You have pain in the butt which comes and goes. You see a doctor. You want to know if you have hemorrhoids or cancer. Well, what else could it be?
There are at least six common causes for rectal and anal pain: pruritus (itch), external thrombosed hemorrhoid (a blood clot), prolapsed internal thrombosed hemorrhoids, fissure (tear), abscess, and fistula (tunnel). Ok, you can add one more condition to the list – proctalgia fugax.
Your next question is, “Doc, what is proctalgia fugax?”
This condition was first described in Ancient Rome over 2000 years ago and still carries the Latin name which translates to “fleeting rectal pain.” It occurs in about 14 percent of healthy people. Seventy five percent of these are women.
Sufferers of this condition often describe waking up from a sound sleep with a sharp pain, often described as stabbing pain “like a knife sticking deep in the rectum.” The pain is usually brief – lasting less than 20 minutes – and disappears as mysteriously as it comes.
Proctalgia fugax falls under the category of “unexplained rectal and anal pain”. Other conditions under this group are levator ani syndrome and coccygodinia.
Let us try and understand some anatomy first.
Colon ends in the pelvis to become sigmoid, rectum and anus. Sigmoid and rectum act as storage area for fecal matter. At a socially convenient place, the anal sphincters (valves) relax to allow us to defecate.
Anal canal is surrounded by two circular muscles known as internal and external sphincters. Rectum is surrounded by and held in place by pelvic floor consisting of a group of muscles called levator ani. Coccyx is the tail end of the spine, not too far from the anal canal.
Proctalgia fugax can begin during sleep, defecation, urination, or intercourse. The character of the pain has been compared to a charlie horse. It may only occur once a year or several times a week. Pain may be severe enough to cause sweating and palpitation. There may be a desire to have a bowel movement, yet pass no stool.
It is thought that a sudden spasm of the levator muscle complex or the sigmoid colon can result in proctalgia fugax. It is believed that people who frequent the toilet are at greatest risk. Professionals, managers, and perfectionists are more likely to be afflicted. Stress and anxiety plays a role in precipitating the pain.
The diagnosis is based almost entirely on the patient’s history. Clinical examination is usually negative. Patients should undergo flexible sigmoidoscopy to screen for other causes of ano-rectal diseases. Careful pelvic and prostate examinations should be undertaken. Ultrasound or CT scan of the pelvis may be necessary.
Patients with levator ani syndrome experience pain for hours to days. The pain is most often constant or rhythmic and may be likened to sitting on a ball or feeling like a ball (or corncob) was inside the rectum. Pain may be caused by defecation, sexual intercourse, sitting for long periods, and stress or anxiety. The pain is probably due to spasm of the pelvic floor muscles.
Coccygodynia is a cramp or ache in the tailbone and typically results from injury to the coccyx or arthritis. Movement of the coccyx can reproduce the pain. Pain from proctalgia fugax, levator syndrome, and coccygodynia may be hard to differentiate.
Treatment is often unrewarding. Some of the measures worth trying are: reassurance, hot baths, bowel regimens, massage therapy, perineal strengthening exercises, pain killers, anti-inflammatory, muscle relaxants, topical nitrates, tranquillizers, calcium channel blockers, acupuncture, and psychiatric evaluation.
Unfortunately, proctalgia fugax is one of the many medical conditions for which there is no good explanation or treatment.
This article was mentioned in my video blog (Had Your Butt Checked Out Lately?) on September 25, 2011.
Topics on my website: Proctalgia fugax and Hemorrhoids.
Thank you for this . It’s a relief to know others are experiencing what you called Proctalgia Fugaxartical. Though horrible, I’m now not in a total panic. The ‘ball’ description is exactly what I go through. The percentage of people that have this is probably higher, as I be a lot of women just won’t mention it! Thanks again.
I just spoke with my Doctor to find that I experience Proctalgia Fugax and knowing this will assist in how I can deal with such episodes. Since episodes have in the past been far between I actually didnt want to bother making a specific appointment for this but my most recent attack was so severe that I had to check it out .. I felt really strange trying to describe the events of an attack but the Doctor soon assured me of the ailment. Just knowing has put me at ease and that in itself is important.
this is going to sound weird, but trust me it works. its all about prevention, because once it starts it has to run its course. the anus is a dry place, so intercourse, sitting or what ever forces the anus “out of place” thats when the cramps start. so if this is what I do. everynight before bed I use KY jell to lube my anus, allowing it to slide back into the natural position, therefore cramps never start. I went from having 10 events a month to maybe 3 or 4 a year. try it youll see.
fantastic and helpful article. I experience this a couple of times a year, no more than 4 tiimes. Aspirin is the only thing that helps along with stretching and walking around. Taking your mind off of it is a big help, distraction and not thinking about the pain makes it go away.
Thank you so much, it sounds like I have proctalgia fugax. I actually told the doctor about it and she just looked at me funny and sent me home without saying anything about it at all. Needless to say… she is not my doctor anymore. However, I never got up the nerve to try to explain the episodes to my new doctor. Anyway. they happen about 3 times a year. I just had an episode where it woke me up out of my sleep and it lasted for about 17 minutes. I am really relieved to know that it is not something really serious. This article helped me a lot. Thanks.
I have been doing a lot of research on this myself. After the birth of my son in Dec 2008 (I had a long, painful labour that ended up being an unplanned c-section), I began experiencing these painful spasms on a daily basis. I guess I have the chronic condition called Levator Ani Syndrome. I’ve had several diagnostic tests done to rule out anything ominous, so am starting physiotherapy, but am unable to find a therapist (would it be a physiotherapist??) who is familiar in treating this specific condition.
Wow thank-you so much for enlightening me on this subject. For years I have suffered and never got an answer from any doctors.
Just recently I went to naturpathy doctor and he came out with the name right away. For me it has been a live and learn experience. With a couple of episodes in the past and having such excruciating pain to the point of fainting. I have found the only relief I get is to supress it before it reaches that point with very hot compresses until it subsides.
Somtimes I get awoken from sleep. long periods of sitting somtimes brings it on, or during intercourse. Usually less than 6 times a year.
I cant believe i have actually found the answer to my problems. My symptoms are exactly that, i wake up in the middle of the night with stabbing pain in my butt. I always just ignored it and hoped it would not happen again, i would take advil and just wait it out and it would go away. I always was trying to thing of ways to explain it to a doctor but all i could think of is that it felt like someone was stabbing me in the but with a knife. I now find out that, that is how people describe it. It is nice to know i am not the only person going through this.
Hi, I also have been really worried about this. Especially with the Farrah Facet cancer story circulating. Actually my pain which only happens occasionally is more stabbing and then it feels like a dull ache that radiates. It is really uncomfortable. I have been really worried about it and have been tested in the past with nothing coming up. I guess it is time for me to have a more thorough exam to make sure it is nothing serious. I am really relieved by all these informative posts. Thanks for sharing. I guess none of us are alone.
Wow, I’ve had this off and on for years and now it has a name. I always called this “the pulling pain,” because it feels exactly like someone is trying to pull all your internal organs out through your anus and vagina. You instinctively want to put pressure on your anus to hold everything in but I found that just the opposite helps a lot. Bear down really hard like you are trying to defecate…it helps a lot!
PS…it sometimes happens to me after orgasm. Other times, it is in the middle of the night.
BABY ASPIRIN–I discovered by trial and error that one baby aspirin, chewed well and not swallowed immediately ( so that it gets into your blood sublingually and therefore almost immediately) will abort the pain of proctalgia fugax very quickly–under five minutes. I keep a bottle of baby aspirin beside my bed . The old-fashioned kind of baby aspriin, orange-flavored, and not the newer coated type, is best because the taste is not bad when chewed.This has never failed for me. I have an attack every couple of months.
I have had this condition (I think) for years and it occurs about monthly. About four months ago I somehow made a connection to how I sleep. I often roll over onto my stomach and habitually pull my left leg up so I am sort of half on my side with one knee pulled up in a fetal like position, the other straight. I find it comfortable – always have. Because this wonderful “fugax” always starts in my sleep I am not really clear on my position when it starts. I used to think that I was maybe rolling over and pulling my leg up for comfort as it was coming on as I always seem to be coming awake in this position and in pain. Now, I slowly have started to realize that I feel a connection, a pull, between my raised leg and my anus and I have started to suspect that this sleeping position is actually bringing on the episode.
So, for the last four months I have been making a concious effort not to do this. I either pull both legs up (a full side sleeping almost fetal position) or both legs straight. I have now gone four months without an episode. This is not conclusive, of course, but I am sleepless tonight and for once it is not connected to a pain in the ___ so I thought I would share this.
Wow, my gynecologist couldn’t even diagnose this. I am like Lynda, but more specific, I have painful bouts if I orgasm while ovulating. My gynecologist did mention that a lack of testosterone after 35 and the weakening of my lining between vagina and anus may be the cause, but of what? I have almost passed out due to the pain but get through knowing I will live now that it has happened to me more than once. The first time almost killed me with fear.
