Proctalgia fugax, a variant of levator ani syndrome, is a severe, episodic pain in the regions of the rectum and anus.
[4] During an episode, the patient feels spasm-like, sometimes excruciating, pain in the rectum or anus, often misinterpreted as a need to defecate.
To be diagnosed as proctalgia fugax, the pain must arise de novo (meaning the absence of clear cause).
[8] High-voltage pulsed galvanic stimulation (HGVS) has been shown to be of prophylactic benefit, to reduce the incidence of attacks.
[14][15] Supportive treatments directed at aggravating factors include high-fiber diet, withdrawal of drugs which have gut effects (e.g., drugs that provoke or worsen constipation including narcotics and oral calcium channel blockers; drugs that provoke or worsen diarrhea including quinidine, theophylline, and antibiotics), warm baths, rectal massage, perineal strengthening exercises, anticholinergic agents, non-narcotic analgesics, sedatives or muscle relaxants such as diazepam.
In patients who have frequent, severe, prolonged attacks, inhaled salbutamol has been shown in some studies to reduce their duration.