What are the main symptoms of proctalgia fugax. How is proctalgia fugax diagnosed. What treatments are available for proctalgia fugax. How does proctalgia fugax differ from other anorectal conditions. When should you see a doctor about rectal pain.

Understanding Proctalgia Fugax: A Common but Poorly Understood Condition

Proctalgia fugax is a condition characterized by sudden, severe pain in the rectum and anal area. Despite being relatively common, it remains poorly understood by both patients and medical professionals. The term “proctalgia fugax” literally means “fleeting rectal pain” in Latin, aptly describing its most prominent symptom.

This condition falls under the broader category of functional anorectal disorders, which are problems affecting the anal and rectal area that don’t have an identifiable structural or biochemical cause. While proctalgia fugax can be distressing, it’s generally not indicative of a serious underlying condition.

Key Characteristics of Proctalgia Fugax

• Sudden onset of pain in the rectum or anus
• Pain typically lasts from a few seconds to several minutes
• Episodes are unpredictable and may occur infrequently
• Pain is often described as cramping, aching, or spasmodic
• No visible abnormalities or damage to the anal or rectal area

Recognizing the Symptoms of Proctalgia Fugax

The hallmark symptom of proctalgia fugax is a sudden, intense pain in the rectum or anus. This pain can vary in intensity but is often described as severe enough to interrupt daily activities or wake a person from sleep. Understanding the typical symptoms can help individuals recognize when they might be experiencing this condition.

Common Symptoms of Proctalgia Fugax

• Sudden, severe pain in the rectum or anus
• Pain that lasts from a few seconds to several minutes
• Cramping or spasmodic sensation in the anal area
• Pain that may radiate to the buttocks or lower back
• Episodes that occur sporadically and unpredictably
• No pain or discomfort between episodes

Are there any warning signs before an episode of proctalgia fugax occurs? Unfortunately, most people do not experience any warning signs before an episode. The pain typically comes on suddenly and without any apparent trigger. This unpredictability can make the condition particularly distressing for those who experience it frequently.

Potential Causes and Risk Factors for Proctalgia Fugax

While the exact cause of proctalgia fugax remains unknown, several theories have been proposed. It’s likely that the condition results from a combination of factors rather than a single cause. Understanding these potential causes and risk factors can help in managing the condition and identifying potential triggers.

Proposed Causes of Proctalgia Fugax

• Spasms of the muscles in the pelvic floor or anal sphincter
• Abnormal nerve sensitivity in the rectum or anus
• Psychological stress or anxiety
• Constipation or changes in bowel habits
• Hormonal fluctuations

Can certain activities or foods trigger episodes of proctalgia fugax? While triggers can vary from person to person, some individuals report that certain activities or dietary factors may increase the likelihood of an episode. These may include:

• Prolonged sitting
• Sexual activity
• Stress or anxiety
• Consuming spicy or acidic foods
• Dehydration

Diagnosing Proctalgia Fugax: Challenges and Approaches

Diagnosing proctalgia fugax can be challenging due to its episodic nature and the lack of visible abnormalities. Doctors typically rely on a patient’s description of symptoms and a process of ruling out other potential causes of rectal pain. Understanding the diagnostic process can help patients prepare for their medical consultation.

Steps in Diagnosing Proctalgia Fugax

1. Detailed medical history and symptom description
2. Physical examination, including digital rectal exam
3. Ruling out other conditions through tests such as:
   • Colonoscopy
   • Anorectal manometry
   • Endoanal ultrasound
   • MRI of the pelvic area
4. Evaluation of psychological factors

How do doctors differentiate proctalgia fugax from other anorectal conditions? Doctors use a combination of symptom presentation, physical examination, and diagnostic tests to distinguish proctalgia fugax from other conditions that can cause rectal pain. Key differentiating factors include:

• The sudden onset and brief duration of pain
• The absence of visible abnormalities or inflammation
• The lack of pain or discomfort between episodes
• The absence of other symptoms typically associated with conditions like hemorrhoids or anal fissures

Treatment Options for Proctalgia Fugax: Managing Pain and Reducing Episodes

While there is no cure for proctalgia fugax, several treatment options can help manage symptoms and reduce the frequency of episodes. Treatment approaches often involve a combination of lifestyle modifications, medication, and in some cases, more invasive procedures. The choice of treatment depends on the severity and frequency of symptoms, as well as individual patient factors.

Common Treatment Approaches for Proctalgia Fugax

• Lifestyle modifications:
  • Stress reduction techniques
  • Regular exercise
  • Dietary changes
  • Improved sleep hygiene
• Medications:
  • Topical pain relievers
  • Muscle relaxants
  • Antispasmodics
  • Tricyclic antidepressants (for chronic cases)
• Physical therapy:
  • Pelvic floor exercises
  • Biofeedback training
• Botulinum toxin injections (for severe cases)
• Sacral nerve stimulation (in rare, refractory cases)

What can individuals do to manage pain during an episode of proctalgia fugax? While episodes typically resolve on their own, several strategies can help alleviate discomfort:

• Applying heat or cold to the affected area
• Taking a warm bath
• Practicing relaxation techniques or deep breathing
• Gentle massage of the perineal area
• Using over-the-counter pain relievers (with doctor’s approval)

Living with Proctalgia Fugax: Coping Strategies and Lifestyle Adjustments

Living with proctalgia fugax can be challenging due to its unpredictable nature. However, many individuals find that making certain lifestyle adjustments and developing coping strategies can significantly improve their quality of life. Understanding how to manage the condition on a day-to-day basis is crucial for those affected by proctalgia fugax.

Lifestyle Adjustments for Managing Proctalgia Fugax

• Maintaining a regular exercise routine
• Practicing stress-reduction techniques like meditation or yoga
• Avoiding prolonged sitting
• Staying hydrated and maintaining a healthy diet
• Getting adequate sleep
• Avoiding known triggers (if identified)

How can individuals cope with the psychological impact of proctalgia fugax? The unpredictable nature of proctalgia fugax can lead to anxiety and stress, which may in turn exacerbate symptoms. Some strategies for coping with the psychological aspects include:

• Seeking support from friends, family, or support groups
• Practicing mindfulness or cognitive-behavioral techniques
• Keeping a symptom diary to identify patterns or triggers
• Educating oneself about the condition to reduce fear and uncertainty
• Considering counseling or therapy if the condition significantly impacts mental health

When to Seek Medical Attention for Rectal Pain

While proctalgia fugax is generally not a serious condition, it’s important to know when rectal pain warrants medical attention. Certain symptoms may indicate a more serious underlying condition that requires prompt evaluation and treatment. Understanding these red flags can help individuals make informed decisions about seeking medical care.

Signs That Warrant Immediate Medical Attention

• Severe, persistent pain that doesn’t resolve
• Rectal bleeding or blood in the stool
• Fever accompanying rectal pain
• Unexplained weight loss
• Changes in bowel habits lasting more than a few days
• Pain accompanied by nausea or vomiting
• Visible swelling or lumps in the anal area

How often should individuals with proctalgia fugax follow up with their healthcare provider? For most people with mild or infrequent symptoms, annual check-ups may be sufficient. However, those with more frequent or severe episodes should consult their healthcare provider more regularly, typically every 3-6 months, to assess the effectiveness of treatment and monitor for any changes in symptoms.

Research and Future Directions in Understanding Proctalgia Fugax

While proctalgia fugax has been recognized as a medical condition for many years, there is still much to learn about its underlying causes, optimal treatments, and long-term outcomes. Ongoing research aims to shed light on this poorly understood condition and develop more effective management strategies. Staying informed about the latest research can help patients and healthcare providers make better decisions about treatment and management.