I Have had a problem similar to Lynda’s for many years. The episodes are infrequent but seem to be increasing in intensity and duration. Last night I had two episodes. The first was quite severe and was triggered by a bowel movement. I found myself doing a lot of pacing until it subsided. It was the first time it was so severe and lasted so long. I really did not know how to help myself. I usually just let it run its course. I am glad that I read the postings on this site and I plan to implement some of the suggestions next time.
Lots of good information on this strange topis
It’s true, it’s like stabbing or moving sharp glass on the skin make broses…
I agree , it might be related to perfectionists or very sensitive personalities, where we are keeping any discomforting or annoying situations inside us and not releasing or venting it out…
We need to change our ways of dealing with life, I will keep on trying…
I am 26 yr old black female, I have never had an STD or any other medical problems in my pelvic area. I have been coping with chronic pelvic pain for 7 yrs. I have had paps, 2 ultrasounds, xrays and a colonoscopy but nothing has ever been found. Here are my symptoms: Throbbing pain in pelvic area (around where uterus and fallopian tubes are) Throbbing pain in lower rectum Pains sometime occur simultaneously Pain occurs before and/or after using bathroom Pain sometimes occurs during sex or after orgasm Pain occurs often during anytime of the day (including the middle of the night which wakes me) Pain is less frequent and not as strong during and immediately after menstrual cycle. Pain is immediate after eating spicy food. Pain occurs during exercise. Pain sometimes occurs when I am stressed. There is also a sharp pain when the wall between vagina and rectum is touched during sex or when I use those muscles down there ( sneeze, got to bathroom, pass gas)
I usually experience relief a couple minutes after using the bathroom. Bowel movements are often small though it feels larger before passing. There has been blood in stool but only 3 times in 7yrs which all can be explained by constipation or diarrhea. I have gas all the time (fortunately there no odor) I feel nauseous from time to time and some times if feel faint and sweaty during an episode.
I believe the issue is in my rectum because that’s where the pain occurs most often especially when I need to go #2. It is also affected by some foods, though I haven’t exactly figured out all of them. I just found out about proctalgia fugax online today and I think this is what I have. It makes me feel better already to know that I am not alone.
Thank you for your article. My husband is having his second episode tonight and the pain is unbearable.
My husband mentioned this to his Doctor at his last visit and the Doc said to take a dose of his Nitro spray. He said some people get this in their lifetime at times and called it "Phantom Pain". He said it may never happen again in my husbands lifetime. Well, here is his second episode. Oh, we changed Doctor's by the way as he was very uncaring and should have retired years ago.
So, after reading these articles, my husband will use hot compresses, try to bear down, have a hot bath, luckily he has a morphine pill to take and we'll pray it doesn't last long tonight.
Thanks everyone.
This article and all of your comments have been so helpful. I am now 99% sure this is what I have.
I have been getting these pains for the last year and finally decided that I had better see my doctor. When I had described all of the same symptoms that are in this articel she said, "Well, I've never heard of anything like that," and looked at me like I was nuts. When I insisted that the pain was real, she sent me for a prostate exam and an ultrasound. That was three months ago and I never heard word of any test results… I had come to the conclusion that I must be having some sort of OCD attack and that I was imagining things.
Thank you for the article… I'm certainly going to be shopping for a new Doctor.
I have the same experience when I take a few days off from training. I get it back quickly, and the awkwardness does go away too. I hear some folks can come back stronger even after taking 2 weeks off. I guess it depends on the person.
What a relief to have found this article and related posts. I have suffered from this for 11 years now. The episodes are more frequent (from two a year to at least 2 a week) and painful then when they started. My doctor sent me for a colonoscopy, which revealed nothing , and I have just been dealing with the pain ever since as he did not have an explanation for the pain. It is difficult for others to understand what you are going through when you are pacing around whimpering and cursing at the mystery pain. I am glad to know there is a medical term for it, that others suffer as I do, and that it is not all in my head. I find bearing down helps for a bit, then when the pain starts to cut through that, I do the opposite and tighten the sphincter, and repeat back and forth until it is gone.
HI,
I am a 22 year old female and I have had these shooting pains occur sporadically for about 4 years. I passed out at work because of it once. I think more people have this than we think, because it is considered embarrassing to talk about, especially for women. Here is the interesting part: my grandfather has them and so does my uncle (who also passed out from it). My grandfather found, through experimenting with his diet, that if he ate processed meat the pain would happen. As soon as he cut out processed meat, the pain stopped happening. My uncle started doing this and same happened with him – he stopped getting the pain. A very health-conscious guy, my grandfather has decided it's the nitrates in the meat (who knows?). I have been trying to cut out processed meats and have the cramp very rarely. When I do get it, I think back to what I ate the night before and it's usually some sort of processed meat or meat at a restaurant. After talking about this with my boyfriend, he admitted to having the pain occasionally as well. He gets it a lot more rarely than me though. Hope this helps some of you. I would be curious to hear back about whether it makes a difference or not. My pain is shooting, sometimes unbearable, never lasts more than 30sec or so, and happens during the day.
Hello. This is kind of an “unconventional” question , but have other visitors asked you how get the menu bar to look like you’ve got it? I also have a blog and am really looking to alter around the theme, however am scared to death to mess with it for fear of the search engines punishing me. I am very new to all of this …so i am just not positive exactly how to try to to it all yet. I’ll just keep working on it one day at a time Thanks for any help you can offer here.
I have had these for years. I read that a puff or two from an asthma inhaler helps if its salbutamol and it seems to help. I know that hot baths and compresses help but they aren’t quick enough so what I do now is I keep a hair dryer close by. When I feel the pain coming I hit it with the heat from the hair dryer, as hot as I can take it and I massage the area aggressively. I helps to shorten the episodes and make them bearable cus with the dryer you can get heat on it right away.
what a great forum to read others’ experiences – thank you especially to bill… i usually sleep with one leg tucked up under me, exactly as he described. i am so glad that i may have found a solution by simply sleeping with both of my legs straight. i’m a 29 year old woman, and have the attacks about once a month – i wake up from a dead sleep and they last about 30 minutes. i finally got the courage to talk to my husband about my pain; he is an emergency room physician and immediately told me the name of this condition. he said it’s more common than people think, because nobody wants to admit this kind of pain to their physicians.
This has been happening to me for quite a while now, at least two years. Exact same symptoms as described above, during the night, extreme stabbing pain deep in the rectum. Quite scary at times. Even if there is no treatment or cure, after reading this article it is good to know that the condition is not serious and that I am not being paranoid with these symptoms.
OMG I have searched so many times for this and never found this condition. This started for me about 6 years ago when it happened one night after masturbation. It occured once or twice a year either randomly at night or after sexual activity, over the last two years it has gotten to the point of happening randomly every few weeks to every few months. I have tried painkillers, hot showers to no avail. I find sitting on the toilet seems to help a little, but not much. All I found before was prostate issues, but this is definately my problem. I will bring it up with my Doctor at my next physical now that it has a name!
I have suffered with this sort of pain since the early nineties. It was about once or twice a year at first. Then it got to be a lot worse over the years. Now I am having this pain almost weekly, in not at least every 8 to 10 days. Last night I had two episodes.
I have been to one doctor after another. I have had every test you can think of and I hope I never have another colon test! After the last one in 2005, I passed out and my husband could not get a pulse for a few seconds. I was very sick.
I am so tired of this. I had an MRI again and do have several bulging dics and a narrowing spine, and was sent to a neuritis surgeon who sent me away within five minutes. So, I still have the bulging dics, and I still have the back pain, and I still have the pain in the rear!
I looked up different things last night. I now know what to tell the Doctor about this and hopefully they can help me. I find that I can’t even stand, or sit. I have to lay on my stomach with the heating pad on high! I just lay there and cry til it passes! I have it not just in the middle of the night, it can be in the middle of the day, early morning, or anytime!
I have emailed my family doctor and asked questions.
I am praying for some help.
Eureka, I’m ecstatic to find a name for this hideous condition. I have been experiencing this awful condition for 13yrs or more. I had mentioned (awkwardly) to my Dr trying to explain symptoms and getting quite a vacant response but as I have changed Dr’s over the yrs finally my latest Dr who (honestly said she had know idea) has taken me more seriously and sent me to a specialist who also had know idea and I am presently waiting to have a colonoscopy done, so in the meantime I thought i will have another go at googling symptoms and after many searches FINALLY found EXACTLY my symptoms – 90% of the time I am woken in the middle of the night although I have experienced pain during the day. When it comes while I am alert I no exactly what I am in for and almost have an anxiety attack also as it usually is severe pain lasting around 45-60mins. I found quite recently if I can have a bowel movement or even expel gas it relieves it greatly otherwise I have slight relief by kneeling over my sofa for the duration of the attack. The pain will leave as quickly as it comes very bizarre. I have realised my attacks are definetly stress related and started around the time I seperated from my husband and now if I am experiencing emotional or overly physical stressful occasions it will bring on an attack. Now that I know I this Pain in the Butt has a REAL name Proctalgia Fugax (still struggling how to pronounce it though
I can confidently go to my Dr and share the info with them to help all those other unknowing sufferers out there.
