Proctalgia Fugax

I've been amazed to read all this stuff about Proctalgia Fugax as I have recently realised my 6yo daughter suffers with it. The symptoms match up unbelievably well. I feel so terrible for all the sufferers out there, as it looks excruciating and is truly a devastating thing to have to watch someone go through with such incredible pain.  Its heartbreaking to see my little girl writhing in agony and up until now I havent known what on earth to do, I have been applying cream for goodness sake and shining a torch in her bottom looking for worms or any clues as to what is causing such distress.

I feel relieved to have a diagnosis finally (thank goodness for the internet), but equally concerned about her future and trying to make sense of all the methods that work for some and not others. 

I'm very interested in this "breaking of the circuit" idea in the form of punching the colon to stop the spasms, but as I am not doing it to myself and rather to a child, I need to clear a few things up, if you can help me???

1) When applying the punches (ie firm not hard), does it actually hurt the person more during the process, or does the punching feel relieving in a way? ie; Will she hate me for punching her, and think I am making things worse, or might it be welcomed?

2) When you say you punch at "different intervals", what does that mean?

3) Does the pain move around, do I need to be punching in more than one spot, or just rectum?

4) She sometimes complains of not only rectum pain but also pain nearer to the "front". Does anyone else get this? How does one punch the front?!! Its all so difficult when its happening that I think she's not really sure how to explain the pain and where it is coming from, or in such pain that she cant verbalise much other than to scream.

5) I am noticing a pattern where she might complain of a sore bottom in the late afternoon, or during evening bath time, but she seems chipper enough and goes to bed, but then it wakes her by about 10pm in crisis.  Is there anything I can do in the lead up if I suspect an attack is coming? Should we administer a few punches before it gets bad??

I am so scared for her and any future attacks - Any information or light you can shed to the mum of a child sufferer would be so greatly appreciated!!

In the meantime I sincerely hope everyone is getting some relief from this awful condition.

Thanks

Jo

 

Hi Jo,

I’m sorry to hear that your daughter gets these attacks. Fortunately, the “punching technique” is 100% effective and it is not painful at all. I first tried this technique probably 15 years ago because I needed a way to stop the attacks in their tracks instead of having to treat the pain.

My theory is that spasms come in waves of increasing intensity and that the way to neutralize them is to interrupt the spasms by sending a shockwave up the colon with a series of impacts. It is not necessary to hit hard at all; you just have to make contact as close to the anus as possible using a knuckle.

Here is the technique:

Lean forward with feet a little more than shoulder width apart.

Make a fist.

Reach around behind you and turn your fist so that you can contact the anal area with your first knuckle, which provides a small surface area that is boney, which will help focus the energy of the strike. Using the knuckle and having good aim is what is important - you don’t need to hit hard.

Give a couple dozen strikes to the area, changing the timing of the hits so that they are not always in the same rhythm (to more efficiently interrupt the spasms).

 

To answer your questions:

 

The punches won’t hurt the person at all – not even a child. She won’t hate you for doing it – she’ll be relieved that you were able to make the attack stop immediately You’ll be able to teach her how to do it as well. Have you ever had a doctor check your reflexes by hitting your knee with the little rubber hammer? Well, the punch might a little harder than that, so you see, you are not hitting very hard at all.  It’s all about the aim and using the knuckle.

I punch at different intervals because the spasms seem to have a rhythm and the goal it to interrupt that rhythm. You do this by speeding up and slowing the tempo of the strikes just a little bit.

The spasms and pain don’t move around; they are localized in the colon. I’ve found that I only need to deliver the focused energy on one spot - the anus. It usually takes me 25 hits or so. I might take you a few more or a few less.

There are definitely nerve connections and transferred pain to “the front”. Before I discovered the “punch technique” I used to pop two aspirins for the pain and also submerge my genitalia in ice water. It helped, but then I discovered how to stop the spasms and that takes care of the pain no matter where it is. The source of the pain is at the back, so taking care of that will stop all the pain.

Definitely administering the gentle but firm punches will stop the spasms in their tracks. It works no matter if the spasms are intense or at the first indications that a spasm is starting. I find that the spasms start slow and gradually increase in intensity. As soon as I have any indication of pain, I administer the punches and it stops and doesn’t come back unless I didn’t administer quite enough punches to completely stop the spasms.