Current Areas of Research in Proctalgia Fugax

• Genetic factors that may predispose individuals to the condition
• The role of the gut microbiome in anorectal disorders
• Advanced imaging techniques to better understand muscle function in the anorectal area
• Novel treatment approaches, including targeted nerve stimulation
• The relationship between proctalgia fugax and other functional gastrointestinal disorders

What promising new treatments are on the horizon for proctalgia fugax? While research is ongoing, several potential treatments are being investigated:

• Targeted electrical stimulation of specific nerves in the pelvic area
• Novel pharmacological agents that modulate nerve sensitivity
• Advanced biofeedback techniques using virtual reality technology
• Personalized treatment approaches based on genetic and microbiome profiles

As research progresses, it’s hoped that our understanding of proctalgia fugax will improve, leading to more effective diagnostic tools and treatment options. Patients are encouraged to stay informed about the latest developments and discuss new treatment possibilities with their healthcare providers.

Anal pain – Mayo Clinic

Anal pain — pain in and around your anus or rectum (perianal region) — is a common complaint. Although most causes of anal pain are benign, the pain itself can be severe because of the many nerve endings in the perianal region.

Many conditions that cause anal pain may also cause rectal bleeding, which is usually more frightening than serious.

The causes of anal pain usually can be easily diagnosed. Anal pain usually can be treated with over-the-counter pain relievers and hot water soaks (sitz baths).

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Show references

1. Anal pain. American Society of Colon and Rectal Surgeons. https://fascrs.org/patients/diseases-and-conditions/a-z/anal-pain. Accessed Sept. 21, 2021.
2. Feldman M, et al., eds. Anal diseases. In: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Sept. 21, 2021.
3. Evaluation of anorectal disorders. Merck Manual Professional Version. https://www.merckmanuals.com/professional/gastrointestinal-disorders/anorectal-disorders/evaluation-of-anorectal-disorders. Accessed Sept. 21, 2021.
4. Understanding minor rectal bleeding. American Society for Gastrointestinal Endoscopy. https://www.asge.org/home/for-patients/patient-information/understanding-minor-rectal-bleeding. Accessed Sept. 21, 2021.
5. Rajan E (expert opinion). Mayo Clinic. Oct. 3, 2021.

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Symptoms, Causes, Diagnosis, and Treatment

Pain is part of life. Headaches, stiff knees, and sudden back pain may make you feel uncomfortable. Similarly, you may have pain in your buttocks. 

Proctalgia fugax is pain or cramping felt around your buttocks and rectum. The rectum is the last part of the large intestine, ending in the anus, which removes solid waste from the body. ‌

This pain is the result of spasms or cramps of your pelvic floor muscles, anal sphincter muscles, or rectum muscles. Because proctalgia fugax is unpredictable, it is difficult for doctors to diagnose or researchers to study.

Symptoms

Proctalgia fugax is temporary rectal pain. You may have intense pain for a short time. Cramps in your rectum may last from a few seconds to several minutes.

Severe episodes of proctalgia fugax can be painful enough to wake you up from your sleep or keep you from going to work or school. Between episodes, you probably won’t have any pain or discomfort. If you do have pain that isn’t coming from another spasm, another anorectal condition may be causing it, so talk to your doctor to rule out other conditions.

Chronic proctalgia fugax. Episodes of chronic proctalgia fugax usually last for more than 20 minutes and happen more often than occasionally. Other long-term symptoms include discomfort from sitting for too long and painful bowel movements.

Proctalgia Fugax vs. Levator Syndrome

Proctalgia fugax is a form of levator syndrome (also called levator ani syndrome). Both include spasms of muscles in the pelvic area. Proctalgia fugax is temporary, but other types of levator syndrome can last for several days.

Another major difference is the location of the pain. Pain from proctalgia fugax is felt mainly in the rectum. Pain due to levator syndrome is felt in the pelvic floor — specific or vague areas — and in the thighs and buttocks.

Symptoms of levator syndrome are usually felt higher in the pelvis than the symptoms of proctalgia fugax. You may notice that symptoms worsen when sitting and improve when standing or lying down.

Causes

Finding the cause of proctalgia fugax may be difficult. The causes vary from person to person and need different approaches for treatment. Other conditions in the anorectal area may cause spasms that seem similar to proctalgia fugax but are diagnosed and treated as separate issues. Sometimes an underlying condition causes proctalgia fugax, and treating that condition will relieve the symptoms of proctalgia fugax.

Stress. Proctalgia fugax may be related to stress and anxiety. In some cases, people with proctalgia fugax felt stressed just before the spasms.

Studies have shown a similar relationship between stress and levator syndrome. Many people with levator syndrome have psychosocial distress, including depression and anxiety.

The following activities may cause proctalgia fugax:

• Sexual activity
• Constipation
• Abnormal bowel movement
• Menstruation

Diagnosis

Proctalgia fugax is difficult to diagnose because of how quick and random the spasms can be. There are no tests for proctalgia fugax. But your doctor will rule out other possible causes for your anorectal pain.

Other anorectal conditions your doctor may check for are:

History. Your doctor may make a diagnosis based on your symptom history. Keep an accurate record of when the spasms happen, how long they last, how severe they are, and what happened before the spasms to help your doctor make a better diagnosis.

Physical exam. Your doctor may do a physical exam to check for places of tenderness in the rectum, or pain when the area is touched. Tenderness in the rectum or its nerves can be the cause of proctalgia fugax. A similar physical exam is performed to rule out any other conditions that cause anorectal pain.

Treatment

Most treatment options for proctalgia fugax depend on the symptoms. Treatments aim to ease pain and discomfort. This is mainly because the episodes are short, irregular, and without a clear cause.

At-home treatment. Before trying treatment options, check with your doctor to rule out other causes. You can take care of your symptoms on your own with the following methods:

• Over-the-counter (OTC) antispasmodic drugs
• OTC muscle relaxers and pain relievers
• Warm baths
• Heating pads and ice packs

Another at-home method that may help you avoid proctalgia fugax is to eat more fiber. Fiber will allow you to have softer bowel movements. These will keep your anorectal muscles from working too hard and may lower the risk of proctalgia fugax spasms.

Injections. For more severe pain, your doctor may recommend a variety of injections to stop muscle spasms. A Botox injection around the anorectal areas will relax the muscles. An epidural injection or a local anesthetic will numb the pelvic areas to ease muscle spasms.

Electrical stimulation. For severe proctalgia fugax, electrical stimulation of the anorectal muscles may provide relief. This treatment option involves inserting a small, finger-sized probe into the rectum and using a low voltage current to relax spastic muscles through vibration.

Proctalgia Fugax and Anal Pain (Levator Ani Syndrome)

colon and rectum

What conditions cause anal pain?