Thank you
OMG- I am 32 years old with 2 kids. I have been experiencing these same symptoms for several years now and every doctor tells me it is IBS (which means I really dont know)! I feel much relief reading the posts and seeing that I am not the only one going through this. This is a very painful problem, to the point I went to the ER and was given Morphine, which only helped for 7 minutes! I was starting to think that I was going CRAZY and I think my husband thought so as well.
Today is a GREAT DAY, since I have finally found out that I am not NUTS! lol. Thanks for all the posts…
Good Luck to all..
I have been suffering with proctalgia fugax/rectal pain for almost 2 years. It does not wake or keep me up, but is painful all day after a bowel movement. I had an anorectal manometry and the balloon could not be felt at 20cc, 40cc, 60cc, or even 80 cc suggesting neurological deficit. As of 2 months ago, I now have peripheral neuropathy in my left foot. I am so desperate for help!
My son had an episode followed by synascope, causing him to pass out breaking several of the bones in his faces, he had to have facial surgery. He has learned to notice the initial symtoms and that he can not get up no matter how bad he wants to get up until the pain passes.
Thanks, this is what I was looking for!
I am so happy to have found this site, because it’s described what I am feeling to a “T” (as in nothing happening in the Toilet) It’s three am and I was awokened once again from sleep (doesn’t happen often, a few times a year – but man-oh-man – Pain in the Butt!!) feeling much like I was in labour again (four kids, no more thanks!) but unable to do much but pace around, stretch and want to hurl pillows at my sleeping husband. Turns out, I did go to bed tonight with heavy thoughts in my mind, so perhaps it’s true that stress seems to bring this on. Thank goodness for the internet, and all you brave souls searching desperately in the wee hours for relief from this!! There … it’s gone now. :-}
I am a Male, 40 yrs, & have been experiencing this problem Proctaglia -F for almost 15 years without knowing what it is called & never even went to doctor though I was concerned that this could lead to some dangerous situation later.
Today I am relieved to know that there is a name for this & many are having it.
In my case this episode happens only when I force the bowels a bit for complete expulsion, & particularly when I use toilet within 2-3 hrs of previous visit & again if it is a little forceful. This happens in my observation if we are not taking lot of fluids.
The usual relief is through an aspirin or a paracetamol/diclofenac.
Recently I experienced when I was in the middle of a Ping pong game after about 90 minutes of visit to toilet, in the evening.
For me it is usually in the night as everybody here, but again because I usually go to toilet before sleep. I wonder if PF can happen even without a visit to toilet, because not many are correlating these two, apart from sexual activity (which is not my case).
I found kneeling with a curled back provides some relief & sometimes bypass the episode. May be this allows the muscle to contract without tension.
I’m a 28. My spasms are very random (without a pattern/schedule) and always happen during the day. Mostly when I’m standing up. I could be walking and out of the blue as if someone sticks a sharp object far up my ass. Usually I would jump up and even gasp if it’s really bad. I have learned not to “jump up” anymore. But it is very painful and sudden. And just as suddenly it’s gone. It usually lasts for just a second. I will rarely get 2, maybe 3 in a row. About 3-5 second apart. That’s it. Never had one that lasted as long as most of you have described.
I am gay and I do have receiving anal intercourse with my partner of 8 years. So I don’t think this could be an STD. However, we do not use condoms (because both of us have never had other partners). I wonder if a contributing factor could be trauma/tears to my rectum. Usually that is attributed to anal intercourse. I don’t think I have had any such spasms before becoming sexually active.
So what about treatment options. I understand the whole taking your mind off it thing, and sitting on a towel and everything for it to go away. But what about actual treatment? Plus in my situation there is no time to react. There is just pain, as if someone sneaks up on you, and then it’s instantly gone. Has anyone talked to their doctor since? If so, could you share what their treatment plan was?
Thanks in advance!
At first suggestion of attack, I set a heating pad on “high” and sit or lie on it for a few minutes. Pain is gone.
Am so glad I found this sight. Just came back from a colonoscope to see what has been causing this excrutiating pain since June 2120. My family doctor would only tell me to buy and use first, anusol, then had me try prep H. This was not even coming close to help with the severe cronic stabbing pain I’ve been enduring 24/7. Finally my 3rd trip to emerge to having a wonderful doctor finally see first hand the pain I was in, gave me a prescription for NITROL.Yup the nitrol on my ass has been my only saving grace to get me through every day since June. Now with the colonoscope done today and a diagnosis of proctalagia fungax, I will try this new prescription and hope it works wonders as the side effects of using nitrol has been unbearable head-aches!
Like the above posts I too have suffered for years. I have tried many remedies and the only one I find to be somewhat helpful is to sit in a shallow and excruciatingly hot bath. I am not sure if it is the shock or distraction of the heat or if it actually helps to retract the rectum but it does help.
I have been experiencing this since I was 10 years – ever since my IBS (irritable bowel syndrome) and anxiety symptoms began. I am now 21 and am a psychology student. Honestly, the best thing that works for me is meditation (mindfulness meditation) and I encourage everyone with this problem to try it! Seriously – it’s amazing how much of a difference altering our perspective on pain can make. Learning to deal with the anxiety, stress, and fear around the pain has made such a difference in my life. I used to be afraid to death of this pain, which would only make it worse and bring on my episodes. But now (after practicing meditation for about a year or so), whenever the pain does occur, I simply think, “Oh, there’s that intense sensation again… Hmm!” and go on about my business. So through meditating, I’ve learned to change my mind-set completely. I also use this to help with my anxiety and depression.
Now I know many of you may be thinking, “Really? How they hell can you react in such a way to something soooo soo painful?” Well, I thought this too at first after I did some reading up on meditation and pain. But I began to realize that this exact label of “soo soo painful” that we attach to the symptom is what prevents the pain from subsiding. So I decided to drop this label, and just TRY looking at it as simply an “intense sensation.” So I meditated. By doing this, I took away some of the power that the pain held over me. The power that once elicited fear in me, which alwaysss made the pain worse, was gone. I realized, I hold the power over this sensation – it is separate from me. It’s just a sensation. Ever since I’ve been practicing this technique, I rarely have many intense episodes. And even when I notice the sensation coming on, I just view it as no big deal, and off it goes!
So really, I encourage ALL of you to try meditating! You should begin to try it when you don’t have the pain so that you can get some practice in before trying it when the pain arises. I realize everyone’s experience with it is different and this may not work for everyone – but hey, it’s worth a shot right?
Everytime I have gone on the Master Cleanse , which consists of lemon water, maple syrup and cayenne pepper, I have experienced the symptons of Proctalgia Fugax. One time, I actually fainted because the pain was so intense. I don’t know if it is one of the ingredients in particular, or the combination that does not work for me, but I only experience this excruciating pain when I have been on this cleanse.
I cannot begin to describe how relieved I am right now to have found this website! I’m 41 and I’ve been having these for the last two years, 2-3 times a month. I’ve been too embarrassed to go to the doctors or even tell my husband. It wakes me up at night from a deep sleep or when I feel panicked about work. The pain is excruciating, feels like someone is squeezing the life out of the rectal area to the point of fainting. Hot baths is the only thing that gives me relief but it’s not always convenient when I’m at work. I will try the baby aspirin though. Thanks for the advice.
Hi! I too have Proctalgiafugax it is a total pain in the butt! Butt having seen a leading colorectal surgeon for another mater she firstly diagnosed the pain for me (I had been suffering for over 10 years and no one knew what it was) and two prescribed a ventolin inhaler – yep the blue one that a lot of people use for asthma! It works like a dream for me in seconds! It has changed my life! I sleep with out fear of the pain from hell and keep one inhaler under my pillow and another with me at all times … it works in seconds and I now do not take pain killers for it – well they were mostly pointless anyway as by the time they worked the pain was leaving anyways.
Hope it works for you too!
Found ref to it on wiki:
http://en.wikipedia.org/wiki/Proctalgia_fugax
In patients who suffer frequent, severe, prolonged attacks, inhaled salbutamol has been shown in some studies to reduce their duration
Very happy to see a name put to the condition. I have suffered from this since I was 15 years old – still vividly remember the first frightening event. I am now 53 and it still occurs on a very irregular schedule.
