The Cause of Proctalgia Fugax / Anal Pain

I've suffered from the worst case of proc for 30 + yrs. Nothing can stop this monster from showing up again. I've discovered we who suffer from this monster have a weakness in our nuero transmitters. Our system has episodes to where our transmitters aren't sending the correct transmissions to our anal muscle & it clenches up on us. Like people who suffer from regular Charlie horses in their calf muscle or foot throughout their lives.

And yes, dehydration & lack of potassium are major triggers for this genetic weakness for sure...

Hello Sam,

I am a female aged 45 years of age.  I have had PF for about 15 years.   

The episodes or sporadic.  I may go 2 months without one and then I can have 3 in a month.  The episodes last between 20 mins and 1hr.  One can never tell how long they will actually last.  Each has its own intensity. As the pain can be classified as "acute" I have spent years researching.  The main trigger for me is a sudden empty bowl movement and stress.  Mine manifests like a dull toothache or ear ache and eventually reaches full blown acute pain.  It starts during the night once I have fallen asleep. I very rarely have day episodes.  There is only one way I have learned to manage the pain and that is to think and focus really deeply on trying to fall back asleep again.  I know that this may sound very strange indeed but almost like a woman focuses on one point in a room during childbirth that is what I do with my eyes shut.  I breath methodically and I think and focus on one thing breathing through the pain and forcing myself back into a deep sleep, albeit only after about 30mins of enduring the agony.

Anyway I really do think that stress is a MAJOR factor in this but mine is definitely brought on only if i have completely emptied my bowls.  I also think this is why they categories it in the "IBS - Irritable Bowl Syndrome" category, although I am not so sure it should be.

To shed some more light on this it is quite possible that this can also be genetic.  My mother has it, my brother has it and so does my son who is 23 years of age. (although my brother and my son's episodes are very few).

In men more so than woman it can also be triggered by orgasm. There is quite a bit online regarding this.

Hope this helps!

Wendy

Dear Samuel & Wendy,

Try this. This is the ONLY thing that works for me & was brought to this discussion a year ago by another sufferer of this monster.

There is a nerve that resides between our upper lip & nose. At the very bottom of your noses PINCH tightly with your index finger & thumb. Hold it firmly & within 30 seconds the pain will begin to subside. Often times doing this will completely break the spasm' cycle altogether & it disappears. But in the very least it dulls the pain 10 fold & makes the episode bearable.

I call this the "PINCH METHOD" & this has worked for many people on this site...

Please reply the next time you have an episode & give me your feedback on this method. If it helps or not. I'm willing to bet if you try this, you'll be very pleased...

Cory

@cory31975, thank you for your response and although I don't disagree with you I still think there are things we can do to reduce the number of episodes, esp via diet. I've been reading about magnesium deciciency being a caause of muscle cramping - so going to try a supplement too.

wendy11930, thank you - it is amazing how similar everyones expereinces are. I agree with you that stress, empty bowels and orgasms are all triggers for me now that I think of it.

@cory31975, I actually read your posts on the pinching method before and see you both have had success with that - so will let you know once I've tried it.

@everyoneelse - please keep sharing your causes! Thank you!

Oh I absolutely agree w/ you on diet helping Samuel! I completely cut gluten out of my diet 8 months ago & take prescription grade multi-vitamins every day. And it went from a 2 hour (screaming at the top of my lungs) attack once every 6 weeks for the last 15 yrs, down to 1 attack in the last 8 months. So diet is a major role player affecting our episode frequency.

And also I too have learned that my 3 biggest triggers are stress, dehydration, & orgasm.

If I've had an extremely high stress day, more stressful than normal, an attack is surely to follow that night or the night after. And my attacks come if I don't drink enough water during the day every time. So I agree with you 100% on diet, stress, & dehydration being the biggest players in our episodes...

Hello,

Thanks to everyone whose posted. I typically just read posts silently, but want to help.

I too have experienced sporadic rectal spasms - started searching online when there was little to no results over 8 years ago.

You all may be on to something with the dehydration, however I had several bananas last week in which I had not consumed in a while (over 1-2 months) and still experience an episode tonight. I normally do not consume enough FLUIDS in a day (I can't say just water I don't get enough of). My spasms have averaged approved every other month for less than 15 mins.

I ask that you all pay attention to this.

I noticed I have a better chance at experiencing PF Spasms if my anus is exposed to a cool draft or cool air.

Whether during sex (not anal) and the fan is on or eliminating in a cool bathroom.

I'm a female, mid 30's.

cd13032 – thank you for sharing! Just so I understand – you are less likely to experience spasms if your exposed to cold air?