Your anus is the very end of your gut, and where it opens out on your bottom. The anal canal is the short tube just above and leads to the rectum just above it. There are many conditions which can cause a pain in the bottom area. In most of these an abnormality is seen or felt on examination or investigation. Possible causes include:

• Piles (haemorrhoids). These are a common cause of anal pain, particularly when one of the piles gets a blood clot in it (a thrombosed haemorrhoid). If this is the case, you may be able to feel a tender lump.
• Anal fissure. This is a split in the skin around the anus, usually caused by passing a hard poo. The pain is much worse when you do a poo, and there may be some blood when you poo.
• Cancer. Cancer of the anus or rectum can cause pain. It is usually a more constant pain, and may be worse when you poo. You may have blood on your underwear or mixed with your poo. It is much less common than other causes of anal pain.
• Anogenital warts. These are a sexually transmitted infection (STI) and if you have them you can usually see or feel small bumps around the anus. Other STIs such as herpes can also cause a pain in this area. Again, usually you can see a blister or blistery rash.
• Crohn’s disease and ulcerative colitis. These are conditions where the gut is inflamed. They usually cause other symptoms such as diarrhoea, blood and mucus in the poo, and tummy pains.
• Rectal prolapse. This is a condition where the muscles of the end of the gut are weak, and some of the inside of the gut may come out (prolapse). You would notice you have difficulty holding your stools in, and you may feel a lump.
• Prostatitis. This is an inflammation or infection of the prostate gland. Men only – women don’t have a prostate gland.
• Coccydynia. This is a pain around the tailbone (coccyx) and is very painful when you sit down. Usually this is set off by a fall on to your bottom.
• Irritable bowel syndrome (IBS). Usually, IBS causes loose stools or constipation, and tummy pains and bloating, but it may sometimes be accompanied by pain in the anal area.
• An infection, such as a collection of pus (an abscess).

The conditions proctalgia fugax and levator ani syndrome are what is left when all these causes have been ruled out. They are a “diagnosis of exclusion”, meaning there is no specific test for them, and that all other possible causes must be ruled out first. This leaflet is mainly about these two conditions.

What causes proctalgia fugax and levator ani syndrome?

This is not exactly understood. It is believed to be due to spasms of the muscles of the anus. The muscles here are very strong, as these are the muscles you use to hold your poo in, or relax to let the poo out.

Most of the time it is not obvious what has set it off. In some people, it starts after an operation – for example, an injection for piles, or after a hysterectomy. It seems to be more common in people who have IBS, and in people who have anxiety symptoms.

What is the difference between proctalgia fugax and levator ani syndrome?

It’s mostly about how long the pain lasts. If you have proctalgia fugax, you have short spells of intense pain in your back passage, but it’s all over within seconds or minutes, and you feel absolutely normal in between attacks. You may get clusters of episodes, several over a week or two, but most people don’t get the pain very often.

Levator ani syndrome pain tends to be worse when sitting, and lasts at least 20 minutes. More often it’s there all the time, or comes and goes persistently. It is usually an aching type of pain.

How common are proctalgia fugax and levator ani syndrome?

Proctalgia fugax is thought to be quite common. Up to one in five people may experience it at some point. Levator ani syndrome is less common, affecting around 6 in 100 people.

What are the symptoms of proctalgia fugax?

Proctalgia means pain around the back passage area. Fugax is a Latin word meaning fugitive or fleeting. So it describes a short-lasting pain in the back passage. Pain occurs on several occasions over a few weeks, each time lasting only seconds or minutes. It is a sudden, cramping, severe pain. It may wake you in the night. You may find you get a cluster of attacks together. In many people who get this condition, the attacks do not happen very often. In between episodes, there is no pain at all. Proctalgia fugax does not cause any bleeding.

Often there is no reason, but the pain can be triggered in some cases by the following:

• Having sex
• Opening your bowels
• Being constipated
• Having a period
• Stress

What are the symptoms of levator ani syndrome?

The levator ani is a muscle. It is part of the pelvic floor group of muscles, and is the muscle group around your anus and rectum. If you have levator ani syndrome, you get an aching pain high up in your back passage. It tends to be worse when you are sitting down, and walking around can make it feel better. The pain is constant or regular, and lasts (unlike proctalgia fugax) for longer than 20 minutes. It continues, either constantly or on and off, for months.

Levator ani syndrome is also known as chronic anal pain syndrome.

Is proctalgia fugax or levator ani syndrome serious?

That depends what you mean. It is not at all serious in the way that cancer is serious, for example. Proctalgia fugax doesn’t usually affect your life too much. Once your doctor has established nothing more serious is the cause then it is usually an occasional problem for most people.

Levator ani syndrome can, however, have a significant impact on your life. It can wake you up at night, and prevent you doing things that involve sitting. This can get in the way of work, and leisure activities such as cycling, for example. It can, for some people, really interfere in the quality of life, and so for those people, yes it can be serious.

Why does it happen?

The cause isn’t really known. It’s thought to be caused by a tightening or spasm of the muscles inside your bottom. In some people, it’s possible to find what caused this to start, but often no trigger or cause is found.

How is anal pain investigated?

When you visit your doctor, you will be asked questions about the pain you are experiencing. For example, how long it lasts, if it is related to opening your bowels, etc. The doctor will also want to know if you have other symptoms, in particular bleeding. Proctalgia fugax and levator ani syndrome do not cause any bleeding from your back passage.

The doctor will then need to examine you. You will be asked to lie on the couch, usually on your side, with your knees curled up towards your chest. The doctor will look at the outside of your anus first, looking for lumps, bumps, fissures and skin rashes. They will want to feel inside with a gloved finger, checking for lumps, tenderness and bleeding. They may look inside your anus and rectum with an instrument called a proctoscope. This is a short rigid see-through tube, which allows them to see the inside of just the lower few inches of your gut.

If further tests are needed, you may then be referred to a specialist, usually a gastroenterologist or colorectal surgeon. Further tests might be advised. This could include:

• A sigmoidoscopy. This is an examination with a camera on a longer tube, which can pass further up inside your gut.
• An ultrasound scan
• An MRI scan
• Anorectal manometry. This is a test used to measure the pressure of anal muscle contractions.

Not everybody needs all these tests. If you have occasional fleeting pains, no bleeding, and a normal examination, you are likely to have proctalgia fugax and will not need any more tests. If this is the case, you would be advised to return to see the doctor if anything changes (for example, if you get any bleeding, or if the pain becomes more persistent).

What is the treatment for proctalgia fugax?

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.

What is the treatment for levator ani syndrome?

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.

What is the outlook for proctalgia fugax?

This is variable. Proctalgia fugax usually isn’t a long-term problem. Either you get a few episodes here and there with long spells of no problems in between, or it goes away altogether. Each individual episode, by definition, is very short-lived. Levator ani syndrome can drag on for a long time in some people and it may be difficult to find a treatment which helps.

Disorders of the Anus and Rectum – Gastroenterology Specialists of Naples

Rectal pain is a common problem. Most people have experienced it at least once in their lives. It usually appears as a mild irritation, but sometimes the pain can be so severe that it can be incapacitating.

Many conditions may cause rectal pain. Most are not serious. Common causes of rectal and anal pain include:

• Hemorrhoids
• Anal Fissure
• Proctalgia
• Levator ani syndrome

Less likely reasons for rectal and anal pain include:

• Cancer
• Infection, including anorectal abscesses or proctitis
• Inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease
• Foreign bodies in the rectum or rectal prolapse

The pain of proctalgia fugax is sudden and intense, usually lasting less than a minute. But in some rare cases, the spasm can go on for an hour. It is described as a sharp, stabbing or cramp like pain occurring at the anal opening. The pain can awaken you from a sound sleep. The attacks seem to occur in clusters, appearing daily for a while then disappearing for weeks to months.

The pain of levator ani syndrome is felt higher up inside the rectal passage and feels like a tight pressure. The sensation is made worse by sitting and improves with walking or standing. The pain usually lasts 20 minutes or longer and tends to reoccur at regular intervals.Most hemorrhoids only cause a mild discomfort, but the pain can become severe if the hemorrhoid thromboses. This occurs when the blood in the hemorrhoid clots. The symptoms are an excruciating throbbing or stabbing pain that begins suddenly and can last for up to 4 days.