What I do know:
– If I drink rum I will frequently have an event within 48 hours
– My events sometimes subside in a 1/2 hour but are usually much longer – longest one was about 10 hours and took place the evening of my daughters 11th Birthday party which I was soley supervising – 8 kids to tend to – tough night
– Pushing hard during a BM is a guarenteed trigger
– Stress is definately a factor – I have had events in the middle of 3 major life moments
– Have had it several times during sex – definately associated with effort and orgasm
– the pain varies a bit in intensity and location the BM pain is in a slightly different spot than the orgasm pain. Neither is pleasant, but at it’s worst … I would do almost anything to get it to subside
– The only thing that ever helped during an extended event was oxycotin. I have tried several other pain killing drugs for relief including atasol 30s and demerol – no joy. I got the oxy from a guy I knew from work who is a druggie and though it worked I was never comfortable using it due to it’s reputation. It was 15% with aceteminophin and did not kill the pain but just left me feeling ok with it. Used it 4 times and once even that didn’t do the trick.
– Get it anywhere from once a day to once a year – recently been getting it a couple of times a week, but I have been having a drink more often lately
– it seems to be affected by BM regularity – if I miss a bm – look out.
– I believe it is genetic – one brother has exactly the same symtoms, my sister and mother get it as well.
I have spent alot of hours suffering with thus over the years and the fact that it is not well documented meant that the doctors that I have consulted with never put a name on it. One was even dismissive about it sarcastically asking me “well what do you think it is?” That occured after the first event.
Anyway – hope that info is useful to someone.
Although it is sad to know that others are suffering from this disorder, it does help to know others share my unique understanding of the “visiter” as my brother and I call it.
Hi everyone,
I have had PF for the last 10 years, I’m now 44 and each episode usually last 30min to an hour or more! Extreme bouts sometimes includes fainting too. For relief I have tried asthma inhalers without any relief but usually use heat packs or packs filled with flax seeds that you heat up in the microwave then sit on it until the pain subsides or goes away. I have also used marijuana and ingested brownies made with marijuana for relief as well. Attacks usual occur after having a bowel movement or a couple hours after an orgasm. Massaging of anal area has varied results too.
Thank God I found this site. I first had this at age 30, and not again until recently– I’m 51 now. It’s happened about 5 times. The first time it happened, I lost consciousness because the pain was so intense. It started in bed in the middle of the night, a sudden, intense pain in a very specific spot. The pain seemed to be getting worse and worse pretty fast, and I felt I should head to the bathroom which was downstairs. I passed out at the top of the stairs and woke up later, at the bottom of the stairs. My husband called an ambulance and the ER docs were unhelpful. My regular doc hadn’t heard of it either. I always described it as an “anal anneurism”, and thought that the loss of consciousness had a more direct and dangerous connection to the rectal pain. Because of these posts, I know that it’s not dangerous, that I won’t lose consciousness each time and that it will pass. When I feel it coming on I draw a very hot bath and it’s usually gone in 5 minutes. Thank you to everyone who shared their experience here!
Wow.. I am also glad to have found this website and the information here. Luckily before spending alot of time, energy, doctors or tests on it. In the last few months I have been having this pain after a BM that is so intense that I can’t stand up straight and no position gives me relief. It has a very sudden onset and is so intense I am almost crying from the pain. The first one lasted 2 days, the second 1 day with the help of muscle relaxers and laxitives. This last one lasted about 15 mins and I was completely confused when it went totally away with nothing but the heat from my hand. I figured after 3 bouts of it, I really should look into this. I also have been diagnosed with fibromyalgia so I am used of having fantom pains and usually just try my best to ignore the pain. This is one pain that I have not been able to ignore.
Some of the simularities I have experienced with the posters here are: I just ate a hot dog today. Due to the hot dog I had 2 BM’s within a few hours. It has always happened only after a BM which feels like half of it got stuck. I get the stabbing/cramping pain that has been described here. I found that muscle relaxers helped during the longer episodes.
One thing that I think may have something to do with it: I have recently had an IUD put in for birth control.. It feels like it maybe it moves into a bad spot during a BM and starts the pain.
So once again.. I find out I suffer from a “syndrome” that really isn’t well documented or studied or known, that really has no cure, that isn’t life threatening but is life altering when it occurs. As many mixed emotions as this produces.. at least I didn’t have to wait 15 yrs to be diagnosed with it after being mercilessly poked and prodded by tests that reveal nothing. I am very grateful for that!! I will definitely not eat any more heavily processed meats!!!
Thanks to everyone for sharing their symptoms and ideas!!
For those not experienced this, the pain is excruciating!!!! It is horrible and sometimes scary. I will try the baby Aspirin trick. Also I noticed that if I lie on my right side down curled in a ball, and totally relax my bum muscles instead of tightening them which is what my body wants to do, it tends to make it more “tolerable” but only slightly so. I also find controlling my breathing and not breathing too fast helps. The worst is when it happens in public and not at night when you are in the privacy of your bed and can grimace as much as you want though mostly it happens at night.
I’ve had this problem since I was in my teens (I’m now in my 30′s). At times it has occurred weekly and at other times it has left me alone for a year at a time. Most of the time it only lasts 10-20 minutes but at times has lasted up to an hour and has been excruciating. What I am most certain about is that it is stress-induced. My dad also suffered from this problem so it appears to be genetically linked.
I’m one of those who had to search for a doctor who cared enough to help me find some sort of solution, and he seemingly did! He prescribed an Albuterol inhaler. He told me it seems strange but assured me that the muscle relaxant pumped into the lungs is quickly absorbed into the blood-stream. Whether or not this was meant to be a placebo, it seems that it often helps and I’ve been using this method for about five years. Perhaps this will work for others.
I’ve suffered this agonising condition [on top of severe ibs pain] for years. Over the last year it has become much worse. The pain makes we want to scream at times- it’s pure torture. I haven’t yet tried Salbutamol [a friend has given me a spare inhaler], but I’ll give it a go next time the pain lasts for more than a few seconds. It’s good to know that others share my pain- if you understand what I mean!!
Thanks for a place like this to share stories. I liken the pain to birthing a baby , but through the rectum. It first occured in me about 10 years ago and I have had periodic episodes ever since. I have no IBS, no do I have any other health issues that would lead to this condition. I do find that If I sit for long periods of time, I get pain in the cocyx, followed by the rectal spasm. Walking helps me. I do have a high stress job and I am a relatively high stress person, so I have had to learn to relax through the spasm. I take Tylenol, too. Sometimes it helps, sometimes not.
I have found that taking Psyllium Husk daily, mixed into a glass of water or a shake, significantly reduces the occurrences. It works wonders! When I’m faithful to the Husk, life is good!
I highly recommend you give it a try. You can buy it where you find bulk foods, in stores like Sunflower or Sprouts – and it’s pretty cheap.
I’m so glad I came across this website. For so long I’ve been wondering why I sometimes feel like my anus has been turned into a kabob or held up at knife point. The pain is random and intense, but in a bad way. I have never found a cause for the pain personally. I’ve been suffering from this since I was very young and kept it to myself. This is so liberating to discover that others have the same condition and experiences as I. Kind of like coming out of the closet or confessing to a murder…. ah I’m soooo relieved!
This should help a lot of people… I’m a male and have been suffering with this for over a year now. It got so bad that my pelvic floor was tightened to the point where I had to use enemas to defecate, and could not go without them. I also have a nonrelaxing puborectalis. I go to a physical therapist once a week for one year. She massages my pelvic area and rectum (digitally with her finger).
This is what has really helped (in two very drastic phases).
1. Compounded Suppositories with Baclofen, Lidocain, Valium.
2. Botox injections into the puberectalis and pelvic floor(coupled with an anti-imflammatory steriod). I searched far and wide for a Dr in the states who would actually do it. Here’s his name.. Dr. Winston in San Antonio, Texas. He’s a colorectal Dr.
You will have drastic improvements with these two things. I did need both.
Also sitting on a heating pad helps. Hot baths help, but not as much as the heating pad. Nifedipine ointment can give mild relief as well. But if you have really bad, get the suppositories first, if they don’t 100% do the trick (they will help though), then get the botox injections.
I forgot to say.. eat one apple every single day. They provide anti-inflammatory qualities and a source of fiber. The apples should be organic because you’ll be eating them daily and should avoid the high concentration of pesticides that are heavily used on apples… seriously, get organic (they taste better too). I also stay away from Lactose and Gluten… but that’s just me. You might not have to.
I also forgot to say that the pain was so bad for extended periods that I couldn’t get away from it and contemplated suicide. If it had not been for my children, I probably would have. I felt like I was being raped by a bull and heavy narcotics weren’t an option as they cause constipation.. which I already severely had.
