Proctalgia fugax
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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.
Historical Perspective
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
Historical Perspective
References
Classification
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
Classification
References
Pathophysiology
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
Pathophysiology
References
Causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
Causes
References
Differentiating Proctalgia Fugax from other Diseases
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
Differential Diagnosis
References
Epidemiology and Demographics
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Epidemiology and Demographics
Onset can be in childhood. One study showed that men were affected more commonly than women.[1]
References
- ↑ 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.
Risk Factors
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
Risk Factors
References
Screening
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Overview
Screening
References
Natural History, Complications and Prognosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
Natural History
Complications
Prognosis
References
Diagnosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Abdominal X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Treatment
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
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