An anal fissure causes a tearing or knife-like pain when it first occurs and turns into a dull ache that can last for hours. The tearing of the skin may also cause a small amount of bleeding. Each bowel movement irritates the injured skin producing a sharp pain. The pain can be so intense that most people try to delay having a bowel movement, which only causes a harder stool and more pain when it is passed.

You should contact your board certified physician if home therapies or over the counter treatments are not helping.

• You should call immediately if you think you have a thrombosed hemorrhoid, because early treatment is the key to relief.
• Also call your board certified physician if you are having any bleeding. Sometimes rectal bleeding can be a sign of a more serious problem such as colon cancer.

Most anorectal problems can be diagnosed by a physical or visual exam. You may require a digital rectal exam if your physician suspects levator ani syndrome. A colonoscopy may be necessary if your physician suspects the problem is not restricted to the anus or rectum.If you have frequent painful or large, solid bowel movements, eating a high fiber diet and using a stool softener could help provide relief. Regular doctor visits will also help you get the best possible outcome.

Proctalgia Fugax – an overview

Treatment

Initial treatment of proctalgia fugax should include a combination of simple analgesics and the nonsteroidal anti-inflammatory agents or the cyclooxygenase-2 inhibitors. If these medications do not adequately control the patient’s symptomatology, a tricyclic antidepressant or gabapentin should be added.

Traditionally, the tricyclic antidepressants have been a mainstay in the palliation of pain secondary to proctalgia fugax. Controlled studies have demonstrated the efficacy of amitriptyline for this indication. Other tricyclic antidepressants including nortriptyline and desipramine have also been shown to be clinically useful. Unfortunately, this class of drugs is associated with significant anticholinergic side effects, including dry mouth, constipation, sedation, and urinary retention. These drugs should be used with caution in those suffering from glaucoma, cardiac arrhythmia, and prostatism. To minimize side effects and encourage compliance, the primary care physician should start amitriptyline or nortriptyline at a 10-mg dose at bedtime. The dose can then be titrated upward to 25 mg at bedtime as side effects allow. Upward titration of dosage in 25-mg increments can be carried out each week as side effects allow. Even at lower doses, patients will generally report a rapid improvement in sleep disturbance and will begin to experience some pain relief in 10 to 14 days. If the patient does not experience any improvement in pain as the dose is being titrated upward, the addition of gabapentin alone or in combination with nerve blocks of the intercostal nerves with local anesthetics and/or steroid is recommended. The selective serotonin reuptake inhibitors such as fluoxetine have also been used to treat the pain of proctalgia fugax and, although better tolerated than the tricyclic antidepressants, they appear to be less efficacious.

If the antidepressant compounds are ineffective or contraindicated, gabapentin represents a reasonable alternative. Gabapentin should be started with a 300-mg dose at bedtime for 2 nights. The patient should be cautioned about potential side effects, including dizziness, sedation, confusion, and rash. The drug is then increased in 300-mg increments, given in equally divided doses over 2 days as side effects allow, until pain relief is obtained or a total dose of 2400 mg daily is reached. At this point, if the patient has experienced partial relief of pain, blood values are measured and the drug is carefully titrated upward using 100-mg tablets. Rarely will more than 3600 mg daily be required.

The local application of heat and cold may also be beneficial to provide symptomatic relief of the pain of proctalgia fugax. The use of bland rectal suppositories may also help provide symptomatic relief. For patients who do not respond to these treatment modalities, injection of the peroneal nerves or caudal epidural nerve block using a local anesthetic and steroid may be a reasonable next step. The clinician should be aware that there are anecdotal reports that the calcium channel blockers, topical nitroglycerin, and inhalation of albuterol will provide symptomatic relief of the pain of proctalgia fugax.

What is Levator Ani Syndrome?

Definition

Levator syndrome consists of pain, pressure, and discomfort in the region of the rectum, sacrum, and coccyx, which appears to be aggravated by sitting.

This is also known as coccygodynia, levator ani syndrome, levator ani spasm syndrome, proctalgia fugax, and proctodynia.

Description

Gluteal discomfort and high rectal distress usually occur. Tenderness and muscle spasm affecting the levator ani muscles are the principal symptoms of this disorder.

Causes

The etiology is unknown.

Symptoms

Most patients complain of a dull ache high in the rectum. There may be a feeling of constant rectal pressure and occasional burning. Some patients complain of feeling like they are sitting on a “ball” or that there is a “ball” in their rectum. The pain can be made worse by a bowel movement when the stool presses against the levator ani (muscle) as it is being expelled.

A variant of the levator syndrome is proctalgia fugax, a feeling of severe pain in the rectum which generally occurs at night and which will awaken the patient from a sound sleep.

The term coccygodynia was often used in the past for this condition, but few patients actually have coccygeal (tailbone) pain.

Diagnosis

Many patients will have sought previous treatment for their discomfort, but the diagnosis was missed. A complete examination fails to reveal other painful lesions in the anorectum. Rectal examination reveals a tender levator muscle, which when digitally pressed, reproduces the patient’s discomfort.

Treatment

Periodic massage of the painful spastic muscle combined with warm baths and muscle relaxants may be useful. The patient should be instructed to take hot baths nightly for 20 minutes. Sleeping on an electric heating pad applied to the anal area is also effective. Biofeedback training is also effective.

In those patients who do not respond to massage, electrogalvanic stimulation is employed. Galvanic muscle stimulation for the treatment of levator syndrome is based on prior experience of physiatrists in using this modality to treat spastic muscle groups. The rationale on which this therapy is based is that a low frequency oscillating current applied to the muscle induces fasciculation and fatigue which breaks the spastic cycle.

Proctalgia Fugax | Digestive Health

Overview and Facts about Proctalgia Fugax

Proctalgia fugax is a condition characterized by episodes of severe pain in the rectum and anus. While it is not linked to a specific disease, the intense muscle spasms of the levator ani muscle are thought to be affected by a muscle disorder or nerve condition.

Symptoms and Signs of Proctalgia Fugax

The primary symptom of proctalgia fugax is sudden pain brought on by muscle spasms around the anal canal. The pain may last for only a few seconds or up to 30 minutes, and usually occurs at night.

Severity of a proctalgia fugax episode can be so painful that a patient is woken from sleep or must stay home from work. The pain is absent between episodes, however, and there may be a long period of time before another spasm occurs.

Causes and Risk Factors of Proctalgia Fugax

There is no specific trigger associated with proctalgia fugax, but some studies reported stress as causing the onset of spasms. Typically, the condition only affects individuals that have started or completed puberty, and more women than men have been diagnosed with proctalgia fugax. It may also be a consequence of certain procedures to treat hemorrhoids or hysterectomy.

Possible triggers for proctalgia fugax include:

• Stress
• Sexual activity
• Menstruation
• Constipation

Tests and Diagnosis of Proctalgia Fugax

Proctalgia fugax is usually diagnosed only by ruling out all other possible causes of anal pain. Your doctor will ask about the severity of the pain and spasm duration and perform a physical examination to rule out hemorrhoids, fissures, digestive health issues, or other conditions contributing to anal pain.

Treatment and Care for Proctalgia Fugax

Because there is no specific cause associated with proctalgia fugax, treatment focuses on symptom relief and management of an identified trigger.

Some of these treatments include enemas with warm water, prescription ointments and counseling. If spasms are extremely severe, a local anesthetic or Botox injections around the anal region may be recommended.