 

I have used this technique for at least 15 years and it always works. It doesn’t hurt and it should be easy to teach even a youngster, which would be definitely reassuring to both parent and child to know that the child can quickly deal with an attack, no matter when or where.   

 

Try this technique out. It’s a life changer guaranteed to reduce PF from being a horrible affliction to nothing more than a minor annoyance.

               I hope you are able to make use of this technique to take control of PF.

               Regards,

               Jim

Hi Jo

Very rare I come accoss someone else that has a child that suffers this. As this is what my child suffers.

Diagnosed at 6, she has suffered all her life with this.

Always looking on net/sites and seeing what helps others.

Just wish there was more to help with ppl suffering.

Hi Jodie

Thanks for your message. How old is your daughter now, and what methods have you tried and tested? I am hoping if my daughter has another episode that we can try the 'punch' method and pray that it will work. But being a 6 year old it's hard for her to understand how 'punching' could be a good thing. We are quite

new at this, and I was talking to her the other night about the 'punch' method (although I called it "tapping" her bottom instead) or maybe try sitting on a tennis ball the next time it happened. The next day I caught her trying to hide all the tennis balls -because she was frightened of even trying that!

I am just praying the punch method will work swiftly for her.

Any tips you have would be great and

I hope your daughter finds relief in some way.

Regards

Jo

Thank you so much for this info Jim. I am praying it will work for her.

No episodes yet to test it on (thank goodness).

Just another quick question - if I am administering punch method for her, how might I know when to stop since it's not my bottom!? Is there a defining moment when you realise you can stop? Or should I just try 10 punches, then 10 more, 10 more at different rhythms. Sorry may be difficult to answer, but am dealing with a child who doesn't give much away in the time of crisis other than to scream so I'm sort of flying blind....

Many thanks

Jo

Hi Jo,

In retrospect, "punches" does sound kind of violent - I'm sure there's a better descriptor we can use. All we need to to is to make contact on the anus with the first knuckle so that a decent shockwave will travel up the colon area. Regarding numbers, it will probably differ between individuals, but for me, it takes a good 25 shots. And if you still feel it, give it another 20. You'll soon have it fine tuned. Remember to change the timing a little bit so that the strikes are are not always at the same rhythm so you will be able to interrupt the spasms. Don't just slap the anus with the hand either. Slapping the surface will not accomplish the goal. A solid yet impact with the first knuckle will provide the efficient delivery of energy up the colon to interact with the spasm in order to interrupt its timing. Don't worry Jo- it will work! As a rule of thumb, begin with 25 strikes, then wait to see if it is gone. At first, you will probably need extra strikes as you master the technique. I suggest explaining the aim of the technique to your daughter so that she can give you direct feedback to help you aim your gentle but firm strikes for the optimum effect. I believe she will soon learn to recognize early signs of an attack so she can let you know. The sooner she masters the technique herself the better. Soon she will be able to quickly take care of them herself and it will not longer be a concern for either of you again. 

Keep me updated,

Cheers and good luck,

Jim

Hi Jo,

I was reading your post - I suffer from an identical pain to proctalgia fugax occasionally too. However, for me, the underlying condition is not proctalgia fugax but pudendal neuralgia. When I read your post I felt I had to sign up to this website and reply to your message, because I think what your daughter has sounds more like pudendal neuralgia CAUSING this searning rectal pain, rather than just proctalgia fugax on its own. Of course, I might be wrong, but the good news is pudendal neuralgia is treatable with physio and other treatments.

So here's why I think your daughter might have pudendal neuralgia. You mentioned that alongside the rectal pain, she also gets pain at the "front". You seem to think that these two pains have a common cause - that cause may well be the pudendal nerve which serves both areas. It also sounds similar to my pain, which is caused by pudendal neuralgia, although it's hard to know without knowing what her front pain is like (burning, stabbing, aching etc).

Secondly, pudendal neuralgia gets worse throughout the day - this matches the pattern you spoke about. 

I'm not suggesting for a second that your child definitely has this (it is quite rare, and I don't even know if children can have it!), but it might be worth looking into. If you decide to do that, a first step might be to email a specialist, as even gynaecologists and doctors who specify in the pelvis are not always experts on this condition. I've left some links at the bottom of this message.

