Proctalgia fugax overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Proctalgia fugax is a sudden, severe, episodic, anal pain caused by cramp of the pubococcygeus or levator ani muscles. It occurs in 14% of apparently healthy adults, and there are some documented cases of proctalgia fugax associated with the irritable bowel syndrome. [1][2]
Historical Perspective
Proctalgia fugax is intermittent, recurring, and often self-limiting pain in the anorectal region in the absence of organic proctologic disease. It was mentioned first by Myrtle more than a century ago, but its existence was more definitively described by Thaysen (1935).[3]
Classification
Pathophysiology
The exact pathogenesis of proctalgia fugax is not completely understood. Several studies suggest that abnormal smooth muscle contractions may be responsible for the pain. A familial form of proctalgia fugax was associated with hypertrophy of the internal anal sphincter. Attacks of proctalgia fugax are often precipitated by stressful life events or anxiety. Psychological testing suggests that many patients are perfectionistic, anxious, and/or hypochondriacal.[4][5][6]
Causes
Differentiating Proctalgia fugax overview from Other Diseases
Epidemiology and Demographics
Proctalgia fugax affects twice as many females as males at approximately aged 50 years. Commonly the roughly once-monthly attack occurs as a sudden pain with no trigger factor, diurnally as often as nocturnally. The nonradiating cramp, spasm, or stabbing pain, without concomitant symptoms, is most severe on average after 15 minutes and declines spontaneously.[3]
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
References
- ↑ Olden, Kevin W. (1996). Handbook of functional gastrointestinal disorders. New York: M. Dekker. p. 369. ISBN 0-8247-9409-5.
- ↑ Thompson WG (1981). "Proctalgia fugax". Dig Dis Sci. 26 (12): 1121–4. doi:10.1007/BF01295979. PMID 7030675.
- ↑ 3.0 3.1 de Parades V, Etienney I, Bauer P, Taouk M, Atienza P (2007). "Proctalgia fugax: demographic and clinical characteristics. What every doctor should know from a prospective study of 54 patients". Dis Colon Rectum. 50 (6): 893–8. doi:10.1007/s10350-006-0754-4. PMID 17164968.
- ↑ Rao SS, Hatfield RA (1996). "Paroxysmal anal hyperkinesis: a characteristic feature of proctalgia fugax". Gut. 39 (4): 609–12. doi:10.1136/gut.39.4.609. PMC 1383278. PMID 8944574.
- ↑ Eckardt VF, Dodt O, Kanzler G, Bernhard G (1996). "Anorectal function and morphology in patients with sporadic proctalgia fugax". Dis Colon Rectum. 39 (7): 755–62. doi:10.1007/BF02054440. PMID 8674367.
- ↑ Minami K, Tatsuta N, Konishi Y, Matsuda K, Shimada I, Fujita S; et al. (1983). "[Clinical cardiovascular experiences with iopamidol: a new non-ionic contrast medium]". Nihon Geka Hokan. 52 (6): 854–63. PMID 6678564.