90,000 what to do – blog of the medical center ON Clinic

What happens when the anus burns?

The skin around the anus is irritated, reddens, a weeping surface appears. Traces of scratching are sometimes visible. What causes itching around the anus? What does itching of the anal canal say? The reasons are very different, and not only helminthic invasions, as is commonly believed. There is primary and secondary itching.

Primary – this is the discharge of intestinal contents from the anus with the failure of the sphincter.

Secondary – due to the presence of a disease.

What diseases cause itching in the anus? For example, itching near the anus may indicate the presence of dysbiosis, the appearance of hemorrhoids, anal fissures, warts, papillomas, polyps. It happens that itching near the anus and due to constipation: hard feces injure the rectal mucosa. Burning, itching places can occur with diarrhea.

Sometimes itches around the anus with allergic dermatitis.Irritation appears due to sensitivity to drugs (ointments, suppositories), a detergent used to wash underwear. Dermatitis can appear if insufficient attention is paid to hygiene (the anus is poorly washed).

Why does it itch near the anus in women – it may be thrush. Therefore, women need to go directly to the gynecologist and then to the proctologist.

Cause anal itching and skin diseases:

If itching around the anus bothers you regularly, you should consult a doctor to determine why there is a burning sensation in the anus.The sooner you learn about the disease that has arisen, the faster you will get rid of not only annoying and unbearable itching, but also help your body avoid complications of the disease.

Remember: with anal itching, you need to exclude the use of toilet paper (wash yourself with cool water after a bowel movement), switch exclusively to cotton linen, exclude spicy and salty foods, alcohol from the diet.

90,000 Pain in the anus with prostatitis: causes and treatment

Many people are embarrassed to talk about such a delicate problem as prostatitis, or inflammation of the prostate gland.However, not paying attention to the disease is not the best strategy: the lack of timely treatment can lead to a worsening of the condition. Lack of awareness often leads to questions, for example, is it possible with prostatitis pain in the anus or in other organs located nearby, what it indicates, and what should be done in this case.

Yes, it is possible. With this disease, the prostate gland becomes inflamed, becomes painful by itself and, depending on where the inflammation is located, begins to give pain to other areas.Most often, the perineum begins to hurt, but there are other localization sites: ^[1]

• suprapubic region;

• genitals;

• lumbosacral region of the spine;

• anus.

As a rule, pain in the anus becomes more intense when sitting or after the act of defecation: in these situations, the pressure on the inflamed prostate gland increases, which leads to increased discomfort.However, there are times when the pain that radiates into the anus persists regardless of the man’s behavior.

Pain sensations can also vary. Sometimes they talk about an acute process, sometimes about a chronic or subacute course of the disease. As a rule, the intensity of pain depends on how pronounced and active the inflammation is: severe soreness most often indicates that the prostatitis is acute, possibly even giving rise to an abscess.If the pain is intense, it is recommended to immediately consult a doctor, and in case of unbearable pain, accompanied by fever and chills, emergency medical care should be called: such a clinical picture can be given by a formidable complication of prostatitis – prostate abscess. ^[2] Consider what kind of pain arising from inflammation of the prostate gland can be.

Whining . Dull aching pains are characteristic of follicular prostatitis – a subspecies of the disease in which the follicles of the gland are involved in the inflammatory process, and purulent contents begin to accumulate in them. ^[2] Usually they are given to the glans penis or perineum, less often to the anus or lumbosacral spine. If the prostatitis is chronic, aching pains sometimes appear outside exacerbations, however, they are not as pronounced as in the acute process. Soreness in such cases increases in the morning or after a long stay in a sitting position. ^[2] The fact is that when a person sits for a long time, there is a plethora of the pelvic organs, which can aggravate the pain.

Sharp . Intense, sharp and throbbing pain is characteristic of acute prostatitis or exacerbation of the chronic form. Usually, such symptoms appear when several lobules of the gland are already involved in the inflammatory process – this is called parenchymal prostatitis. ^[2] Pain may be accompanied by fever, fever and general weakness. If the soreness of the rectum continues all the time, and not only during bowel movements or urination, the nature of the pain is pulsating, and it itself is very intense, it is likely that the cause of this condition is a prostate abscess.This complication requires urgent medical attention, without which an abscess can break into the urinary tract, rectum or perineum. ^[2] Breakthrough of purulent contents can lead to sepsis, a condition that is directly life threatening.

When urinating and defecating . Pain in the anus with prostatitis rarely occurs at rest. Most often, it is associated with either a prolonged sitting position and in this case passes after a walk, or with an act of defecation. ^[2] At this time, pressure is exerted on the inflamed prostate gland, which makes the pain even more intense: in the case of severe acute inflammation or abscess of the prostate, it can become unbearable, such that the patient cannot go to the toilet. In the case of an abscess, defecation can lead to a breakthrough of purulent contents: in such cases, the patient needs urgent medical attention. Also, with prostatitis, both acute and chronic, symptoms of the lower urinary tract are noted: too frequent urination, harsh, intense urge, soreness before and during emptying of the bladder. ^[3] In this case, the pain is usually localized in the suprapubic region, in the groin or in the perineum.

As a rule, prostatitis occurs due to the defeat of the prostate gland by bacteria, mainly intestinal, against the background of hypothermia, decreased immunity, congestion and other factors. ^[1] Acute inflammation and a chronic form are distinguished, which usually develops due to insufficient treatment of the acute process.Pain in this case occurs due to inflammation, in some cases purulent: the tissues become swollen and painful, this is also noted by the doctor during the diagnosis. ^[2] Burning and stinging in the urinary tract usually indicates that the infection has spread and is common in acute prostatitis. There is also a syndrome of chronic pelvic pain – a disease with similar symptoms, but non-infectious. There are suggestions that the syndrome is even more common than chronic bacterial prostatitis.This disease is not fully understood, but there are suggestions that the causes of pain are the throwing of the contents of the bladder into the prostate, which causes inflammation, and neurogenic factors in non-inflammatory CPPS. ^[3]

• Usually, with prostatitis, the anus does not hurt by itself: pain from the prostate gland gives back there. Such painful sensations do not indicate any inflammatory process in the rectum, if there is no reason to suspect that an abscess has broken through there.

• Pain during bowel movements is caused by squeezing the affected gland, resulting in increased sensations.

Spicy . Simultaneously with pain, the patient may notice an increase in temperature, in some cases – up to high rates (up to 40 °), as well as general weakness, malaise, chills and fever. In some cases, myalgia is noted – muscle pain caused by general intoxication of the body. ^[3] Symptoms also affect urination: it becomes difficult, sometimes there is a sharp urinary retention, while the urge may become more frequent and become sharper, more intense, sometimes even false. This happens when the urinary tract is also involved in the inflammatory process or because of its irritation. Usually, if the clinical picture shows a high temperature, fever and systemic manifestations of intoxication, for example, rapid heart rate and breathing, the patient is indicated for hospitalization.

Chronic . If acute prostatitis is not adequately treated, it can become sluggish. It is characterized by periods of complete or partial remission, during which there are almost no symptoms or they are mild, and exacerbations – they resemble acute prostatitis along the course. ^[3] Primary chronic prostatitis is also distinguished, which occurs against the background of congestion or an unhealthy lifestyle. Outside of flare-ups, the pain is usually quite mild and may worsen in the morning or after a long sitting position.Walking helps relieve symptoms, and hypothermia or overheating aggravates them. Sometimes the manifestations of the disease include disorders of the genital area: too fast or painful ejaculation, weakening of erection. ^[2] Occasionally, prostatorrhea occurs – a symptom in which a secret is released from the prostate after a bowel movement or urination. This is due to the weakening of the muscles of its excretory ducts.