I hope I don't sound too alarmist but the longer a person suffers from this condition, the harder it is to treat. Diagnosis is often preceded by years of misdiagnosis, which is just what happened to me. I have had this for ten years and my muscles are now so contorted as a result of my body's automatic pain response that I'm going to need a lot of physio to sort it out... but like I said, the good news is it can be sorted

For more information on the condition, have a look here: http://www.webmd.com/a-to-z-guides/pudendal-neuralgia-overview

or here: http://www.pudendalhope.info/node/9

I hope you find this information useful - I am sure it is terribly distressing to watch your daughter in pain - I find my own pain distressing enough and to see it in your child must be horrible. 

Best of luck finding something that works for relieving the pain in the meantime! Just FYI I can imagine the punching working for the rectum pain that I get (although having only just read about it, I have never tried it!) but for the vulval pain all my instincts are telling me that it would make matters much worse, so I would hold off on the front for now

Jenny

Hi Jenny

Thank you so much for your note.  I appreciate as much information as I can get to make sense of this condition for my daughter.  Its really difficult, because when she is not having an attack she doesnt really want to discuss it (shrugs, goes quiet, gets a worried look on her face as though she doesnt want to revisit that!). And when she is having an attack, she is in too much distress to explain where the pain is and what it feels like.  Also in between her waves of pain I feel terrible firing questions at her when all she wants is to be cuddled and rest.  

I will definitely look into Pudenal Neuralgia, you never know if thats it.......

So to clarify - with Pudenal Neuralgia you get the rectum pain as well as the front pain?  And in your last comment, are you saying that it might be best to hold off on the punch technique altogether, or just no punching anywhere near the front region?  If she is indicating pain in the rectum I'd be keen to try the pucnh technique.  I dont think I'd punch the front anyway as there is a bone there.  Is it more vulval pain or pain above the pubic bone?

Thank you SO much for your comments.  I really hope that you are able to get sorted and pain free. Please stay in touch!

Jo

Hi Jo,

Good to hear from you!

Pudendal neuralgia can cause pain literally anywhere served by the pudendal nerve, which is almost everywhere in the pelvic region as it's the only nerve down there... I get the pain in my bum and also the vulval area. I'm not suggesting you don't try the punches on the bum (I can oddly see how that might work and will try it myself next time I get an attack!) but it's a different type of pain at the front (for me at least) - a hot, burning pain, that doesn't feel like it would be helped by punching. As the bum pain feels like an intense stitch or muscular cramps, I can see how it might feel like intense muscular relaxation! Of course, your daughters front pain might be nothing like mine... So I could be wrong. Hope that makes sense!!!

Good luck!

I’ve had PF several times a year for over 20 years (I’m now 57).  Jim77426’s from Vancouver’s punching technique  (posted in 2015?) works brilliantly for me, can’t thank Jim enough for posting details on here, you’ve saved me a lot of pain!  I’ve been able to use his technique twice in the last month and the pain is gone in no time, I only have to punch about 10 times.  Wish all doctors had this information to pass onto patients to try.  Anyone with PF should read his posts on technique.  My episodes are nearly always in the early hours of the morning, and last 20 minutes at least.  

Prior to reading Jim’s posting I’d got some relief from sitting on a firm ball (a rubber dog’s ball) which helps put pressure on the painful area, and moving around on it to vary the pressure and the placing of the ball. 

With me it seems to be triggered by my bowels being more empty than normal, so varying the normal amount of fibre I have is asking for trouble.  If we’re away from home for example, and my diet alters, that cause an episode.  It feels as though the muscles of the colon are contracting (as they should do normally) but as there isn’t enough in the bowel for them to work on and move along, instead it causes spasms and pain.  

Very interestingly, my yoga instructor sometimes gets us to pummel our muscles to help them relax into a deep stretch, which is totally consistent with Jim’s theory of how the punching works on our pain. 

hi lesley. great that the technique works for you. it has helped me a few times also, but sometimes the pain is too intense too quickly for me to have the nerve to punch myself at the site. im exploring the cause as well as mediating the pain, and a psychotherapist prescribed me valium to take only at the onset of an attack due to its muscle relaxant properties. this seems to help manage the pain greatly and also to shorten the attacks as much as possible. placebo? i dont know and i dont care. it seems to work. he also believes the root cause may be inherent chronic stress, emotional and muscular, so im looking into relaxation, meditation, and trying to find a therapist who realises that its not only women who have pelvic floor muscles that require attention!

