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My Self-Treatment for Proctalgia Fugax

Posted , 31 users are following.

doron89072
doron89072

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 scary—with 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 bath—the 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 consolation—no matter how long or painful the episode is, it will not kill you and it WILL pass. 

Good luck!

3 likes, 33 replies

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  • dave00806
    dave00806 doron89072

    Edited

    I’m currently laying in a hot bathtub (1+ hour so far).....pain now at 4/10 -- vs 9/10 when I was woken up with PF again today.

    This is the 4th "major" time this has happened to me. All of the major times have occurred within the last 6 months. I’ve had milder occurrences for many years and can feel them occuring typically before extreme pain (while awake) and have learned to avoid them.

    I’m adding this reply to explain what causes them for me ( awake and asleep versions), as well as what works for me to avoid/treat them effectively.

    Awake (milder) version :

    • caused by stretching to reach something.
    • caused by almost reaching sexual climax.
    • caused by orgasm.
    • caused by suddenly standing or twisting my body.

    To stop/ reverse these types (pain typically 5/10 max), STOP WHAT YOU ARE DOING!! The desire to orgasm is hard to stop, but try again later! If you do, it will be much more painful than the pain leading up to it.

    If you get " awake PF" after orgasm, you need to use your index and ring fingers to push against and slowly massage the outside of the " area" until the pain lowers. It will not be instant reversal, but you will feel much less sharp pain. Also, lay on your back and lift your feet off the ground -- this removes muscle tension going through your legs and into your buttocks.

    Night time " asleep PF"

    • caused by dehydration ( specifically lack of WATER intake -- not lack of liquid intake).
    • allergic reaction to certain bedtime tea that I have consumed before laying down.

    My attacks last approximately 1.5-2 solid hours. The begin by waking me up to 7/10 pain -- going to 9/10 within minutes.

    To fix, I do the following :

    • immediately start running HOT bath.
    • try and " go" to the toilet as water is filling the tub -- if anything passes , it hurts more in the moment, followed by slight relief.
    • DRINK WATER IMMEDIATELY!!! ( at minimum a standard bottle of plain water during your time soaking).
    • Pressure/ massage exterior of area with my hand under the water.
    • legs UP against the shower wall, do not bend your knees and keep your feet in the water, that position tenses up those muscles running up to your rear.

    Within 30 minutes of the above procedure, the pain goes from 9/10 down to 7/10. Another 30 min to 5/10. Another 30 min to 3/10 ( which i can then go back to sleep).

    I wake up the following day with 0/10 pain.

    Also for reference :

    • allergic to NSAIDs ( cannot take aspirin or ibuprofen).
    • allergic to "sleepytime DETOX tea" (100% PF rate after consuming and going to sleep).
    • less than 24 ounces of plain water consumed the day/ night leading up to each nighttime event.
    • 40, non-smoker, drug-free, moderate drinker, athletic, zero health issues of any kind.

    The only pain I’ve experienced worse than this has been a kidney stone. That was 10/10 sustained for 3+ hours until i got the 3rd dose of morphine at the ER pre-surgery. This pain is 80-90% as bad as that.

    Good luck. The pain is temporary.

  • cheryl48826
    cheryl48826 doron89072

    Posted

    I appreciate all the tips here. I am a 54 yr old female and have had PF for a few years. I too usually have them at night, feel like taking a BM would help but it doesn’t, usually end up lying on the bathroom floor until it passes, but it lasts for mintes to hours. yesterday I was out by myself and had an attack in the middle of a hospital pharmacy! I knew it was happening, and I couldn’t stop it! I wish I had known about some of these things. I got tunnel, vision, and hearing, I was very dizzy, I could barely walk to the pharmacy counter. And then it hit me, full on. I was immediately surrounded by a dozen medical personnel, who thought I had passed out.I just sat down quickly on the floor and laid down and was waiting for the pain to subside. They made me go to the emergency room, and kept me for three hours! I can’t tell you how embarrassing it was, but I am OK. thank you so much for all of these Great ideas! It is comforting to know I am not alone in this suffering.

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