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Proctalgia Fugax

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I have had this problem since my late teens or early 20's. As I get older (now 56) this pain is coming much more frequently.

The pain generally comes when I am sitting or in bed, which is fortunate since the pain is so severe it is very difficult to do anything until the pain subsides. Each episode lasts 5 minutes or so (never actually timed them)

Since my early 20's I have brought this up to my Dr. and have been fully dismissed. Over the alst 10 years or so I never bother mentioning it when I change Dr's because I have not expected an identification.

While watching the Dr. Oz show on TV this morning this was brought up during a question period. This was the first time I heard of others having this and an identifying name for it. I now am able to do research on the internet and decide on further action.

7 likes, 261 replies

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  • rojotoro
    rojotoro Guest

    Posted

    So I wanted to jump in here as a fellow traveler. I will offer brief bio only for purposes of validation and comparison. 51 WM, Northern Cal. Healthy lifestyle but nothing crazy, daily coffee drinker, moderate alcohol consumption, non smoker. Lifelong asthmatic, also mild allergies (and there is a point to that later) college educated. No food or drug allergies. I do suffer from overall joint stiffness and so take Advil somewhat regularly, and in severe cases I have a valium script for pinched nerve pain. I have suffered from strain related hemorrhoids although, and this is another tip, unrelated, with valium I can stop them from presenting.

    So I have suffered from this since I was a teen. Like everyone I thought I was dying, or accursed by Satan. I recall a very painful episode post coitus although only the once. But that caused me to associate them with something sexually related thereby making me even more hesitant to discuss them. Also early on I might go years without having the pain. Now in my 50's it's every couple months.

    I finally plucked up the nerve to run it past the old man and it turns out he was familiar with it too. Being men we of course didn't go into detail, but he said soaking in a hot bath helped. No more was ever said. As I aged I got to the point where I would do the "girl thing" (I have daughters so I've seen them doing it) position the legs on either side of the tub spout letting the hot water run. 

    Mine are ALWAYS at night. Sometimes I get a tinge during the day but being up moving seems to prevent them from becoming full blown. Some folks mentioned that their MD's prescribed valium, I get it, if P.F. is a cramp then benzodiazepines make sense but it seems like a long time to wait, and do you have to work, or drive a car? Cauuuuuuse that's not a great idea on a muscle relaxer. Someone suggested that valium was addictive, everyone is different, but they are not opiate based so unless you're special . . . ? But I make note of the valium because I remember taking it for something else and one night getting a P.F. flare up, so if it works for you I guess it's great. I've also had them flare while on Advil for something else? 

    Eventually I switched from hot bathes to a heating pad (which lives beside my bed). I also noticed that getting up and doing deep knee bends seemed to lessen the pain. Although again, at 3 a.m. in the morning, really?

    I wanted to go back to the allergies. Lifelong suffer and I've been given every drug invented. What I learned several years ago is that a small amount of NyQuil stops everything, including unfortunately consciousness. But if my allergies are bad, and occasionally they are I do what I have to do. But I noticed a correlation to NyQuil and P.F. flares and I think I know why.

    Dehydration! For me staying hydrated seems to make a huge difference. So if you're using decongestants be aware, at least for me that compounded the outbreaks.  

    Now, here's another weird thing. And again apologies for the personal stuff, but once, many years ago I had a gout flare up in my toe. So long story short I read up and ever since have been an almost daily drinker of lemonaide and cherry juice. And I add a little fizz with some soda water. But that is my post work (virgin) cocktail and I drink it nearly daily. 

    So recently I had a P.F. flare, and I can feel them coming, they wake me up, so I got up and thought "you need to drink something" and so hit the lemon / cherry / soda water blend . . . and it disappeared! In fact, it never really got started. It was doing it's characteristic throb, throb, but then it decreased and went away.

    Citric acid? Potassium bicarbonate? I have no idea, but it stopped them cold, and did so quickly.

    So I got hit A-GAIN last night, and while bored and sitting on my hot pad, having consumed the cherry / lemon, which helped but didn't knock them out, I sat reading about the "punch method."  I was in the declining stages so when I got around to trying it I can't say for sure if it worked. But I tried it and that seemed to end it quickly. I'm almost wishing I'd get it again to attempt the punch method solely. And here I'd like to mention that it is less intrusive if you leave your shorts on, and instead of the "knuckle" I hold my hand as though I'm making a shadow puppet of a crane - ala Bruce Lee - and hiiiiiya!

    I'd also mention that I read other people say their doctor prescribed a suppository generic name: mesalamine. This is listed as a rectal NASAID, although my reading indicates that it is merely a derivative of aspirin in suppository form. I haven't tried them, but I want to offer everything I know in hopes that one of these things might help a fellow sufferer. 

    Good luck! And as you Brit's say God speed!