Since 2017 I have started to log when they happen for me – so I hope this data might be useful:

2017

•23 Feb

•14 May

•13 June

•23 July

•21 August = no water

•16 Sept = during day, no water

2018

•15 April = no water

•31 May = during day

•29 June = during day - not great eating past few days

•17/18 August = stress

•5/6 Sept = no fruit/water

•4 Nov = no fruit/water

It’s truly amazing how regularly they are – I know there are gaps (less in winter months and more in the summer) – but essentially they are once a month. It is almost like a period in regularity, apart from I’m a male aged 30.

Re the Pinching Method – it’s worked on and off for me – but I still do it as I do think it helps.

Re triggers – couldn’t agree more with cory31975 - stress, dehydration, & orgasm.

Re my current thinking – I’m going to get my bloods done soon and see if they show anything. But I think I really need to start vitamins/supplements to see what makes a difference.

Thanks again for everyone that is contributing to this.

Sam

Thank you Sam for creating this discussion and I will add my story for what it's worth, albeit 5 years late. I (male born 1982) started experiencing PF in my late 20s and the episodes were fairly mild to begin with and were happening around once every 2-3 months. By 30 I was experiencing them at full intensity. It would begin with a faint pain in the rectum and over 15 minutes would crescendo into a 10-out-of-10 stabbing pain there. I tried sitting on the toilet because it felt like that may help to release " the monster" but that didn't help (I couldn't pass anything) and I ended up passing out from the pain while sitting there, falling to the floor. Possibly 5 minutes later I would come to, covered in a cold sweat, but the pain was gone. These intense (10/10 pain) episodes happened around 10 times between ages 30-35. I also had many less intense (8/10 or 9/10 pain) episodes in that time, probably 5-6 a year. Usually at night in bed, but sometimes during the day at work too. I told several doctors about these experiences and incredibly not one mentioned proctalgia fugax and didn't suggest any other possibility. They said that because it was infrequent that it was not a major concern. You've really got to be your own doctor in many ways these days, especially with the wealth of knowledge and shared experiences found on the internet (taken with a grain of salt). Anyway, now age 40 I pretty much never have episodes of PF anymore or if I do they are only mild.

Here are things that I reckon were causing it:

(1) diet: I have been on a strict diet free of gluten, dairy and eggs and also low in sugar for the past 3 months, mostly to see the effects on my rheumatoid arthritis, which has also improved and I suspect mainly because of the low sugar. After recently breaking that diet by having half a loaf of good quality homemade bread, I had stomach cramps 1 day later (I guess what would be called IBS) and then indicators of proctalgia fugax 3 or 4 days later. By indicators I mean that faint pain in the rectum but which in this instance didn't escalate and went away after a minute or two. In my 20s until mid 30s I was eating way too much bread and breakfast cereal and I believe this was a trigger, or worse: the bullet loaded into the gun!

(2) Body position while sleeping: I used to sleep with one leg curled right up to my stomach with the other leg straight - it felt nice to stretch out the glutes in this way, especially because I was cycling a lot. I did notice eventually that this was a possible trigger for PF with several episodes beginning in this position. Possibly nerves being squeezed by the muscles around them or simply pain in the muscles themselves?

(3) Stress: one of the worst PF episodes I had occurred during the day at work and it was a stressful day with the boss cracking the whip on me.

(4) Orgasm: like others, sometimes I would experience PF immediately after a strong orgasm, which could be related again to contraction of muscle around the anus.

Treatment of proctalgia fugax:

For me there was 15 minutes between the early signs of a PF episode and full blown excruciating stabbing pain. As soon as I felt those early signs I would take 1 paracetamol, crushing it between my teeth before swallowing to release it quicker (though some caution may be required in others because this causes a spike in its effect). I kept the paracetamol next to my bed to be readily available because time was critical. It takes about 15 minutes for it to take effect (based on what I've read), so would reduce the pain as it was peaking. I never had a 10/10 pain when I did this and wished I had tried this sooner.

But prevention is better than treatment. Good luck figuring out what is best for your body!

Glad I found this as it's not very well known. Suffered with this for several years. To start with it was once in a while now I can go weeks without an attack and then I can have three in a week. 9/10 it's at night. Had a Sigmoidoscopy when I first went to GP about it, but all was fine bar a bit of Diverticulitis. Stumbled across sitting in a hot bath as a remedy but more recently a couple of paracetamol seems to do the trick quite quickly. However last night I was woken up again by it and also was in desperate need of a pee at the same time. Struggled at first but once I managed to pee the pain subsided. Now I am a bit worried that it's not PF at all but maybe my prostate although I can't find any evidence that prostate pain can be relieved actually by having a pee! Can PF be relieved this way?! Looks like another trip to the GP!!