Thank you God, as I have been praying every nite for an answer. I have found so many angels on this website. I have been to 5 different doctors with no clue as to what I have. In two days I will have a colonoscopy after having a previous anal manometry. Doctor still hasn’t told me the report on that one yet. I have also been scared to thinking I might have cancer (Farrah). But I always have to remember how this all started. The first time I had IT was after I took Miralax for constipation. I can’t remember for how long I had it, but it was for months. My husband had had a pancreatis attack at the time, and I guess now, I thought a miracle had happened for me in that the horrible pain I was in, suddenly just went away. I suppose my mind was just on him since I did not know if he was going to die right then and there in the hospital. That was 3 years ago. The next time I got IT was late Feb. 2011. I have only had relief for 1 day in 5 months. Yes, Bob, I can very relate to you. I also contemplated leaving this world as I am so exhausted and depressed from the pain. Only 4 hours or less into the day I will not have pain, if I am lucky. I cry almost every day. This pain started when I stupidly thought I would hurry things along, using a fleet glycerin suppository. That suppository immediately brought on a horrific spasm, which I am now wondering why they would put such a thing on the store shelf. I try to describe to my sister and daughters the horrible pain. The closest thing I can find is if you have had given birth naturally and had an episyotomy (incision made by the doctor before delivery, for you guys) and the incison never, never, never, heals up. Very painful. The episyotomy is worse than the birthing as the pain last for at least 2 weeks with no relief. I had over 30 stitches. Yes, the pain goes from one end to the other. After trying to describe my pain to my gastro dr., after examing my rear, he said he could see no reason why I should be having that much pain.All he said was, “I’m sorry for all your pain”. And also”, you shouldn’t have put that suppository in you”.No —-! I thought to myself. And then he commenced to giving the nurse orders for the two tests I mentioned. Thanks to you all so much, as you made me laugh and have hope. I will try all the remedies you all offered. I have already tried most of the creams you mentioned and the heating pad and ice pads and asscilces and hot baths, etc. One thing I did that really seemed to help was rubbing Blue Emu cream all over my rectum and my butt, hips,groin area and any where I might feel pain after a hot bath or shower before going to bed. You see, I have chronic pain from having back surgery 20 years ago, and also using my TENS unit and taking Klonopin for my muscle spasms. And also tylenol sparingly as I don’t want to eat my liver up over this. I will definately tell my gastro dr. about this PF syndrome. I now have a name to give the MONSTER. Thanks, for letting me know this is real and I am not crazy. How many are of us are out there and am embarressed to tell?
I have the shooting knife-like pain that comes on in the night or the odd time sitting on a hard surface. Comes on very occasionally.
I’ve found taking the homeopathic remedy ‘Aconite’ 30 eases the pain very quickly. I really try not to go out without it.
Recently didn’t have it with me and walked thru the pain which eased and didn’t get worse.
I am a 52 yr old white male that has been experiencing this for 20 years plus. After consulting with 3 or 4 different doctors with negative results. Finally my fiance googled the symptoms and found what it was and how many other people it has affected. My episodes last about ten to twenty minutes, thirty max. I read where some people recomended anti inflamatory, muscle relaxers, and pain meds. My pain would be gone before any of these would take effect. Then in my younger wilder days I remember trying (N2O) Nitrous Oxcide from a seltzer bottle. This works immediatly, and makes you totally relaxed which I believe will help relax the spasm. I haven’t tried this yet because my fiance just discoved what this was. We are on our way to the head shop to see if we can still buy the Nitrous Oxcide (whippits), and we may have to wait two months before I have another episode to try it. So if anyone reading this is game, you may be able to try it before I have another episode. I do believe this will work. Anything is worth a try when you experience this excruciating pain.
I had my first attack when I was 10 or 11. Try explaining that to your friends….so like many others, I never did. I keep this little secret to myself for almost 40 years. I will be 50 next month and continue to have these pains. I had another attack last night. Because I had found a similar site a couple of weeks ago, when I was woke up once again and could not bear the pain, I had some idea of how to get relief. Looking for the quickest and easiest form of relief I use a hot washcloth as a compress. As hot as I can stand it! It seems to give me enough relief so that I can get back to sleep but in the morning my butt still aches. (Just a dull ache, but an ache non the less. Feels like I am recovering from a swift kick in the butt.) I finally got up the nerve with the last attack to tell my husband. It was so embarrassing and of course he strongly suggested I go see the doctor, which I haven’t yet. It seems like the attacks are coming more frequently the last few months, but if there is no cure ….and obviously I have been living with this a very long time, I think I will just try a few more of the recommended remedies suggested here and hold off on seeing the big DR. Like so many others have experienced, I am tired of the unknowing doctor blaming everything on IBS… Good luck to all my fellow suffers. Sleep tight, ( or should I say relaxed) and God bless us all!
Here’s what works for me, sometimes: I press down hard on my thighs with my straightened arms for as long as the pain continues, or until my arms fail. Somehow, the stretching of the lower back (and possibly the spine) can relieve the pain. I haven’t ever seen this in the literature or comments, so it might be just me. Anything that seems to work, though, is worth trying.
Try THIS during your next proctalgia fugax/rectal pain event:
Straddle or sit on [like on a saddle] the narrow part of a bathtub edge to put pressure on the nerves and muscles around your anus, but well between your hip bones. It works. This was recommended to me by an on call nurse at Group Health in Seattle, whom I never got to thank. So thanks! It stops the pain in a minute or two.
AND, when traveling, I take the very thick cardboard inner tube (it’s 1.75″ dia. & you can’t crush it) from Costco’s [Kirkland] brand of plastic wrap with me as a surrogate to the bathtub edge. If I have an event, especially on an airplane, I have discretely taken the tube out of my camera bag and just sat on it for a couple of minutes to take the pain away. Sounds weird but it works. Plus, TSA has never asked me what it’s for.
Med schools need to train doctors on proctalgia fugax, as with most people, I have described this condition with exacting and excruciating detail with little or no response from our general practitioners.
The only doctor to nail a diagnosis of it on my 1st visit w/ him was actually last week, and he is an older neurosurgeon.
Good health and luck to all,
Marcel
I am an 60 year old male. My first encounter with this condition was while driving, at the age of 17. Very sharp stabbing pains moving me around in the seat, lasted about 60 sec. Very scarey, almost had to pull over. Very rarely get them like that anymore and never have had very many like that again. Now like most I wake up in the middle of the night with the intense dull aching pain that will not subside if I continue lying down. I also sleep on my side with a leg pulled up and the other straight. Does not matter which side with me. I get these randomly maybe 15 -20 times in a year. The episode will last from 10 to 40 minutes. Once the pain starts I can not will it away, I must get up, I can not just lay there and take it. I find the sooner you get up the sooner you can get it to go away. Also with me reaching orgasm too quickly during sex may trigger an episode, or it may not. I also have not found a doctor that knew what this was, even my Gastroenterologist, nor did any of my family have this that I know about. For me relief can be achieved by tricking the body to send blood elsewhere by doing some exercises (squats usually) and walking around or sitting on the toilet and rocking back and forth or sometimes curling up in a ball, knees to chest and hold it, If I return to bed before it completely subsides it will start over again. I will try the heat method next time. So glad to have found this site and thanks to Dr. Bharwani and all who have commented. Looks as though we can look forward to having this for life. Will be just wonderfull to be 90 and have to get up with this, ha!
This is something I have I have been suffering from for almost 20yrs now! I also went to the Dr. only to get a funny look and no answers. That response from the Dr. made me leary to go through medical testing. I just knew they would run all kinds of test on me just to come away with “we really don’t know what’s wrong”. I kept telling my husband if it was serious it would have already killed me! I ended up self diagnosing and figured they were just bowl cramps. But painful!!!! I have passed out from them. Mostly I get them while sleeping but have experienced them during the day. I have had to leave work twice over the years. I have learned to control the pain through trial and error. Hope some of my suggestions help others as this condition can be very scary at times.
1. when an episode starts to hit me in the middle of the night I can usually feel it coming on. I try to relax my body as much as possible. I guess you can call it meditation but I just really try to relax and take some deep breaths. A lot of times this will make it go away. If not then I will usually have to get up and pace for 20 min.
2. I think diet has alot to do with it. To much red meat, cheese ect. will cause episodes
3. Drink plenty of water (which I don’t do and will have more epispodes)
I’m going to try the baby asprin and Inhaler to see how that works. Thank you so much for the suggestions! I printed this article out so my family and Dr. will know what’s going on when I do have an episode.
I started noticing my symptoms about 8-10 years ago and it always only happens during my menstrual period and the pain appears right before my bowel movements. The pain is so severe but as soon as I have my bowel movement, the pain disappears. The worst episode was right after I had my appendectomy in 2009, we went to Key West a few days after my surgery, I had my period while we were in Key West and the pain started while in the car on the way home from our vacation. The pain this time lasted for a few days. It is the most excruciating pain I have ever experienced and for a few days, I couldn’t even sit at all and all I can do freeze & scream in horror as the pain arrives. I saw 3 doctors including my surgeon who did my appendectomy but no one could tell me what was wrong. The pain slowly resolved itself after a few days. I haven’t had another episode until yesterday. This time around, the pain woke me up from a sound sleep, the pain started at end of my period and it lasted all day yesterday and this morning. I will be making an appointment to see my PCP so that I can be referred to whoever needs to see me to rule out other problems (I am definitely convinced that Proctalgia Fugax is what I got). Oddly enough, they seem to be a common problem to professionals, managers & perfectionists?. I was all that at one time when my symptoms first appeared. I’ve been a housewife with no children since 2005.
