Proctalgia Fugax (Proctalgia, Frigidinal Myofascial Disorder) is a chronic functional disorder of the digestive tract which manifests through persistent pain in the abdomen and lower back. Functional bowel diseases are becoming prevalent all over the world as people become more concerned about their overall health and the risks of not eating properly and suffering from the long-term disease. Proctalgia sufferers may often have diarrhea, abdominal bloating, and lower bowel frequency.
Functional dyspepsia is often diagnosed through magnetic resonance imaging or echocardiography and confirms that there is no abnormality in the paraventricular nucleus of the heart. Proctalgia fugax or recurrent anal fissures is part of a broader spectrum of acquired functional bowel disorders defined by the Rome III diagnostics criteria, which includes episodes of severe acute abdominal pain that occur over weeks to months, are located in or around the rectum or anus, and last for at least five minutes without any pain between them. Patients with functional dyspepsia often do not experience constipation, but may still have a low-grade fever. Rectal bleeding is also noted in patients with functional dyspepsia, although this symptom is rarely severe.
There are several treatments available for proctalgia fugax, including antibiotics, which may provide some symptomatic relief. Patients with inflammatory bowel diseases are usually advised to take non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen sodium, to reduce their pain during attacks. However, NSAIDs may cause gastrointestinal side effects such as diarrhea and stomach cramps, which may hinder patients’ efforts to self-manage this painful disease. Thus, in addition to anti-inflammatory medications, non-steroidal anti-inflammatory drugs (NSAIDs) that relieve pain can also be used in order to manage episodes of pain and discomfort.
Patients with functional dyspepsia and proctalgia fugax can avoid triggers that precipitate episodes of pain and discomfort by avoiding known or suspected triggers, which may include foods such as chocolate, colas, spicy foods, coffee, nuts, and alcohol. Eating smaller meals, avoiding snacks and fast food, exercising more, and decreasing consumption of beverages such as sodas, juices, and coffee can help control symptoms. Smoking and chewing tobacco are also strongly associated with episodes of chronic abdominal pain and discomfort, as well as other digestive complaints. Patients should maintain a regular bowel movement schedule in order to avoid triggering episodes of pain.
In order to treat proctalgia fugax effectively, it is important to identify and target specific triggers. A physical exam, blood tests, and an examination of the pelvic floor are effective in identifying specific triggers. Treatment strategies involve dietary modifications, relaxation techniques, NSAIDs, stress management techniques, pain reduction techniques, exercise, symptom reduction, physical therapy, vitamin supplementation, alternative treatments, and symptom therapy. These techniques can be combined in the proper manner to achieve optimal treatment.
Proctalgia fugax sufferers can prevent recurrence of their symptoms by identifying and avoiding known triggers that cause episodes of anal pain and discomfort. Patients should avoid foods and beverages that have been identified to trigger symptoms; instead, they should eat foods that have less irritating carbohydrates, such as whole-grain products and oat bran, and more potassium, such as bananas. In addition, patients should increase their fluid intake and drink at least 8 glasses of water each day to maintain proper hydration.