Makes total sense to me that a muscle relaxant works.  Cramping muscles = pain, relax the muscle = (hopefully) take the pain away.  Only drawback is that it must take time to for the valium to work.

actually it is surprisingly quick - thats why i wonder if there is also a placebo effect - and while any wait seems long, its always a blessed relief when it passes. sometimes the relief is so marked, i have been known to laugh, because at its worst the pain causes me to faint. better that than how my first doctor tried to treat my 2nd ever episode. he did a housecall during the night when i still had no clue of the condition ( it was a long time ago when doctors actually did that kind of thing!) and he gave me a suppository painkiller. or tried to. he gave up when the spasms just pushed it back out! ''whats up doc?'' indeed.

Hi Lesley

I'm glad the punch technique works for you! I am thrilled that, thanks to this website, so many people are able to share ideas regarding this painful affliction. The very first time I experimented with the punch technique I could not believe how well it worked and how easy it was to do. Thanks to the punch technique, Proctalgia Fugax Is no longer a problem in my life. It is a minor irritant that takes me about as long to solve as picking up a Kleenex and blowing my nose.

I emphatically encourage everyone else who suffers this pain to give the punch technique a try.

In case you haven't read my previous posts describing the technique, the purpose of the punch technique is to send a shock wave up the colon to interrupt the spasms.

Find a private room, pull your pants down, bend over, make a fist, and deliver gentle but firm punches directly to the anus. Focus the energy by slightly rotating your fist so that you are striking your anus with the first knuckle. You don't have to strike really hard at all. Just a nice solid contact so it will send a shock wave up the colon. I usually need to deliver a couple of dozen hits. Sometimes I'll stop after a dozen or so to see how I did but if I sense any lingering spasm still in there then I deliver another dozen hits.

It is 100% effective, It is immediate and doesn't require are seeing a doctor or buying drugs.

It's always great to hear success stories from people who have defeated this affliction and no longer let it control their lives.

Thanks,

Jim

Vancouver

Thank you Jim!!!!

I'm so happy to have something to try next episode of this awful embarrassing and painful situation. I was too embarrassed to tell my doctor. So ive been suffering for about 5 years now. Food is my trigger. Spicy, onions and all gas producing foods. Going to bed after that type of meal is a sure set up for an episode. Bad one last night!! I've been massaging but without any relief. Prayers for all of you suffering .

Nikki

please dont ever be embarrassed to see your doctor about this. they see worse things. far worse. ok my gp wasnt a lot of help at first but that was because he hadnt heard of the affliction. but certainly, dont be embarrassed. get yourself checked out, if only for no other reason than to rule out other causes

Hi Nikki,

I'm happy to be of help and glad that you found this forum. Hopefully, like myself and many others, you will be able take control of PF so that it ceases to cause you pain and stress.

I'm eager to find out if the punch technique works for you too!

Jim

Jo,

i can't imagine what a nightmare it must be to have a child with this condition.  My heart truly hurts for you and her.  What she is describing, with the pain radiating toward the 'front' is exactly what I experience every time.  I am a prude and dislike saying this on a public forum but around the clitoral area, the pain can be tremendous.  Mine also seems to have a center of pain in one side and can feel as though it's actually radiating outward from inside my buttock rather than the anus although I have no idea is this is just a sensation or the actual 'focus point'.  Love to you both and I hope the punch technique will help.  It seems that this is a lifelong condition but if your little girl can learn to do this herself, it will be a huge relief for both of you.  Even with this condition, I'm sure we all lead perfectly normal lives.  ??

Hello Jo

I'm sorry to hear about your daughter I have had this condition for over 25 years. All I can say to help your daughter on the onset she will complain her bum is starting to get pain as she gets it run a bath as quick as poss it only needs to cover the lower stomach.. put her in and then massage quite hard the area whilst in the bath ! Stay in the bath until completely gone as it can reoccur if she gets out before the pain and dicomfort subsides

This should help as the majority of attacks happens at night. Though if it happens in the day time and can't get to a bath e45 cream and heavy massage on the area usually towards the back.. what ever she does don't let her try and go to the toilet the pain makes you feel as if you need a pooh but it's imperative she don't as this intensify the pain. I have passed out on many occasions. Poor little thing ! I hope this helps you Jo

Hi Jim

I'd like to try this punch technique myself as I suffer really brutal attacks of PF for which absolutely nothing helps. This may seem a silly question, but do these strikes have to be applied to one's bare backside??!!