I just wanted to share this information with you because I am 100% sure that this is my problem although I think I should see a professional to rule out other possible problems. My pain lasted all day yesterday. The pain subsided from 15 minute intervals to 30 minute intervals with the help of 2 Aleves, 1 glass of Fiber, 10mg Alprazolam & I slep on a heating pad (I did not take these meds all at same time. They were spread out throughout the day). Last night, I woke up twice in the middle of the night with the pain and I took 2 tabs of Tylenol at 5am. Had my 1 cup of coffee this morning and took my morning supplements. I had an attack prior to my first bowel movement of the day. I took 2 Aleves and so far……it looks like the episodes had stopped. I only feel a mild residual pain right now. I will describe my pain as……someone just shoved a samurai sword up my ass and is wiggling it around, a bowling ball is trying to get out of my ass, someone lit a dynamite and shoved it up my ass and it is exploding inside me. Bottom line “it’s huge a pain in the ass”!
Definition
The term “proctalgia fugax”, a Greek–Latin hybrid term was coined by Thaysen in 1935 [16], and the condition was more firmly defined then as
1. Attacks that begin suddenly at irregular intervals during the day or night.
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2. Pain spontaneously disappears without leaving any ill effects except a quickly passing lassitude.
3. The localization of the pain in the rectal region is always at the same place.
4. The degree of pain is so severe that some patients feel faint during the attack (no shit!
5. The duration is short, continuing for only a very few minutes in most patients.
6. The pains are very uncomfortable, often described as gnawing, aching or cramp-like.
The pain has been reported to be precipitated by sexual intercourse, masturbation, stress, defaecation and menstruation although it can be largely without a trigger. Conversely, other authors report that it is independent of evacuation. There is also a great variation in the length of the pain from a few seconds to 2 h. The average duration has only been reported twice as 15 min and occurs less than five times per year in 51% of patients.
Presently, it is very clearly defined by the Rome III Criteria as recurrent episodes of recurrent episodes of pain localised to the anus or lower rectum which last from seconds to minutes with no anorectal pain between episodes. Proctalgia fugax is differentiated from chronic proctal- gia, also a functional anorectal pain disorder based on duration, frequency and characteristic quality of pain. It is necessary to exclude other causes of anorectal pain such as haemorrhoids, cryptitis, ischaemia, intramuscular abscess or fissure, rectocele, malignancy and inflammation and to differentiate from other urogenital and pelvic pain disorders when making the diagnosis, and this can be done successfully with the criteria defined.
I am so glad I found this site! I’ve had this for over 30 years now!
And a big thanks re: baby aspirin! I had the start of an attack a few weeks ago and took two….just melted them on my tongue. In a matter of minutes it felt like someone flicked a switch. The pain was gone.
Thanks again!
Funny I found this site while suffering through an attack as we speak. This is about my 6th in 6 years so not too often, I am 34. I thought it may have been dehydration.
I fainted once for 5 seconds luckily as I was falling into a bed. Another time got dizzy and very close to fainting. What a weird penetrating pain, ouch.
Anyway, the nitrous oxide should work, I am going to put 4 bottles of whip cream in my refridge for when this happens again. That stuff relaxes your whole body and fast. I will post back if/when I try it.
I seem to have the same problem. I am 32 yrs old female and the first time I got this was 6 months ago. I was in a hut in the mountains. I thought I am going to die there. After that I had 2 more attacks. Each of them happen for me when I am on my period. Also happens after sitting down of a not so soft chair and standing up. First it begins with a knife cutting pain in my lower abdominal area combined with my bum, as if I need to go to have a BM. I go and sit on the toilet and it gets worse – nothing comes out and the knife cutting gets so intense that I think I am going to faint any second. Last time I was close -everything became white – but maybe I was too scared and was breathing wrong. After 2 visits at the emergency, blood tests and x ray nothing was found. My attacks usually last for about 2 hours and then the stabbing pain transforms into a dull ache and radiates all over my tummy and stomach (still very uncomfortable especially during movements, lying down, standing up, etc).
This dull ache lasts then for about a week.
I have no idea what triggers it – the only similarities of these 3 attacks were:
day 1 or 2 on my period
standing up from a hard chair
thinking heavy thoughts/ being worried/ stressed
The 2 months where nothing happened I was taking magnesium for about a week – as my period cramps are usually really bad. I know for a fact that magnesium has helped me get rid of very bad calf spasms over night. So today I am on my period again (after the last two months I had attacks) and I have been taking magnesium. So I really hopes it will work.
Other things I have tried during these attacks- while I had no clue what was actually happening with me:
Buscopan (cramp relief drug) – small relief –
Baking soda – small relief – thought it will help pass gas or BM
Clonazepam (anxiety drug & muscle relaxant) – small relief – took it because I was freaked out
Novaminsulfon (= metamizole – powerful analgestic drug) – good relief of the stabbing –
Walking – once it helped – the second time: not at all
Drinking water – once – it seemed to have helped now that I think about it
I have also hemorrhoids and been wondering if this affects the severity of it? since many of you seem to have shorter attacks and then it’s all gone.. while I suffer from the “aftermath” for about a week…
Hope the Magnesium idea helps for me now and for you all – it certainly won’t have negative effects. Only one thing, make sure you take it daily!! (300-400 mg dose) and 1x day and after a meal, otherwise it could cause some pretty bad (not long lasting) runs!
So great to read all your stories – I will try the bum pressing, the aspirin and the meditating and maybe the hot bath – but I pray I won’t have to!!!
Wow I am so happy to read all this I have tried most of the tips before I have sat on the toilet at 2 am crying with so much pain hoping my girl won’t hear me! Nice to have a name!!!
Mine started about nine years ago when a certain hard-seated stool came into the house. Sitting on it–especially in front of the computer–relieved some lower back pain, only to be replaced be this excruciating cramp deep in my rectum just behind the tailbone. They never last more than ten minutes, but once when I insisted on getting up to go to the bathroom (even though I knew from past experience that no bowel movement would happen), I fainted twice, once in the bedroom and then in the bathroom– as others have stated, this is probably the most dangerous aspect of the issue: sinks, bathtubs, etc. are hard on the bones! Anyway, through various sites I figured out that sitting on that stool and perhaps the racing saddle of my bike triggered the attacks. I will also note that stress does seem to be a factor: the last two times these attacks occurred, I had given up alcohol for the day–we live in a winemaking region, and those few glass of red wine at the end of the day were my stress releasers.
Fellow sufferer here. I have had bouts since about the age of 17 (I’m now 55) sometimes twice a year, sometimes twice a month. Most often at night but once in a while during the day at work. I am afraid of it happening at work as fainting from the pain can be an issue for me. In January 2006 I fell down the stairs at home and broke my ankle while trying to get from bedroom to bathroom (for a hot bath) during an episode. Husband has anti-spasmodics for a condition of his and if I take 1/2 a pill immediately upon feeling pain it seems to lessen the severity and duration. Hot bath with pressure (sit hard) seems to help or make it at least more tolerable.
Today I had a rare midday episode at work and could not talk myself out of it becoming major. I ended up sitting in a toilet stall, not to do anything other than keep myself from fainting. The pain was excruciating. And then it goes, leaving just a tiny rumbling in its wake. Most episodes of mine last for around 20 minutes, years ago it was only 10. Today’s attack was a half hour.
I am so glad to find this website and see all these replies. My daughter whom is 16 has been having these episodes about 2years. The first doctor prescribed her some Miralax and Stool softeners. She doesnt have any issues with bowel movements or constipation. The “ATTACKS” come along in the middle of the night while she is sleeping. She had an episode last night which lasted about 20 minutes. She also sleeps with one leg up and one leg down. The second Doctor prescribed some antibiotics for a bacteria infection maybe. She asked my daughter was she sexually active and my daughter told her no. She just could’nt believe that so she asked me after my daughter left out of thr room. I told her no. My daughter and I talk about alomst everything. I think she was believing from the symptoms my daughter had that she had an STD. So my daughter had to get a pelvic exam and a pap smear before her and she was almost traumatized by that. When I think about it, I had an episode a couple of times. Last year I was sleep laying in the bed and I got that sharp pain. It was so exruciating Icouldnt lift myself out of the bed. It was so bad, I felt like I was going to faint. My son was about to take me to the ER. I had him take me to the bathroom and I sat on the toilet for about 20 minutes feeling like I was having labor pains. I finally had a bowel movement and it felt a little better. But I was so weak after that. I cant wait until my daughter gets home from work to read these responses. She is going to feel so relieved someone knows what she is talking about and can relate.