SHTB . There are no characteristic symptoms, except for pain similar to that that occurs with chronic prostatitis.However, pain may increase after ejaculation and be accompanied by lower urinary tract symptoms. ^[3] Treatment of the disease is difficult, at the same time it can seriously worsen the quality of life of patients, therefore, against the background of chronic pelvic pain syndrome, neuroses, depressive conditions, decreased performance and insomnia often develop – the same is observed in chronic prostatitis with a persistent course. ^[2] Therefore, during therapy, the doctor can prescribe anxiolytic drugs, that is, reduce the level of anxiety. ^[3]

Pain in the anus may indicate not only prostatitis. If there are no other symptoms, and you mark only it, it is recommended to undergo an examination to exclude other reasons that may cause such sensations. These may include: ^[4]

• anus injury or fissure;

• inflammatory process directly in the anus or rectum;

• haemorrhoids;

• neurological diseases;

• problems with the musculoskeletal system, in particular with the spine;

• suppuration in the anal glands, or paraproctitis;

• narrowing of the anal canal;

• cancers.

If pain in the anus is not associated with prostate discomfort, difficulty urinating and fever, the patient is advised to undergo a complete examination to rule out or confirm the presence of the disease. It is worth starting with a visit to a therapist who will orientate himself in the clinical picture and appoint a visit to a narrow specialist.

If you begin to be bothered by pain radiating to the anal canal, perineum or groin area, as well as discomfort during urination and other listed symptoms, you should immediately consult a urologist.The specialist will conduct an examination, take the necessary tests and prescribe a treatment appropriate to the situation. Do not hesitate: although the problem is delicate, it can and should be solved. Delay in contacting a doctor or self-medication can only aggravate the situation, so it is recommended to visit a professional as soon as possible. With proper treatment, started and completed on time, the prognosis for a patient suffering from prostatitis is quite favorable. See your doctor: the earlier you start therapy, the sooner you can return to a fulfilling life.

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Koktsigodinia – ProMedicina Ufa

Coccygodynia is the appearance of pain in the coccyx and / or anus, perineum, caused by damage or inflammation of the branches of the coccygeal nerves.
More common in women. The age interval in which coccygodynia may appear is very wide. Most often, the disease occurs in people aged 40 to 60 years.

Reasons

• The main cause of this disease is damage to the nerves located in the coccyx and sacrum.Traumatic situations can serve as an impetus for the development of the disease. They can be falls, bruises in the coccyx area, blows on it with various objects. The cause of painful sensations in these cases is dislocation or displacement of the coccyx. The disease can also manifest itself if scars appear in the soft tissues in the area of ​​the coccyx, which caused muscle inflammation. Painful sensations can occur after a long time interval after injury.For this reason, many patients do not associate the emerging discomfort with pain in the tailbone region that arose later. Therefore, it is so important after injury to go to the clinic, and not to self-medicate;
• Another cause of nerve damage is deformities in the pelvic organs, perineum and anus. These problems can cause the formation of adhesions of the peritoneum (the membrane overlying the internal organs). In another way, the formations under consideration are called adhesions.Also, the inflammatory process can cause the appearance of cicatricial deformities;
• Problems with bowel movements can also affect the development of the disease. Chronic constipation and diarrhea lead to overstrain of the pelvic floor muscles, which also leads to coccygodynia;
• In women, birth trauma can develop coccygodynia. During childbirth, hemorrhage may occur in the tissue around the tailbone. After a while, this can lead to pain in the coccyx area;
• Also, the cause of the development of the disease can be: syndrome of prolapse of the perineum and problems with the neuromuscular apparatus of the perineum.

Symptoms

Symptoms of coccygodynia:

• Pain syndrome. The pain can be constant (it lasts for months and years), or it can occur periodically, for no apparent reason or after exertion, prolonged sitting, defecation (emptying of the rectum), sexual intercourse. Pain can be limited only to the tailbone or radiate (spread) to the buttocks, rectum, genitals, perineum, lower abdomen, to the front thigh.The pain increases with pressure on the coccyx area.
• Gait disorder (the patient walks slowly, waddles over, as unnecessary movements increase the pain).
• Irritable bowel syndrome is a complex of functional (caused by dysfunction of the intestine in the absence of structural damage to its tissue) intestinal disorders, which includes pain and / or discomfort in the abdomen, relieved after defecation.
• Constipation (since the patient rarely goes to the toilet due to pain).
• Mood swings, depression (depressed mood, feeling of hopelessness for a long time – usually more than 3 months).

Diagnostics

There are quite a few diseases that can cause pain in the tailbone area. These are, for example, a crack in the anus, hemorrhoids, inflammation in the fatty tissue that surrounds the rectum, inflammation of the sciatic nerve, diseases of the spinal column, gynecological diseases, etc.That is why the diagnosis of coccygodynia is rather complicated and requires a complete and sufficiently detailed examination of the patient with obligatory consultations with a neurologist, urologist and gynecologist.

For pain in the coccyx, a digital examination of the rectum is performed. It is such a study that allows one to assume or determine the cause of the onset of the disease while still in the doctor’s office. Usually, when conducting a study with a finger through the rectum, the doctor pays attention to severe pain in the coccyx and the presence of a painful seal, which looks like a radial cord passing along the posterior sector of the palpation area.

In order to establish a definitive diagnosis, an X-ray examination of the sacro-lumbar spine and rectum, as well as an ultrasound examination of the abdominal cavity are usually carried out.

Treatment

Treatment of coccygodynia is carried out based on the identified causes of the disease. Specialists prefer the conservative method of treatment, which helps in the vast majority of cases. The general principles are to prescribe a comprehensive treatment, which includes physiotherapy and massage procedures.Ultrasound technologies are widely used in combination with glucocorticoid therapy, anesthesia and electrotherapy. The latter technique is based on the introduction of an electrode into the rectal space. Massages, underwater traction, paraffin application help well against muscle spasms. The purpose of the procedures is to straighten or return the coccyx to its normal physiological state.

Diseases accompanied by pain syndrome require the use of analgesics.

90,000 Pain in the rectum while sitting

Pain in the anus is a feeling of discomfort in the anus and rectum.There are many nerve endings here, so ulcers, cracks, growths and other anomalies in this area are especially painful.

Pain can be caused or aggravated by diarrhea, constipation, too hard stools, often accompanied by severe itching and, accordingly, leads to scratching, which irritates the skin and nerve endings.

Reasons . Pain is usually a symptom of diseases of the rectum and anus. The following diseases are possible:

– painful cracks in the mucous membrane of the anus,

– abscess – accumulation of pus in the anus,

– fistula – an abnormal opening in the skin near the anus,

– hemorrhoids,

– spasms of the muscles of the anus and pelvic floor.

Symptoms . The pain can be sharp or dull, burning or cutting, and intensifies during or after a bowel movement. Some people even avoid defecating for fear of pain. Pain may be accompanied by:

– constipation or diarrhea,

– bleeding,

– abnormal discharge, such as pus,

– sensation of a foreign body in the rectum, as in hemorrhoids.

What to do .See your doctor, describe your symptoms, and get an appointment. Pain in the anus is a symptom of many serious illnesses. Do not disregard her!

