Dr. Weyrich's Naturopathic Functional Medicine Notebook is a collection of information on topics of interest
to Dr. Weyrich that may be of interest to the world wide audience.
Due to limitations of time, not all information that Dr. Weyrich knows or would like to further research is
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Overview of Proctalgia Fugax and Levator Spasm
Proctalgia fugax and Levator spasm are similar pain syndromes
of the pelvic, rectal, and perianal areas. Attacks may last about 20 minutes,
building to an intolerable crescendo and then gradually abating.
The constriction of the anal muscles makes the patient more susceptible to
formation of anal fissures, both by reducing blood supply to the area, making
the tissue less healthy and more friable, and simultaneously exacerbating the
mechanical stress caused by passage of hard stools.
The pain from anal fissures may lead to spasm of the levator ani muscles,
resulting in a vicious cycle.
Signs and Symptoms of Proctalgia Fugax and Levator Spasm
More common in young men.
Brief episodic pain may last about 20 minutes.
Sensation as if a knife were inserted up the rectum.
May awaken patient at night.
More common in women.
Episodic spasm of the levator ani muscle.
Pain tends to be left-sided, may radiate into gluteal region.
Sensation as if sitting on a ball, or as a dull ache high in the rectum.
Levator sling tenderness upon transanal palpation.
Etiology of Proctalgia Fugax and Levator Spasm
Physical examination is usually found to be normal.
Onset may be associated with the following: