My Self-Treatment for Proctalgia Fugax

Edited , 22 users are following.

I am a 59-year old male and have suffered from PF for about 7 years. My episodes were about 6x/year earlier, but thankfully are down to about one per year. The attacks can be incredibly painful, and scarywith the worst ones, you feel like you’re going to pass out. 

After suffering through these for four years, I discovered something that consistently gives me very fast and complete relief. It’s a hot baththe hottest you can stand. And while you are waiting for the tub to fill (you only need 2-3 inches of water), apply a washcloth, soaked in hot water, to your anus. Stay in the bath until the pain is completely gone. Run more hot water if necessary. 

As for cause, a couple times it has come on after ejaculation, but mostly it comes on while sleeping. My theory is that there is a stool in close proximity to the anal sphincter that cause the sphincter to spasm. So I think there is a correlation between the episodes and mild constipation. 

That said, though the episodes often are accompanied by the strong sensation of needing to poop, don’t try! The sphincter is in no condition to permit a bowel movement during spasm. If anything, trying to poop lengthens the episode. 

Other tips - lying on side is better than on back; passing gas, if you can, helps a little, anti-anxiety meds (e.g., Ativan) help, but not nearly as fast as the bath; deep breathing helps take focus off the pain. This is as close as I’ll ever get to childbirth! 

Some consolationno matter how long or painful the episode is, it will not kill you and it WILL pass. 

Good luck!

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25 Replies

  • Posted

    Thanks for your post, doron.  I just now had my second episode of this and it’s truly frightening.  I live alone and the first time it happened, I did pass out. When I came to, I  was afraid that I was dying.  After googling it, I found what it was and just prayed that it would never happen again, but it did :-(  I was awakened tonight by the feeling that I needed to have a BM, which is super weird, went to sit on the commode, and as the pain increased with no stool, it dawned on me that I was having the second episode of PF.  I’d read in the past that a hot bath helps, so quickly filled the tub and was both surprised and very grateful to feel some relief as soon as I got in. It took 10 to 15 minutes before the severe pain completely stopped, but it was much more tolerable while in the tub than during my last episode, where I sat on the commode thinking I had to pass stool. It’s now 4:45am and I’m back in bed, still afraid to try and sleep.  The terrible pain is gone, but I still feel some pressure.  I’d have stayed in the hot water longer, but was sweating so much I feared dehydrating. I guess my pores are pretty clean now!!!  Anyway, it’s good when we’re alone and suffering to get on the internet and find others who understand and have survived what we’re going through. 

    Good luck to you as well!  

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  • Posted


    I think this might be what I've been experiencing for about 15 years. Although, not as severe in pain. It is, for me, very very achie; not to the point of passing out though. Thank God. I might try the hot water. One thing I recently tried that worked, is massaging the sphincter.

    Sometimes, I feel like it might be caused by being dehydrated. But it's weird because it only starts when I'm in bed.

    Best of health to everyone!

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    • Posted

      I’m glad for you that it’s not the most severe version!  

      I’m curious about your dehydration theory -- I’ll watch that, as I ride a bike sometimes for hours at a time and know I don’t fully rehydrate until the next day.  Mine only happened during the night too -- it wakes me up.  

      Best to you as well!  

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    • Posted

      Wow, riding a bike for hours at a time is very impressive. You must be quite the athlete.

      I came up with the idea of dehydration because it seemed to happen more often when I would engage in consecutive days of intense exercise. I would sweat a lot, and not necessarily replenish that water adequately. Not a scientific study though, lol.



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    • Posted

      Hah!  Love your #’s!!!  

      Sports wise, I was a runner for over 40 years and loved it, then tore a meniscus and had to give it up, so started biking instead.  Being fairly recently retired, I have time for long rides. I’m one of those rare RN’s who practice what I preach ;-)  With warmer weather coming, I’ll start adding electrolytes to my biking water and see if that helps with dehydration.  It does make sense, as I often have leg muscle twitches/spasm after riding on really hot days...

      What’s your exercise?   

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  • Posted

    I am a 71 yr. old man (as of 2018). Since about 1998 I have been collecting lots of annoying medical conditions, including "PF". Most of these conditions seem to be aimed at disrupting my ability to get a good night's sleep. However, I can get a PF attack at any time of the day or night. Attacks seem to come in clusters; that is, I might go for months, or even years, with no attacks at all. Then I will have an attack every day or so.

    I have 2 remedies that work for me:

    (1) Heat: Instead of soaking in a tub of hot water, I heat up a "rice bag" in the microwave and sit on it, or straddle it. You can make them yourself or buy them in all different shapes. The one I like is called a "Bed Buddy". It's shaped like a long tube and has a rope handle at each end of the tube. These rice bags are usually advertised for muscle aches, but they work for PF too.

    (2) Massage: I have found that J-sticks or S-sticks, such as a "Theracane", are great! These sticks are shaped as either a "J" or "S". They have knobs at the ends of protrusions along the shape of the stick. The shape of the stick gives the user tremendous leverage to apply as much pressure as you need to your unreachable spots. (I have several of these laying around the house.)

    May God bless all who suffer.

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  • Posted

    I, too,  am a 71 year old male suffering from PF for five decades.  Few doctors (actually none) over my lifetime  have had any idea what it is.  The episodes for me are in the agonizing 9.9 out of 10 pain range.  And I have found only one sure-fire way to beat it:  ASPIRIN.   I go no where without a couple tablets in my wallet or in my car.    When I feel the onset and slow build up of the pain I immediately chew one or two tablets and get as much under my tongue as possible.  It breaks the intense agony fairly quickly and I am on my way - dreading (but expecting) the next episode. Not sure how I discovered the secret, but it does work!

    My Best To All My Fellow Sufferers!

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  • Posted

    Hi, I'm a 43 year old women from India. I don't remember when i started getting PF. Unfortunately I don't have a bathtub at my place and it's too much of a hassle to take bath in the middle of the night when your only thought is to get back to sleep as quickly as possible. What works for me every time is sitting on a hot patch and the pain just vanishes with in a minute. Some time it may last for two or three minutes max.

    Hope it works for you!

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  • Posted

    58 years old male who has had PF for around 20 years.

    It can be agonising.

    I can go for a month or so with no attacks and then they can start. Usually at bedtime or on the middle of the night.

    Without trying to sound gross I use a big blob of hemoroid cream with local anaesthetic in it and wriggle it around up my bum. Whilst I'm doing that my wife prepares me a very hot water bottle to sit on. That often breaks the pain cycle and gives relief.

    Thank goodness over all those years it hasn't happened when I'm out.

    It can be very debilitating, goodness knows what it's cause is

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  • Posted

    Like other contributors, I have suffered from PF for years and have been traumatized and terrorized by the intense pain that often (but not exclusively) comes on at night and wakes me. Over time I discovered that hot water is the fastest and most effective solution and I will now not live in a house that does not have a bidet! It's the perfect thing for PF.

    In trying to understand what brings on an episode, I have narrowed it down to dehydration. I am a runner and if I don't rehydrate well after a run, the pain hits. If I catch an episode early, I can stop it by taking a big drink of water. I also agree with Doron's description of a hard/impacted turd pressing against a nerve in the anus. Hot water relaxes the rectum and allows that fecal matter to pass and the pain goes. This is not always the scenario, but it does happen.

    Of course, as an older man (62), I also have to consider bladder capacity and how many times I am willing to get up during the night to pee, or whether I will have access to a toilet wherever I am going. So drinking a lot has other repercussions. Frankly, anything that prevents the excruciating pain of PF is acceptable.

    As for the other causes that people mentioned, I don't have any allergies or intolerances, no other medical conditions and I have never used medication for this problem. The answer for me seems to be water - drinking enough and running hot water on the anus when the cramps hit.

    I hope this helps other sufferers, and I am relieved to know that I am not alone with this.

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    • Posted

      I think heat and a physical means to interrupt the pain is pretty typical in the way that people have used those to help with the relief from this rather debilitating condition.

      I haven't noticed dehydration being a factor for me, great that you might have found something that could help you. I understand that drinking lots, 58 years old male, can present other issues...!

      I'm not sure of sexual activity or exercise could contribute.

      Like most mine are often in the middle of the night, but only last week I had a bad episode midday thankfully we were at home and could be dealt with.

      I dread if one should happen if I'm out of the house.!

      Best wishes.

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  • Posted

    So glad I found this forum,. I'm a 50 year old male with a history of IBS and had an attack of Prostatis last year. Nearly a year ago I can't remember if I was in bed or getting ready for bed I had this sudden pain in the rectum area which I can only describe as a muscle spasm that was getting worse by the minute and started sweating and feeling very lightheaded but the pain was right up there with the worst ever felt. After around 30 minutes it subsided. I think it happened again a couple of months later when it woke me up and was very similar. I then googled and found the words proctalgia fugax and levator ani syndrome on the NHS website and when I felt it coming on again around 4 months ago I ran a hot bath at 4am and sat in it which after 5 minutes or so seemed to do the trick. Then around 6 weeks ago I was awoken again and once more ran a shallow bath and problem averted. Touch wood I haven't had another attack but at times I seem to get a little "feeling" up there and whereas before I wouldn't even notice it I now start to panic. I agree with others it feels like a bowel movement will sort it but you never actually need one at the time it happens.

    After the fourth time I went to my GP hoping/expecting he would just diagnose the above. However he hadn't even heard of proctalgia fugax or levator ani syndrome which was quite unnerving and proceeded to assess my stomach and performed a digital examination which were clear. However he has now referred me to a colorectal specialist to get to "the bottom" of it although this referral has now filled me with fear about cancer. I had a colonscopy when I was 21 to diagnose IBS and the whole process including laxative and camera still haunts me to this day!!

    So just wondering if anyone here went to their GP with this issue and had specialist diagnostics to rule everything else out?

    No idea what causes it but in the last couple of years I now work at home so wonder if the constant sitting down plays a part.

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    • Posted

      You can read of my experiences from this condition above.

      Like you, and many others, my doctor has heard very little about it. As it is a group practice I then mentioned it to a second different doctor and they were reasonably dismissive, after calling it proctalgia fugax, which amazed me,lol...!

      However I have lived with this condition for at least 20 years.

      Within the last twelve months I have had a colonoscopy, a CT stomach scan with contrast and dyes, as well as a endoscopy. Other tests as well. They were for unrelated issues but nothing was shown to indicate any other reason for this proctalgia condition than what we know already. The gastro specialist seemed more interested with the internal haemorrhoids he saw (and that was just to make a comment) than seeing the proctalgia as anything other than painful condition to best manage, as I do.

      You might find a water bottle is a quicker solution than a bath, especially at 4:00AM..?! We have a water bottle and kettle in our bedroom just ready for such an event, great isn't it, lol...!

      Best wishes

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  • Posted

    I am a 50 year old male that has had this condition my entire life. At the worst stage, I was having the pain for 1 1/2 hrs per episode three times a month. I have been pain free for three years. I found this remedy when my doctor put me on Clomiphene 50mg to boost testosterone levels. I was taking the pill every day for three months when I realized that I had not had a spasm episode. Long story short, I now take 1/2 pill every other day. I told my doctor he should write a paper on this because there is NOTHING on the internet about clomiphene helping Proctalgia Fugax.

    Also, I did all the treatments mentioned in this article and every other article online. Nothing worked at all until this accidental discovery.

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    • Posted

      That is a very good result for you and I can imagine that it will give a lot of make sufferers some possible hope for them. At least to talk to the doctor about what you have used.

      As long as mine does not become too frequent and not long lasting I seem to manage as I have for so long.

      I would be reluctant at this stage to add yet another pill to what I need to take each day, unless my symptoms changed for the worse..!

      Great news for you.

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