Ian

Hi Ian,

That's a really good question. A couple nights ago I was reviewing my previous posts and was planning on making a clarification on that point. I have found that the strike technique (or "punch technique" works very effectively when fully clothed. A better description of the technique is to lean forward and extend one arm behind you. Swing from the elbow (like you would when playing pool) so that the back of your hand will contact your backside. Now turn your wrist slightly so that you will be making contact with your first knuckle. This focuses the energy where you need it. A couple of contacts and you will get the hang of it. A couple dozen should do the trick. I give it a second round to make sure it won't come back but that is personal choice.

Give it a go Ian and let us know how it worksfor you. I hope it is the magic bullet as it is for me and for many others.

Cheers

Jim

Vancouver

Jim, I've dealt w/ this anal pain since I was 13 yrs old. Always comes at night while sleeping. It lasts a minimum of 2 hours every time & comes every 2 months like clockwork. During that 2 hrs I sit on the toilet screaming because the pain is so severe. I've woken up on the floor because it's knocked me out the pain is so severe. It's the worst 2 hrs a person could ever imagine. So your saying that punching my butthole w/ my knuckle will help this horrible situation?

I'm 41 yrs old now. It's been a long 28 yrs dealing w/ this misery.

the only things i had found to help is the punching technique  - if i get it quick enough. its too painful if i leave it too late. also a therapist has prescribed me valium as it is a muscle relaxant, and the pains are a muscle spasm ( i think ). my gp is not happy about it as it is an addictive drug, but i have to be strict and only allow myself to use it when i have an attack

I appreciate your response itsapain, & I can relate to the reality of the addictive properties of valium. As I am a recovering, opiate addict & have been on Suboxone for the last 7 yrs for recovery efforts.

Hi Cory,

I'm sorry to hear about the horrible pain you're suffering. Yes, most definitely the punch technique works. Sending a shock up the colon neutralizes the spasms very efficiently. Many others are using it now with great success so give it a try. Let us know how it goes.

Jim

Hi Jo,

Get her to try the 'cycling in the air' method. It works for me. And much less scary sounding than the other options.

Jo I see your post is already 2 years old but I'll make the suggestion anyway, in case your daughter is still struggling with PF.  I'm a runner and I have battled with this for about 8 years now.  I consistently stay on potassium supplements, I'm not sure they are doing anything but its more of an attempt at lessening the number of episodes than anything else.  But the one thing I have found that consistently works is sitting on a tennis ball on a hard surface.  Like any normal cramp where you need to stretch the spasmed muscle in the opposite direction to relieve the cramp the same principle applies here.  I have geared my running routes around trails and parks with benches even, because sitting down hard on the edge of the arm rest does the same trick !  Nowadays I run with a ball just in case, it helps keep my anxiety down as I feel prepared. You need to catch it immediately it starts, Sit down on that ball so that you are pushing back on that spasmed sphincter muscle and stay put until the pain has subsided completely, Doesn't take long if you catch it early. Hope this helps somebody out there like it has for me

 

Hi Jo, I'm not sure if you've seen a doctor by now and had some help with your daughter, but to try and give you some advice from my experience for her is to make sure she drinks plenty of water and is hydrated throughout the day, as I find my spasms occur if I'm dehydrated. Also, when they do occur my magnesium oil spray has been a life saver, sprayed directly onto the pain area, the pain dissipates in seconds for me. If I am going away for the week end etc. I would never leave home without it. I hope this can be of some help as PF is such an excruciating pain, I feel so badly that your little girl has to suffer this.

Cass

Hi there.

Just sharing something that may help, along with other good suggestions on this site like the pinching and punching (have only just heard of these but not tried).

Occasionally, I wake up in the night with the pain, feeling very faint and panicky. I read somewhere that sitting on a tennis ball helps. It does.

I have even screwed up a tshirt into a ball and used that, or if I'm laying down, reach down between my legs with a fist and use my other hand to pull the fist up firmly. All these work for me. After a minute the pain becomes bearable (which is a relief) so then just stay with it until it is completely gone, which actually isn't very long.

I hope this is helpful to you, your child and others.

All the best to you.

put your feet up on a squatty potty while sitting on the toilet