To Tisha’ This is Shirley, my first bout of rectum was when my doctor also recommeded taking Miralax. When I told my doctor of the pain and like something hanging out my rectum, she said , oh, you took too much, needless to say, I thru out the Miralax. Never took it again, but episode came back 2 yrs. later. Don’t know what really set it off. I just went to a dr. spealizing in pudenal nerve entrapement and they gave me a ct guided steriod injection with lidocaine. It felt like Christmas for 4 hrs until the lidocaine wore off….. I’m still waiting for the steroids to kick in , this is day 2. Try to keep regular, magnesium really helps with that. Hopefully her pain will go away on its on as mind did 2yrs ago after about 3 months. Pray it don’t come back, it was extremely worse the second time. Take care.
Straddle the bathtub wall and shift your weight around. It doesn’t cure it, but it makes it bearable until it goes away.
Proctalgia Fugax……I have the best pain releiver/cure for this debilitating pain!!!!! Really it works… Yea ha. Use a vibrating massage machine! One like a hand held type. Yes sit on it or use it over the anal area and crank it up. My husband gets this pain and so do I. A friend gave me this machine as a gift to massage our backs.LOL One night when the pain suddenly appeared as it always does I used it on my butt and 5 minutes later the pain disapeared! Beleive me I have tried everything and this is the quickest.
I used to roll my butt over a tennis ball or a rolled up towel but this works so much better!!!
Best of luck, try it!
I had one of these phantom pains the night before last. It was a little more a dull pain than usually when I get them. They start always when I am asleep. Usually I get up and take a bath as hot as I can stand it. If the pain persists, I got back and do the bath again. Night before last though I had taken some over the counter sleep medication and it took enough of the edge off of the pain to manage to just wait it out. Of course I wasn’t sleeping through it, it would be like sleeping through a labor pain. It isn’t that it is located where labor was in me when I had children, but it is just as persistent a hard pain and there is not ignoring it.
It feels like I had the hardest bowel movement in the world but instead of it being dry the next morning, I have a normal bowel movement. I am mostly vegetarian but have eaten some meat lately which I am determined now not to do soon again if at all. It is hard to maintain my regimen as I am the only one in my family who is vegan. It feels like the bowel movement turned sideways. Perhaps it did. But the duration of my pain always seems to be about an hour. I may not get another one of these pains for months or even a year.
I have a desk job and I frequently sit at my desk in the evening too. I think movement is therapy, and is something I must do to avoid this monster pain coming back. This time it came in conjunction with days of insomnia and migraine headache from the lack of sleep. I have taken so much Execedrin Migraine medicine that this might have had a trigger effect on this pain. I also have at this time a boil or carbuncle on the right check of my buttocks but not near enough to have formed from leftover feces after wiping clean. It is subsiding now.
Thank you so much for the reassurance, I’ve had this pain on and off for years. The attacks have almost always come at night, they have been lasting longer recently. Will check it out with my doctor sometime soon. Thank you for all your comments, makes it a bit easier to deal with it knowing you’re not the only one!!
Thank you for the article. I’ve had the pain many times. I find that eating too many oranges or nectarines brings it on for me. I also sometimes get it after sex when I feel as if my rectum remains open. Often my erection also remains in place for some time. I lie down on a cold floor and just wait for it to pass.
You people are so lucky, you only have these spasms once in a while.I have had Levator Spasms for the last 19 years. I have these spasms 24/7/365 days a year. One night I was laying in bed and I had one of these spasms and it has never went away. I was doing a search on the internet one evening when I came across a forum called Tipna.According to the information on this site,Levator Spasms(and Proctalgia Fugax) are caused when the Pudendal Nerve gets inflammed or entrapped. The Pundendal Nerve runs vertically down each side of the buttocks near the butt crack.Botox injections into these nerves provides some relief,but only for a short time.I have tried everything but surgery.People who have had this surgery claim they are 50%-75% better.I really don’t like the the idea of being cut on, but I don’t like the idea of living the rest of my life feeling like I have a golf ball in my butt!
I have had this problem for at least 15 years. My son was seeing a gastroenterologist for crohn’s disease type symptoms, and in discussing my son’s symptoms, after I described my own, he instantly said, “You have proctagia fugax.” The symptoms are exactly what others describe: an excruciatingly sharp, stabbing pain in the rectum. I always have described it to my husband as “that pain I get”. My episodes almost always happen in the night, waking me up from sleep; but I have had it happen at other times of the day as well. It is absolutely incapacitating; all you can do is try to survive until it goes away, which usually takes about an hour. As someone else above mentioned, it subsides as mysteriously as it comes, and I may not have it again for six months.
I have found that the biggest contributing factor for me is not drinking enough water. If I drink a minimum of two large glasses of water every day, plus take fiber in the morning (I use Benefiber), it seems to prevent episodes. More water is even better (like 4-6 glasses). If I go a couple days not drinking water, just drinking tea, coffee, juice, etc. (especially when we are traveling and it’s hard to get enough water), I can pretty much predict I’ll have an attack.
When I do get an attack, I immediately get out of bed and take four, 200 mg Ibuprofen, and within 15-30 minutes the pain goes away. However, 15-30 minutes is a long time when you’re in this much pain, so prevention is important.
I also agree with the comments about feeling like if you could have a bowel movement, it would alleviate the pain; but it never does. However, just knowing what my condition is, helps so much; plus reading comments of others describing exactly what I go through; thank you all for posting!
P.S. – I also believe that it’s genetic, because I have two sisters plus an aunt who describe the exact same symptoms. I think it’s way more common than thought, because as you said, most people who have it never tell anyone. I never told anyone for years about it, except for my husband.
thaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaank uuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu
I’m a 39 year-old male who’s experienced this at least monthly for the last twenty years. It’s exactly as the others have described. I wake in the middle of the night with shooting pain coming from my rectum. It lasts about 20 to 30 minutes. It’s excruciating, totally debilitating, and wall-pounding agony. At first I thought it was constipation so I feverishly tried defecating….felt like I was trying to shit a bowling ball. It took me about 5 years, but I slowly realized that this just made it worse. I can’t identify a pattern or cause, but will take into consideration the other commenter’s ideas. The only thing I’ve found that helps is to distract myself by reading. My only condolence is that I now know the technical name (although I can’t pronounce it) and that I’m not alone…..and that (for me) it never happens during intercourse! That would put a serious damper on the festivities.
Thank You Doctor for spreading the word on this.
I am here to discuss other methods that help me and may help others..
For me I discovered that I was Gluten intolerant. When eating gluten the little silia fingers in the intestines that are there to grab nutrients from food get matted down. The body then sends antibodies to attack the Gluten grain and treats it like poison breaking it down in the gut too early.
This causes severe gas and bloating and a lack of Absorbtion of vitamins and minerals.
For me I was becoming deficient in Magnesium.
One of the 300 things that magnesium does is relax muscles.
The right balance of Magnesium versus Calcium is the Ying and Yang of the Body.
Since I was being depleted of Magnesium my level of Calcium which tightens cells was taking over. Magnesium also helps with bowel movements.
So needles to say here is the cause order of events:
1. Ate Gluten
2. Became Magnesium Deficient
3. Became Chronicly constipated
4. Developed a Anal fissure from the constipation
5. Having a Anal Fissure causes the anal region to spasm because the
body is trying to protect itself from the fecal matter cutting itself.
6. Spasms then become chronic after BM
7. Developed External hems from straining
8. Thought of Suicide several times.
Here was the Solution for me.
1. I had a LIS proceedure
2. Went on a Gluten Free Diet
3. Started Taking Magnesium Supplements
4. Pain and discomfort 90% better
5. Still have spasms occasionally after sex
6. life is better
Recap Magnesium deficiency may be a epidemic
and so may be Gluten Intolerance or Celiac Disease.
Please look into it and help more of your patients.
It only took 3 days after not eating Gluten to change my life.
Try this. No joke. After having this a few times, and being a physician, I knew (or thought I did) what the problem was. PF is much like a cramped leg muscle, which stops hurting after you stretch it out. I had my wife glove up, use lube, and and insert her finger into my anus, pressing down in all quadrants. I experienced almost immediate relief when she placed pressure on the 6 O’Clock(anterior) region(as viewed from behind). 20-30 seconds of this relieved my pain. Many people would be uncomfortable with this idea, but if you hurt like I did, they would not care if it gave relief. This is not written for any reason other than passing along another strategy for a condition that may otherwise not respond to anything. I have never had to use this on a patient, but you will find in medical literature that the treatment is, in fact, forced dilation of the anal sphincters.
My wife got the huge pain in the butt right after we had sex. I found online that it is possible for proctalgia fugax to be triggered by an orgasm.