Pain in the anus in a child . In children, cracks along the mucous membrane of the anus are often the cause of pain and bleeding. When you have a bowel movement, pressure on the cracks causes severe pain. The child is sometimes so afraid of her that he is afraid to defecate, and this leads to constipation. If he complains of pain, take him to a doctor.Watch out for bleeding, discharge, and infection. In newborns, pain can be caused by a birth defect. It is necessary for the child to be examined by a doctor.

Treatment . Anoscopy and proctosigmoidoscopy, which are procedures by which doctors determine what is causing pain, may be used. A thin tube is inserted into the anus, rectum, and lower intestines to allow examination and tissue samples to be taken for analysis.

After identifying the causes of pain, the doctor will prescribe a treatment that relieves discomfort and eliminates the cause.For example, hot wet compresses and sitz baths provide relief by relieving sphincter muscle spasms caused by rectal disease.

If a protruding hemorrhoid is causing the pain, cold compresses will reduce it, prevent blood clots, and relieve pain. Lying with your buttocks raised will also ease the pain.

Your doctor may recommend stool softeners to make bowel movements easier, and analgesics in the form of ointments and suppositories.A diet high in fiber can help to soften stools and help avoid worsening pain during bowel movements.

Get well soon!

How to treat pain in the anus

The main causes of pain in the anus are hemorrhoids, thrombosis of hemorrhoids, rectal prolapse, paraproctitis, anal fissures. The sources of discomfort, sometimes excruciating, include anal itching.

This entire group of diseases is most often a consequence of an extremely common ailment today – chronic constipation.Imagine a tube of toothpaste: the tube is the rectum, and its nose is the anus, around which there are many veins. The denser the toothpaste, the more you need to squeeze the tube.

Each defecation is a transformation in the rectum of large-diameter feces into a diameter corresponding to the anus of the individual. When straining, the outflow of blood from the lower body is disturbed, the veins of the anus swell, and dense feces passing through the anus pushes these veins towards the exit.The more effort is made to expel feces from the rectum, the more the veins are inflated and the more tissues are injured. Over time, the veins expand, forming hemorrhoids. Depending on at what level of the intestine the node is “protruding”, we are talking about external or internal hemorrhoids.

Hemorrhoids can hurt, bleed, become inflamed and even thrombose. The tissues around such veins can twist into the anus and become inflamed. The venous nodes interfere with the tight closure of the anus, and the contents of the rectum involuntarily leave it, causing anal itching and other painful conditions.

Similar changes can be observed not only due to constipation, but also during prolonged sitting, pregnancy, and frequent lifting of weights.

If the stool is very dense, then during a bowel movement, they can rupture the tissues of the anus, causing anal fissures.

Treatment of pain in these diseases, as well as the diseases themselves, must necessarily include the fight against constipation.

Since pain in the rectal region can have different origins, they are not the same in nature.So, with hemorrhoids, patients often complain of discomfort in the rectum and in the anus, itching, burning, stabbing pain, often combined with bleeding. If the pain is sudden, local, intense, burning and directly related to bowel movements, then most likely it is an acute anal fissure. Constant pain in the anal canal most often indicates thrombosis of hemorrhoids, acute paraproctitis or rectal fistula. Pressing pain, sometimes associated with defecation, usually accompanies colitis, proctitis.Dull, burning pain accompanying defecation can cause incomplete rectal fistula, cryptitis, papillitis.

Conditions requiring medical advice: bloody discharge from the anus of dark red or brown color; the appearance of tarry, black or rusty stools; if the patient is over 50 years old; if the patient has a family history of colon or rectal cancer; if the pain is severe or persists for more than a week.

B.H. Jerel

“How to treat pain in the anus” and other articles from the section Proctological diseases

Treatment of rectal diseases

Diseases of the rectum in an adult are very common.This is primarily due to the fact that with age, blood vessels and tissues lose their elasticity, and the situation is aggravated by factors caused by the person himself. Improper diet, a sedentary lifestyle, bad habits, smoking and alcohol abuse – all this leads to serious problems, really serious, since many of the proctological diseases are prone to degeneration into malignant processes. To prevent such an outcome is real – you just need to consult a doctor at the first symptoms.

Our advantages

Rectal pain

Rectal prolapse

This ailment is also called rectal prolapse. With it, the distal intestine can fall out of the anus by 2-20 centimeters. The condition is often aggravated by bloody discharge, pain, and involuntary bowel movements.

The causes of pathology are:

• congenital anatomical features;
• weakening of the sphincter and pelvic floor muscles;
• extreme physical activity, heavy lifting;

90,031 injuries to the pelvis and coccyx;

90,031 numerous and difficult childbirth in women;

• Frequent constipation.

Burning in the anus

A burning sensation may indicate the initial stage of the development of hemorrhoids. However, it is evidence of many other conditions, for example:

• insufficient or too intensive hygiene, use of unsuitable products;

90,031 diaper rash, often found in obese people or in those who are prone to excessive sweating;

90,031 parasitic infections – helminthic infestations, giardiasis;

90,031 diabetes mellitus;

• intestinal dysbiosis;

90,031 sexually transmitted diseases;

• of the incipient tumor process.

Blood in the stool

Even the smallest bloody discharge from the anus is a reason for an early appeal to a proctologist, since they say that an actively developing disease is present in the body. Scarlet blood often indicates the presence of:

• hemorrhoids;

90,031 anal fissures;

90,031 rectal polyps;

• malignant neoplasms.

Occult blood, during the release of which the feces become black, may indicate:

• gastric bleeding, gastric ulcer, tumors in it;
• liver cirrhosis;
• duodenal oncology.

Lump in the anus

This is a hemorrhoid that occurs when hemorrhoids are not treated promptly. These sacs, filled with blood, interfere with the natural process of defecation and can become inflamed, causing serious disturbances in the general condition of the body. If a lump in the anus has crawled out, you should consult a doctor as soon as possible, since hemorrhoids tend to form blood clots, which are often eliminated only by surgery.

You can get an accurate diagnosis of proctological diseases in the medical center “Es Klass Clinic Orel”. Here you will find an effective treatment that will allow you to forget about the problem forever.

Pain in the anus, cannot sit

Dear Doctor &

I live in Germany, I am 42 years old.

In July, she turned to a proctologist with suspicion of hemorrhoids,

I had symptoms such as bloating, itching, foreign body sensation,

had the impression that I wanted to go to the toilet.The examination revealed hemorrhoids

and prescribed oil injections. In total, two injections were made, first one,

and six weeks later another. After the first injection, I felt much better and all the above symptoms went away,

and after the second, it became worse literally the next day, and on top of that, there was added pain when sitting

and I cannot sit, constant discomfort, in the lying position I feel better.I went to the doctor again, he said that he did not see any inflammation or cracks.

I don’t know what to do, what it might be, help with advice, please &

Sources: www.winalite.cc, medeffect.ru, orel.s-classclinic.com, medcanal.ru

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Hemorrhoids in women: symptoms, causes, treatment

The main causes and factors of the development of pathology

Hemorrhoids are pathological expansion of the cavernous plexus in the anal canal and the formation of hemorrhoids. The main cause is weak venous vascular walls.

In women, this disease often occurs during pregnancy and worsens after childbirth. This is due to hormonal changes and an increase in intra-abdominal pressure. It is important to start treatment right away, as hemorrhoids can complicate pregnancy and lead to complications of labor.

Other adverse factors that can lead to the onset of this delicate disease:

• congenital venous insufficiency;
• heavy physical activity, frequent heavy lifting;
• prolonged sitting or standing;

90,031 disturbances in the functioning of the intestines, which leads to constipation;

90,031 obesity, the accumulation of excess weight in the abdomen is especially dangerous;

• diseases of the liver, intestines;

90,031 anal sex;

• unhealthy diet, including “hard” diets;
• inflammatory processes or neoplasms in the pelvic organs.

