Proctalgia fugax (whaaaat?)

Well, in my continuing quest to explore the outer limits of human endurance, I added another extreme activity to my repertoire last night. What I omitted from my account yesterday was that I spent about half an hour of the night in the most *excruciating* pain. Worse than when I broke my femur, worse than when my front teeth got smashed in, worse than childbirth...well, ok, worse than watching my daughter being born.

And it was all focused on my bottom. Yep, i really thought for a while that I might die from a pain in the bum.

It seems that it is something called "proctalgia fugax", described by Wikipedia as "a severe episodic rectal pain". My GP has little to offer by way of treatment as its cause is poorly understood. We are just hoping that it will be a rare visitor!

I wonder if it is related to the ongoing nerve pain I have from my old hip and femur fractures, and whether the amitriptyline and other meds I'm now taking have any effect, one way or another. Or nerve compression from my extremely sedentary lifestyle?

It would be interesting to know if anyone else has had any experience with this.

P.S. I'm surprised the neighbours didn't come hammering on the wall at the time, as I was alternately howling with pain and laughing out loud at the thought that at my funeral, the eulogist would be saying, "Let's not dwell on the manner of his death....", prompting the whole congregation to think, "....he died of bum pain..." It must have sounded weird.

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  • Second laugh out loud post of the night! Barnclown was first...

  • Hi, whisperit.

    You have described the pain of Proctalgia fugax brilliantly! Having experienced it and having had a very wise old GP sympathise and explain it, I can pass on her tip: when you first feel it starting, bear down as hard as you can (stay with me here, guys), through your bottom, as if you were going to have your bowels open. It sounds completely barmy, when you are in such pain, but believe me, it works every time. Thinking about it later, I decided it must work on the same principle as getting up and standing on a leg that goes into agonising cramp. That works too.

    tess

  • That is gold, Tess. I

    It makes a lot of sense, as I noticed the point when the pain started to ease seemed to come when I felt a distinct, involuntary contraction like doing a poo. So it does feel like it is some sort of spasm. In a funny way, it hows you just how powerful are parts of your body that you never think about normally.

    Thank you so much for that tip X

  • 😏 Problem with this plan for me is that my prolapse + the post op side effects makes this a very risky manourver...

    Tess, you have this stuff too? did you see this thread:

    healthunlocked.com/lupusuk/...

    Argh....

    πŸ€πŸ˜˜

  • Hi, coco. I hadn't seen your thread from 5 days ago...thanks for the link to it. I've been off gallivanting. We went to Marrakech for a few days and it was wonderful. Yikes, I can really understand that my advice to whisperit wouldn't be at all helpful for you. Oh my word. What a lot you have to deal with. I sympathise and wish you all the best, dear coco. I hope you've got an urgent referral to a colorectal surgeon. That tip for when you saw your GP, to push the family rectal tumours was very sound. Warm hugs. And I love the daffs-thank you.

    Tess😘

  • Oh Tess: thanks vvvv much....here I am feeling quite nervous about my appt tomorrow: My early onset crohns husband Badger wants me to see the top colorectal surgeon privately while we let NHS gastroentrrology continue with their investigations which will take months based on the speed since my first appt in January. After 17 months of these abdo/pelvic investigations, Badger has had enough....even though I'm telling him that gastroenterology will have to refer me to NHS colorectal clinic anyway...(The only advantages to going private I guess are speed + I definitely am seen by the senior surgeon)

    So tomorrow I must tell my gp about my colorectal history & that "Bad Me" has simply neglected out of "denial" to fess up to these worsening colorectal signs & symptoms

    You'd think after everything I've been through in the course of my life, I'd manage this ok. I think I probably will, thanks to everyone here being so supportive. But I really feel nervous.

    So, your encouragement turning up tonight means a lot

    I ❀ the sound of your time away πŸ‘πŸ‘πŸ‘πŸ‘

    πŸ€πŸ˜˜πŸ€πŸ˜˜

  • πŸ‘πŸ‘πŸ‘πŸ‘I know PF well. No picnic. Agonising. This has long been part of my anorectal stuff 😝

    My oh my, this has been an amazing 2 weeks here re the undercarriage dept...πŸ€·β€β™€οΈπŸ€πŸ˜˜

    For what it's worth, my fav ref:

    Common Anorectal Conditions: Part I. Symptoms and Complaints

    JOHN L. PFENNINGER, M.D., The National Procedures Institute, Midland Michigan GEORGE G. ZAINEA, M.D., Midland, Michigan

    Am Fam Physician. 2001 Jun 15;63(12):2391-2398 (tel:2391-2398).