I also read that caffeine might help, so next time it happens I’ll make her a strong espresso.
Dr. B, thanks for your article!
I have had periodic attacks of Proctalgia Fugax for about 15 years. The longest has been about an hour and the most severe resulted in passing out. I feel that for me I have found a direct connection to the amount of white flour ingested. If I am only eating whole grain and high fiber foods I often go many months (the longest has been a year) without an episode, however, an attack is often followed by a dinner or two of white flour pizza or pasta, or if my general diet has swayed more towards lower fiber foods and highly refined grains.
I have found that I can greatly manage the pain until the cramp fully subsides by alternating series of sit-ups (hands in front not behind the head) and gentle rocking on a carpet or mat. I take two Advil the moment I awake with the cramp and begin the sit-ups. Usually relief is in about 30 minutes. Thanks to everyone for sharing. I had all of the tests to rule out the various more serious possibilities and was fairly worried until I found this condition through internet searches. I am writing this at 2:00 in the morning after a fairly severe episode – but a fantastic pasta dinner. I won’t share the recipe.
Thanks for the info. I was just speaking to my father earlier today about how I have those same pains in my rectum and I how I was going to go see my doctor about it asap so that she could recommend me for a rectal exam. As I was sitting here googling to find any possible explaination for the “stabbing pains in my butt” I’ve been experiencing for the past 8 years, I began to have an episode. Oh God, it’s horrible. As I read more and more of the previous comments, it began to diminish. The sudden pain usually lasts no longer than 2-5 seconds and I normally have them about twice a month. I’ll generally have the sharp pains for a period of 5-30 minutes and they subside. I’m going to speak to my doctor next week, so I’m soooo happy I’ve found a name for the condition. Thank you.
Phew! I’ve been having similar ‘episodes’ for about a year now and in fact, the past three days have been almost unbearable due to the sharp pains! Just when I decided to finally go ask my doc about it, I found all this info. Sitting, standing and walking, everything seems so difficult. I need to ride a bike to work and that half hour ride makes the entire day extremely uncomfortable. Even right now I can feel intermittent spasms that seem like they’ll make me pass out. I just pop a painkiller to try and feel like I’m doing something about it (not always effective). But I’m beginning to understand the ‘pressing down’ option and it makes sense. Thanks a bunch for this. Feel loads better!
I had one of these excruciating episodes last night that lasted about 20 minutes. I’ve tried hot baths, sitting on the toilet etc & have found no relief!This only happens to me while I’m sleeping. So happy to find this website & understand this awful condition!Not sure how to say this tactfully but here goes……i was in such pain I felt that I needed to push the knife stabbing pain to release the pressure. I had my husband put his finger in my rectum. He could feel that it was actually in a spasm. Great news….after about a minute of the pressure he appliedI hopped in the hot tub & it completely went away! Over the past two years I haven’t found anything that significantly helps. Hope this can help thers!
Male, 37. I have suffered from these symptoms for 19 years now, over half my life. I have more or less ruled out food by keeping a very strict log of everything ingested and eventually ended up with no discernible pattern. Like a few previous mentions, my bouts seems to occur during times of heavy stress and when I allow myself to become dehydrated. My bouts typically last exactly an hour, most often waking me from sleep or occurring after an orgasm. I have learned to recognize some warning signs before a bout and I can usually lie a different way or hop out of bed and pace, allowing me to skip a bout. Attempting a bowel movement usually brings on more pain, but there have been a few times that I managed it and the bout duration ended early. What I do to avoid a bout… always try to sleep on my back and if I do sleep on my side, I don’t bring my knees up in front of me at all. I have actually successfully reproduced a bout on purpose by pulling my knees up close to my chest and sleeping on my side. I can do this almost anytime I want, which is never, but it can be done purposefully. Also, if sex with my partner doesn’t happen, I masturbate. I have found that the stronger the orgasm, the more likely it is that I’ll have an attack. And to keep strong orgasms infrequent, a daily orgasm tends to do the trick and it’s good for my prostate anyway. The good news is that as I get older, both the bout frequency and pain levels are greatly decreasing.
I’ve had these excruciating pains since I was about 7 or 8, all my life (I’m 62). I have them at night, and during the day (when something stressing happens or something very irritating).
I found a fool proof method to almost instantly get rid of the pain (well it works for me when I can manage it). The trick is to get your self to the toilet and pass faecies, even a little bit will fix the pain. Sometimes just passing wind will do the trick. I’ve found that even the process of ‘straining’ whilst seated on the toilet will relieve the pain as you do that.
If you can’t manage that sitting on something like a tennis ball can relieve the pain. Someone (writing above) suggested sitting on the edge of a bath.
It’s a terrible pain and in me comes and goes in waves for 20 minutes to half an hour if it were to go its full course. But I haven’t had to let it run it’s full course for a good 20 years.
I found out the name today. Only my oldest friend and my brother has admitted to experiencing this. Why the silence?
i have what is called proctalgia fugax and if you ever had a bee sting imagine having hundreds sting you in your rectum a one time constantly.and feel like they are crawling around thats what it is like it will make your nerves on end it is the horrilest pain you could imagine .i have been on muscle relaxers pain killers nerve pills and all they do is make you drowsie .if anyone knew anything else .i go through this aleast eight hours aday i have used everything there is .to no avale.
Very helpful article. I guess I am the minority male sufferer of this condition. I had hemorrhoids for over 2 decades, I always thought this pain was caused by my hemorrhoids. I had the hemorrhoids removed couple years ago and the pain still wakes me up in the middle of the night a few times a year. My doctor told me about this term proctalgia fugax and your webpage put my mind at ease. Thanks.
K ive had this for ten years im 35 and a dude in perfect health. I have found a way to push the pain back where it came from as is randomly shows up and and quickly raises its volume. I suck my anus in as the pain comes. The best way to do this is to pace this action with the speed of the on coming pain.(if that makes sense). For me by sucking in my asshole as the pain tries to stab me it muffles it. Then i begin a short back and forth anus flexing tug o war lol. (I’m serious). I get a small hint of the pain that could set in, but i never allow it to really stab me good.(only people who have this problem will understand this). I just won a war with it while i typed this and its over i think now. I havent had this happen in about 3 months btw and sometimes it will go away long enough for me to forget about it(6months or longer). Learn to flex your anus the right way and u can naturally fight this thing off. lol I’m serious but this sounds a bit strange
Maan-oh-man!..thank god for this..I was so scared that I had something serious. This pain is/ was so unexplainable. It’s the worst pain I have EVER felt in my life. Just like everyone says, like a knife pushing something in and out at the same time. I get this wave of fear,anxiety and start sweating, begging god to help me! Ive been going thru this for about 15 years on and off. But the frequency and painfullness has got worse.. I use to think I had a high pain threshold.. But as the pain has gotten worse and the duration is longer I may just pass out from the pain because the episode I just had was unbearable. I WANTED to pass out just to exscape the pain, which led me to the internet determined to find out what this is! THANK YOU SO MUCH….
Male, now 53, probably could be characterized as a somewhat driven somewhat up tight professional. I have had the pains associated with Proctalgia Fugax likely for 20 or so years. I found the breathing regimen recommended for childbirth helpful in reducing the intensity of the muscle cramp, and perhaps shorten the ordeal. I used to get it more when there was more stress in my life. But i can still get it shortly after orgasm, spontaneously in the middle of the night and randomly (sitting, standing, walking). If needed I will excuse myself to the bathroom, settle down and breathe. Last night’s episode lasted for 20 minutes, with the pain increasing and decreasing several times. A few mini-movements seemed to help everything relax.
It is assuring to know I have plenty of company, that I don’t have the knife in the butt pain many have described, and there are some approaches providing more immediate relief, namely coffee, baby aspirin taken sublingually and hair dryer… except we have not got a hair dryer and I hesitate to use a heat gun.
I have had the colonoscopy and gastroendoscopy (lower end was pink and healthy, upper end showed ibuprofen caused early stage lesions and irritated esophagus) so no causes for the PITA.
I wonder if this relationship to orgasm has any connection to the severe headache I sometimes get after a really good orgasm. Yes, I have had my head examined (including and MRI) and the good neurologist concluded there was nothing there. >:-| That is supposedly related to the Vegas (or maybe Vargus?) nerve and is associated with low blood pressure. Hydration seems to help so I try real hard to drink plenty of water (not very exciting).
Hi guys..
I have just had an attack yesterday and was looking on the web on what are the causes. So glad that I am not alone. I have tried doing a couple of things but nothing seemed to work. Thanks for the different methods that I could experiment with. I tried something yesterday that worked for me. I drank 2 glasses of cold water, and had two asprins just in case the cold water didnt work. The pain was gone in less than 5 mins. I think different methods work for different people. Maybe you could try this after trying everything out. I only tried it once so I guess I have to try it a couple more times to see whether it was really the cold drink that helped.