Alcohol abuse, frequent consumption of spicy foods and smoking also have a negative effect on the state of blood vessels. This increases arterial blood flow to the cavernous joints in the anus, which can provoke pathological changes in the tissues.

Cardiovascular disorders, varicose veins of the lower extremities, as well as the constant use of laxatives or bowel cleansing drugs can also lead to painful changes in the veins in the rectum.

Hemorrhoids: symptoms in women in the initial and chronic stages

Often at an early stage, the pathology is asymptomatic. A delicate problem is revealed only during a medical examination, for example, when a woman registers for pregnancy. In order not to miss the development of the pathological process, you need to carefully monitor the signals of your body.

First signs

The enlargement of the venous plexus in the anus is always accompanied by some discomfort, but this symptom is often stubbornly ignored.Consider how else the body signals that it is time to see a doctor.

90,030 90,031 itching;

90,031 soreness during bowel movements;

The peculiarity of the course of the disease in women is that these symptoms intensify during menstruation. This allows you to identify pathology at the very initial stage.For this reason, in pregnant women, hemorrhoids often do not manifest themselves at all until they are accidentally discovered on examination or when they enter the chronic stage.

Chronic stage

Signs of hemorrhoids in women when the disease has become chronic:

• the presence of scarlet blood in the stool and / and during bowel movements;

90,031 persistent itching;

• aching, dull pain in the anus;
• sensation of a foreign object in the anus;
• prolapse of hemorrhoids when sneezing, exercising or while going to the toilet.

The main symptom that occurs one of the first, and is observed in more than 50% of cases, is bleeding.

Symptoms of internal and external hemorrhoids in women

Hemorrhoids can form inside the rectum under the mucous membrane and outside, after the scallop line. The first option is considered a hidden pathology option, since it does not have external visible changes.

The following symptoms indicate the occurrence of internal hemorrhoids:

1. Burning and itching are some of the first to appear, as the inflammation produces mucus, which causes irritation.
2. Discomfort during bowel movement.
3. Small bleeding visible on toilet paper.

These symptoms indicate the beginning of internal pathological changes. Later, bleeding intensifies, the pain becomes constant, and the nodes may fall out.

With the external form of the disease, the following symptoms appear:

1. Edema and alteration of the anus.
2. Formation of cones that are tactile.
3. Discomfort during bowel movements.
4. An anal fissure may appear.
5. In the sitting position, there is a sensation of a foreign object in the rectum.

As the disease progresses, symptoms worsen. Often they turn to a doctor when the disease is running, therefore, if such manifestations are found in oneself, a proctologist’s consultation is imperative.

Stages of “female” hemorrhoids

The chronic course of the disease has 4 stages:

1. The initial stage in which small changes occur in the rectum.Symptoms are usually mild or absent.
2. Pathological changes weaken the ligamentous apparatus, due to which there is a prolapse of hemorrhoids when going to the toilet. But they fall into place on their own, since the muscles have minimal stretch.
3. Hemorrhoids fall out, but due to the strong weakening of the ligamentous apparatus, they cannot be adjusted back. The woman needs to insert them into place herself.
4. At this stage, the knots that have fallen out cannot be adjusted on their own.The ligaments and muscles of the anal canal are severely deformed. Here you need the professional help of a specialist.

According to statistics, they come to the doctor with a 2 or 3 stage of the disease. Hemorrhoids in women at the last stage require only surgical treatment.

Methods for diagnosing a disease

The diagnosis and treatment of rectal disease is carried out by a proctologist or coloproctologist. In women, a gynecologist can also detect external hemorrhoids.

At the initial appointment, the doctor collects an anamnesis. Be sure to report all the symptoms, when they first appeared, whether they were treated on their own, describe the nature and intensity of the pain. It is important to inform about pregnancy and whether you practice anal intercourse.

For an accurate diagnosis, the doctor uses the following methods:

1. Rectal examination (digital).

Most informative, although a little uncomfortable.Allows you to accurately determine the presence of nodes, including internal formations.

1. Sigmoidoscopy (rectoscopy).

It is carried out using a special device – a flexible probe, which is equipped with a mini camera. Helps to examine in detail the condition of the rectal mucosa at a depth of 30 cm.

1. Anoscopy.

Endoscopic examination is carried out using an anoscope. Such a device allows you to examine the inner surface of the anal canal at a depth of 10-12.

Early detection of the disease in women will help to avoid complications such as anemia, thrombophlebitis, anal fissure, abscess in the anorectal region, entrapment of nodes.

How and how to treat hemorrhoids in women

This disease responds well to treatment, and the prognosis of its course is favorable. Therapy depends on the stage of the disease. The sooner a woman turns to a specialist, the greater the chance that it will be possible to cope with the pathology with the help of pharmaceuticals and preventive measures.

Drug therapy

In the early stages, the main goal of therapy is to eliminate edema and inflammation, as well as to normalize blood circulation in the vessels of the rectum. For this, venotonics, anti-inflammatory medicines, local ointments, suppositories are prescribed. Herbal baths are recommended, and you also need to follow a diet to eliminate constipation.

To improve bowel movements and eliminate spasm of the sphincter, suppositories with the addition of oil are prescribed.During treatment, women should not lift weights, you need to increase physical activity.

Minimally invasive and radical treatment methods

If drug therapy is not effective and relief does not come, then the doctor prescribes bloodless, low-traumatic operations.

1. Sclerotherapy – used only at stages 1-2 of the disease. A special solution is injected into the affected area using a needle. The drug leads to a significant reduction in the node.
2. Ligation – recommended for dropped knots. The doctor uses the apparatus to pinch the base of the lump, which leads to its death.
3. Photocoagulation, laser and radiofrequency coagulation – the leg of the hemorrhoidal formation is cauterized.
4. Cryodestruction – is used for bleeding. The processing of the nodes is carried out using liquid nitrogen.

If the disease is started, and the nodes have reached large sizes, then it becomes necessary to use surgical intervention.In this case, a complete excision of nodular defects and a tightening of the rectal mucosa are performed. This treatment requires long-term rehabilitation.

Folk remedies for hemorrhoids in women

It is possible to achieve an improvement in the condition and long-term remission of the disease with the help of folk remedies. These can be baths with potassium permanganate and garlic, cold lotions, compresses with medicinal plants (chamomile, oak).

For many, the use of ice brings relief.It helps stop bleeding and relieves pain. To reduce inflammation and disinfect cracks, microclysters can be used based on a decoction of chamomile, wormwood.

Candles made from linseed or sea buckthorn oil help to normalize stools, nourish tissues, which helps to reduce knots. To make them, you need to mix oil and honey in equal proportions.

Folk recipes are best used in combination with drug treatment and after consultation with a proctologist.

Preventive measures

To cope with hemorrhoids, pills and ointments alone are not enough. Here it is important to adhere to preventive measures that will allow you to forget about this disease for a long time.

1. Be sure to include cereals, vegetable oils, fresh vegetables and fruits in the diet. The list of prohibited foods includes all spicy and spicy dishes, pickles, alcohol.
2. Try not to be in one position for a long time, do physical exercises.
3. Move more, do pelvic strengthening exercises and avoid strenuous physical work,
4. Monitor the work of the intestines, without the normalization of the stool, it will not be possible to completely cure the disease.

Hemorrhoids are a very delicate problem with which women are in no hurry to see a doctor.