=48 |issue=1 |pages=114–20 |year=2005 |pmid=15690667 |doi=}}</ref> and lasts approximately 20 minutes, occasionally 30 minutes or longer. Because pain threshold drops during sleep it intensifies as you go to sleep and wakes the sufferer up again. Most sufferers encounter it less than 6 times a year and can go for many months without an episode. Onset can be in childhood. One study showed that men were affected more commonly than women.<ref name="pmid17164968">{{cite journal |author=de Parades V, Etienney I, Bauer P, Taouk M, Atienza P |title=Proctalgia fugax: demographic and clinical characteristics. What every doctor should know from a prospective study of 54 patients |journal=Dis. Colon Rectum |volume=50 |issue=6 |pages=893–8 |year=2007 |pmid=17164968 |doi=10.1007/s10350-006-0754-4}}</ref>
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| During an episode, the patient feels spasm-like pain in the anus, often misinterpreted as a need to defecate. Simultaneous stimulation of the local autonomic system can cause erection in males. It is a disorder of skeletal muscle, it is recurrent and there is also no known cure. It is not known to be linked to any disease process and data on the number of people afflicted varies, but is more prevalent than usually thought.
| | ==[[Proctalgia fugax historical perspective|Historical Perspective]]== |
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| Like all ordinary [[muscle cramp]]s it is a severe, deep rooted pain.
| | ==[[Proctalgia fugax classification|Classification]]== |
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| It has been reported to occur immediately following ejaculation.
| | ==[[Proctalgia fugax pathophysiology|Pathophysiology]]== |
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| Episodes happen almost always with an empty colon. [[Defecation|Defaecation]] of any faeces present can to worsen the spasm, but may relieve it, or provide a measure of comfort. The pain might subside by itself as the spasm disappears on its own, or may persist or reoccur during the same night. At the time it can seem like 'it will never go away'.
| | ==[[Proctalgia fugax causes|Causes]]== |
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| In males there seems to be some indication that prolonged and tense sexual arousal may lead to an episode later that night.
| | ==[[Proctalgia fugax differential diagnosis|Differentiating Proctalgia Fugax from other Diseases]]== |
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| ==Treatment and prevention== | | ==[[Proctalgia fugax epidemiology and demographics|Epidemiology and Demographics]]== |
| Traditional remedies have ranged from warm baths (if the pain lasts long enough to draw a bath), warm to hot [[enema]]s,<ref name="pmid17949444">{{cite journal |author=Olsen B |title=Proctalgia fugax - a nightmare drowned in enema |journal= |volume= |issue= |pages= |year=2007 |pmid=17949444 |doi=10.1111/j.1463-1318.2007.01399.x}}</ref> relaxation techniques,gentle massage of the anus, and various medications. None of these is effective, however.
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| The use of [[botulinum toxin]] has been proposed<ref name="pmid17168867">{{cite journal |author=Wollina U, Konrad H, Petersen S |title=Botulinum toxin in dermatology - beyond wrinkles and sweat |journal=Journal of cosmetic dermatology |volume=4 |issue=4 |pages=223–7 |year=2005 |pmid=17168867 |doi=10.1111/j.1473-2165.2005.00195.x}}</ref>, as has [[diazepam]].<ref>{{cite web |url=http://www.aafp.org/afp/20010615/2391.html |title=Common Anorectal Conditions: Part I. Symptoms and Complaints - June 15, 2001 - American Family Physician |accessdate=2007-11-17 |format= |work=}}</ref>
| | ==[[Proctalgia fugax risk factors|Risk Factors]]== |
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| An episode may sometimes be avoided by making sure not to engage in sexual activity within a close time proximity to defecation. Those afflicted can usually tell after either sex or after defecation whether they would be in danger of an episode if they were to engage in the other activity, the potential onset of an episode being usually preceded by a very slight version of the pain that will eventually become much more intense.
| | ==[[Proctalgia fugax screening|Screening]]== |
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| Several people have expirienced relief by cold water [[enema]].
| | ==[[Proctalgia fugax natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| Also, moist heat, for example a warm wet towel has been reported to have more or less effect.
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| ==References== | | ==Diagnosis== |
| {{reflist}}
| | [[Proctalgia fugax history and symptoms|History and Symptoms]] | [[Proctalgia fugax physical examination|Physical Examination]] | [[Proctalgia fugax laboratory findings|Laboratory Findings]] | [[Proctalgia fugax abdominal x ray|Abdominal X Ray]] | [[Proctalgia fugax CT|CT]] | [[Proctalgia fugax MRI|MRI]] | [[Proctalgia fugax ultrasound|Ultrasound]] | [[Proctalgia fugax other imaging findings|Other Imaging Findings]] | [[Proctalgia fugax other diagnostic studies|Other Diagnostic Studies]] |
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| ==External links== | | ==Treatment== |
| * [http://menshealth.about.com/cs/embarrassments/g/proctalgia.htm About.com]
| | [[Proctalgia fugax medical therapy|Medical Therapy]] | [[Proctalgia fugax surgery|Surgery]] | [[Proctalgia fugax primary prevention|Primary Prevention]] | [[Proctalgia fugax secondary prevention|Secondary Prevention]] | [[Proctalgia fugax cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Proctalgia fugax future or investigational therapies|Future or Investigational Therapies]] |
| * [http://www.medic8.com/healthguide/articles/proctalgiafugax.html Medic8® Family Health Guide]
| | ==Case Studies== |
| * [http://www.gihealth.com/html/education/proctalgiaFugax.html Three Rivers Endoscopy Center]
| | [[Proctalgia fugax case study one|Case #1]] |
| * [http://www.embarrassingproblems.co.uk/anal_pain.htm healthpress.co.uk]
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| {{SIB}}
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| {{Gastroenterology}} | | {{Gastroenterology}} |
| [[nl:Anaal spasme]] | | [[nl:Anaal spasme]] |
| [[es:Proctalgia fugax]] | | [[es:Proctalgia fugax]] |
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| {{WikiDoc Help Menu}} | | {{WikiDoc Help Menu}} |
| {{WikiDoc Sources}} | | {{WikiDoc Sources}} |
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| [[Category:Proctology]]
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| [[Category:Gastroenterology]] | | [[Category:Gastroenterology]] |
| [[Category:Mature chapter]]
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| [[Category:Disease]] | | [[Category:Disease]] |
| [[Category:Needs patient information]]
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