    Proctalgia fugax is a unique anal pain. Patients with proctalgia fugax experience severe episodes of spasm-like pain that often occur at night. Proctalgia fugax may only occur once a year or may be experienced in waves of three or four times per week. Each episode lasts only minutes, but the pain is excruciating and may be accompanied by sweating, pallor and tachycardia. Patients experience urgency to defecate, yet pass no stool.

    No specific etiology has been found, but proctalgia fugax may be associated with spastic contractions of the rectum or the muscular pelvic floor in irritable bowel syndrome. Other unproven associations are food allergies, especially to artificial sweeteners or caffeine. Reassurance that the condition is benign may be helpful, but little can be done to treat proctalgia fugax. Medications are not helpful since the episode is likely to be over before the drugs become active. Sitting in a tub of hot water or, alternatively, applying ice may provide symptomatic relief. A low dose of diazepam (Valium) at bedtime may be beneficial in cases of frequent and disabling proctalgia fugax.

  • Thanks, coco - thats exactly how it is. I am pleased to hear that it is "benign" (although that is a bizarre way of describing something so painful). The fascinating thing at the time was that, although I hadnt experienced it before, and it was agonising, at no point did I have that feeling that something really *bad* was happening. With some other symptoms, less "severe" ones, one sometimes has an instinctive sense of how serious it is. Does that make sense? Anyway, thank you for those extra tips x

  • πŸ˜† Good point! Originally I reacted to PF same as you...I like your description. But it is a v Spooky sensation...sort of haunts me even now πŸ‘»πŸ€πŸ˜˜

  • Hello whisperit. Sorry to hear about your suffering. I think I can relate to it. Interesting post. I have experienced sharp, shooting pains through my derriΓ¨re on quite a few occasions. I have haemorrhoids and I have IBS type symptoms with my lupus. GP says I've got some sort of inflammatory bowel disease going on, linked to my lupus. But I have never mentioned the sharp shooting pains. I'm not sure why not, when I've had the doctor inspect my piles!! But the description of the feeling of wanting a poo but not doing one fits with my symptoms too. Unfortunately I get it during the day and sometimes whilst out. Worst was on a long beach walk with my family and no loos around. Sharp, sharp pain, I think I need the loo. But I have to keep walking. Hurts to walk but I had no choice. Made it home. Go to the loo. No stools. Pain subsides. Another thing to mention, another one to add to the ever growing list. Great post and discussion. We have talked a lot about bottom issues recently and I posted about my heamorrhoids. Oh, the glamour. Let us know how you get on.

  • Hah! Yes, I have very quickly lost any sense of shame about my bodily functions this past year or two. My body is a "hot mess" as I think the young people say these days. There's no point pretending otherwise :D

  • I experienced it once and thankfully only once many years ago. I have never had it since.

  • Glad to hear that, thanks Geoff

  • Hi whisper it

    So sorry to read of your agonising rectal pain suddenly. Fingers crossed it is a one off!. Don't we wonder what our bodies will give us next!.

    Interesting you talked of nerve pain in your leg and nerve compression. I have both and been treated very successfully at a pain clinic. Injections have helped both as I know how severe the pain can be. Have had to have stronger painkillers . Hard not to keep sitting so much. How did it go with O. Health?. Are you retiring early?. X

  • Thanks for remembering misty. Yes, I got the Occ Health medic's report to the early retirement panel this week. Although there is no box to tick saying, "I support this application", he does say that I am unable to carry out my duties. My sick pay ran out last week, so I hope to have good news from the Panel very soon x

  • Hi whisper it

    Fingers tightly crossed for you that you get early retirement although a double edged thing!. X

  • I find sitting on hot water bottle helps .

  • Thank you. another weapon in my armoury! And not a pointy one, luckily

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