Proctalgia Fugax and Anal Pain - Treatment

Authored by Dr Mary Harding, 09 Jul 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Helen Huins, 09 Jul 2017

Often no treatment is needed. For many people, the episodes are infrequent. If you know it isn't anything to worry about, you may not need any treatment. You know the pain will settle quickly on its own. In a few people, it can be more troublesome, and may need treatment. There are no proven treatments for this condition, but options include:

  • Using a salbutamol inhaler. This is the same inhaler used by people with asthma. It opens up airways so it makes sense that it can work on the muscles around the anus as well, relaxing them.
  • A cream which works on the blood vessels around the anus, such as glyceryl trinitrate or diltiazem cream.
  • An injection into the nerve to make it less sensitive.

Options include:

  • Biofeedback therapy. This is a type of therapy whereby you learn how to relax your pelvic floor muscles. Electrodes are attached inside providing a trace which shows you what happens as you try to relax and contract the muscles. You need several training sessions to learn how to control the muscles well. This is the treatment option for which there is most evidence that it works.
  • Electrogalvanic stimulation. This involves stimulation of the anus by an electric current through a probe placed inside it.
  • Botox® (botulinum toxin). An injection of Botox® helps to reduce episodes in some cases.
  • Stimulation of specific nerves. This involves trying to de-sensitise some of the nerves in the area.
  • A salbutamol inhaler (as above).

Most options require you to be referred to a specialist for advice and for the treatment to be arranged.

Further reading and references

The attacks described on this forum are exactly the same as what i've been experiencing for 4-5years now. I get a stabbing/pressure pain in my butt that feels really deep inside and like something in...

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