     

    • itsapain
      itsapain rojotoro

      Posted

      hi rojotoro

      nice to see that you have retained a sense of humour :-)

      your post makes a lot of sense. the only thing i would qeustion is the possible use of suppositories. during my 2nd attack many years ago, in the middle of the night, back in the days when a gp would do a house call at such a time, i can remember him being very confused by my symptoms and trying to give me a suppository. suffice to say the muscle spasms just kept forcing it back out! i agree that hydration may be an issue. my first attack was on holiday in spain when i definitley could have been dehydrated. i see a psychotherapist - about general anxiety issues ( who wouldnt be, with this condition!) and also a lack of sexual sensation,  and he prescribed valium to relax the muscles. but only to be taken during an attack not regularly. he is of the 'all physical symptoms have an emotional basis' group. im not so sure but i think rather than an attack coming on DURING stressful times it seems to be when our bodies are starting to relax AFTER a bout of anxiety, thus the prevalence of night time attacks. does any body concur with any of that? 

    • phyllis96278
      phyllis96278 itsapain

      Posted

      I agree it could be dehydration. Maybe some stress also. Before acupuncture, I would wake up out of a deep sleep with a cold sweat and hurry to the couch and sit on the hardest throw pillow I have (for that occasion only). It does provide relief for PF.
    • donna58019
      donna58019 itsapain

      Posted

      Hi

      first of all I cannot believe I have found this discussion and an explanation for this odd condition that has been plaguing me for 30 years. The fainting thing occurred again this week and was quite scary - boiling hot, gagging and when it was over was freezing and dripping in sweat, also white as a sheet when I got up off the bathroom floor. The odd thing was it wasn't the most severe attack. I have described this to my GP as feeling like a childbirth contraction in my back passage which left him a bit perplexed.

      I have had a colonoscopy which was all clear in the past. 

      Wanted to to agree that I too find it comes on following a stressful time when I am just starting to relax. Almost always wakes me up and usually treatable with Nurofen express which I carry everywhere now.  Anything with codeine makes it worse for me or brings on an attack. Played around with diet and noticed when eating a low carb diet it can help. Interested in the Chinese tea and wondering if my arms are long enough for the punch method? I shall have a go. 

      I have started to let people know I have a bowel condition - fed up being embarrassed about it although I do not have a diagnosis.

      Following an attack I sometimes struggle to urinate for a couple of hours and if it has been severe I feel quite bruised around the area. 

      Noticed the seat heater in the car brings relief immediately.

      A real relief to find I am not alone. 

      Thankyou to whoever started this thread.

       

    • rojotoro
      rojotoro donna58019

      Posted

      Hi Donna,

      I noticed you said you wondered if your arms are long enough to do the "punch."

      Like you I wondered about that, and being a guy with fairly big hands the thought of getting in there with a fist, plus being a guy with other stuff that requires moving out of the way . . . 

      I modified it and it seemed to help, I bunch all five fingers in a point (imagine making a shadow puppet of a goose) and then tapped the finger tips against the rectum area.

      I'm not sure if "punch" is the right word, for me it's more of a striking motion. The idea of delivering a punch with a closed fist to that part of my body is hard to imagine.

      But as far as being physically able to reach I wanted to say that you can clean yourself after using the toilet so if you lay on your back and raise your knees up, or squat beside the bed you should be able to get up in there.

      Also, I experience the difficulty with urination, I assumed it was somehow related to my prostate, but being a woman you don't have one of those so it must be related to the uriter. Interesting.

      I hope it helps, your case sounds much worse than mine. As I said in previous comments staying hydrated seems to really help me. Also be careful of decongestants if you take those as they tend to dry you out. 

      I will also editorialize a little bit and say that I do really gentle yoga (the kind of classes that elderly people would take) and it seems to help just about everything; tightness, relaxation, stress. I always thought yoga was some sort of vegan hippy thing, wouldn't be caught dead doing it. But I tried it and am now a devote.

      You might give it a shot, even if it doesn't help it will relax you and that can't be bad for anything.

      Good luck!

      R. 

       

    • lalaxton
      lalaxton rojotoro

      Posted

      Just to clarify The rectal supossitory mesalamine is not an NSAID (like Ibuprofen/advil) it is a 5-ASA which is an antinflamatory specifically for the gut.

       

    • rojotoro
      rojotoro lalaxton

      Posted

      I thought I read that it was sallycyclic / salycylic based which is good ole aspirin, mais non?
  • rojotoro
    rojotoro Guest

    Posted

    Oh, also wanted to mention that "I too" tried the doctor route thinking it might be prostatitus (inflammation of the prostate) and endured a very unplesant exam that turned out to be negative, and nearly got the doctor in question punched in the mouth. But before I knew about P.F. I Googled my symptoms and came up with that. So again, in the interest of helping others, I want to offer the full corpus of my experiences. Apparently this is something men can get, and it might bear looking into. It's such a maddening condition, again, not trying to overshare my medical history. Merely hoping to create a "me too" moment that will help someone else.
  • b25663
    b25663 Guest

    Posted

    Have suffered from this since my teens. Now in my 40's still dealing with this horrible whatever it is.  Get it about every couple months, usually at night, wakes me up.  Had one last week in the afternoon, lasted for 45 minutes, about passed out.  3 out of us 4 sisters have it.  I need to know how to deal with this pain, get this to not last so long.  I have tried everything.
    • prayer
      prayer b25663

      Posted

      Hi,

      I get immediate relief if I lie down on my back and move my legs as if cycling on the air. This has worked for me each time I have had the pain.

      Relief come within 3-5 min.

      Someone else has posted a punching technique. Lot of people seem t have benefitted. You can find it if you read some previous discussions.

      I hope you manage to find something that works for you.

      My best wishes !!!

      Prayer

    • sadders
      sadders prayer

      Posted

      I had my first bout in ages last night. I'm currently away at a conference which doesn't help.

      I'm almost positive that there is a stress related component to this.

      My current method or management is firm and vigorousl massage of the peroneum and peri-anal areas. I'm not sure that this works but is certainly a distraction.

    • itsapain
      itsapain b25663

      Posted

      i have been prescribed valium by a psychotherapist on the understanding that i use it only when i have an attack. it has muscle relaxant properties and i take 5 to 10 mg as soon as i feel an attack starting. USUALLY it helps. sometimes the punching technique works too but if its too late i am not brave enough to punch the area simply because it is already so painful.
    • rojotoro
      rojotoro b25663

      Posted

      Did you read the post about the "punch" method, which I have modified and trademarked (jk) as the Striking Crane?

      A lot of people seem to find relief with that simple method.

      And I also always add my big one, which is hydration, especially at night. Yes you will get up a lot to pee, but isn't that better than getting up in agonizing pain?

    • Merrymary
      Merrymary b25663

      Posted

      Heating pad!! I just turned 50. I get this more frequently the older I get. I always sit on heating pad til it subsides and I can go back to sleep.
  • derrick02695
    derrick02695 Guest

    Posted

    I have had this issue since about the age of 13. I am now 36. Of course before I was sexually active it would just happen, but when I did have sex it was a high probability that PF was going to strike. Just like everyone else it happens at any given time.

    The times I feel it coming, I take an aleve extra strength 'GEL' tab with some ice cold water. Then i go and lay down with a fan blowing in my face to keep the heat flashes from coming. Before the pain peaks, the aleve has kicked in and the relief begins. People dont realize that this specific tab is for imflammatory pain relief. I actually dont leave home without at least three of them in my pocket. I have a small tube I carry them in. 

    It has been said that it isnt life threatening, but what if this happens... and have to me. It hit me hard about midnight with no warning, just straight to full strength pain. I tried to walk to kitchen to get water and take pill, but I start blacking out and getting heat flashes then fainted. The next morning I had a bruise on my temple. Then my wife discover that the knob on kitchen cabinet was bent down. We put 2 & 2 together. When i fainted, I hit my head on knob. That could have killed me. It happened when I was driving, had I not had time to pull over to a store and park... could have crashed and hurt someone or myself. This PF thing is dangerous, especially since there is no scientist out there to figure out WHY?

    Does anyone has it so bad to the point your hands tingle and get numb? I do. Or when you smell a certain scent it triggers? Yup, thats me again.

    • itsapain
      itsapain derrick02695

      Posted

      hi derrick

      i empathise. i too go nowhere without my meds but in my case i have valium - used for its muscle relaxant properties. i woke at 2 am last night with the sure sign that an attack was imminent - cold sweats, pain beginning to kick in. i usually take 5 mg valium but they havent worked as well recently so this time i took 10 mg, and did the punching technique you will find referred to on this forum. heavens be praised it worked within 30 seconds. immediate relief and because it didnt develop into a full blown attack i didnt have the washed out drained feeling for the next 24 hours that i usually get. not to mention the fainting. i totally agree with you about the lack of research about this condition. is it because its rectal and people dont want to admit to it? my gp knows nothing about the condition and i was only put on to valium by a psychotherapist ( gp was none too happy to be usurped but ive had this for 30 years without even a clue as to its cause let alone a cure). 

      anyway, please post any potential discoveries you happen across.

    • phyllis96278
      phyllis96278 derrick02695

      Posted

      Hi Derrick,

      I went to my GP also, she said you have proctalgia fugax! So what can I do about it? Not much...sit on a tennis ball.  So I asked my acupuncturist 6 months or so ago. She said at my next visit, bring in some lubricating jelly.  So I did and she did a manipulation (rectally)

      during my next 2 visits. Well, surprise, surprise, I have been free of this heinous condition for about 6 months.  Mind you, I had proctalgia almost every day so this is like a miracle!!

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