Proctalgia fugax, an evidence-based management pathway

  title={Proctalgia fugax, an evidence-based management pathway},
  author={Santhini Jeyarajah and Andre Chow and Paul Ziprin and Henry S. Tilney and Sanjay Purkayastha},
  journal={International Journal of Colorectal Disease},
PurposeProctalgia fugax (PF) is a benign anorectal condition which has been described in the literature since the nineteenth century commonly presenting to general surgeons. There is little high level evidence on the subject and its therapeutic modalities. We aimed through this systematic literature review to outline the definition and diagnostic criteria of this condition, the aetiology and differential diagnoses and describe the different treatment modalities that have been attempted and… 

Proctalgia Syndromes: Update in Diagnosis and Management

A number of therapies to relax the pelvic floor may be employed to improve symptoms in functional anorectal pain syndromes; however, only biofeedback to improve defaecatory dynamics in patients with levator ani syndrome has proven effectiveness in a randomized setting.

Proctalgia and Other Anorectal Pain Syndromes

Diltiazem for the Management of Malignancy-Associated Perineal Pain and Tenesmus

Two cases using oral diltiazem for malignancy-associated perineal pain and tenesmus are described, including an elderly male with advanced urothelial cancer post surgical resection and chemoradiation who suffered from rectal pain described as “sitting on a football” despite nerve blocks and oral opioids.

Diltiazem for the management of malignancy-associated perineal pain and tenesmus.

Oral diltiazem is proposed for use as an adjunct therapy for management of chronic malignancy-associated perineal pain, specifically with characteristics of pressure-type pain and tenesmus.


It can be concluded that leech application can be an option for Proctalgia fugax patients with recurring attacks of distressing rectal pain with no positive local findings in the rectum or in anal canal.

The Role of Botox in Colorectal Disorders

BTX-A treatment was found to be effective for the treatment of obstructive symptoms after surgery for Hirsprung’s disease as well as for the Treatment of internal anal sphincter achalasia and is safe.

Proctalgia fugax

Proctalgia fugax or functional recurrent anorectal pain is part of a spectrum of functional gastrointestinal disorders defined by the Rome III diagnostic criteria as episodes of sharp fleeting pain

Benign Anorectal Conditions: Evaluation and Management.

Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are

Benign ano-rectal disorders

The aim of this article is to outline the epidemiology, pathophysiology, diagnosis and management of common benign ano-rectal disorders in primary care, including the indications for surgical referral and important cancer referral guidelines.



Sequential treatment for proctalgia fugax. Mid-term follow-up.

A total resolution of PF is not always possible, but it may improve symptoms and their frequency, and anal endosonography can help in the diagnosis of organic diseases or IAS hypertrophy.

Proctalgia Fugax: Demographic and Clinical Characteristics. What Every Doctor Should Know from a Prospective Study of 54 Patients

Proctalgia fugax affects twice as many females as males at approximately aged 50 years, and commonly the roughly once-monthly attack occurs as a sudden pain with no trigger factor, diurnally as often as nocturnally.

Pudendal canal syndrome and proctalgia fugax

It could be clearly demonstrated in further studies into this area that a causative relation exists be tween pudendal nerve entrapment and conditions of fecal incontinence that had been either considered idiopathic 5 or were related to rectal prolapse because their treatment by pUDendal canal decompression attained good results.

Proctalgia Fugax: Caused By Pudendal Neuropathy?

  • M. Takano
  • Medicine
    Diseases of the colon and rectum
  • 2005
The location, character, and degree of pain caused by digital examination were confirmed by all of them to be similar to that which they experience at times of paroxysm and suggest that the pathogenesis of proctalgia fugax is neuralgia of the pudendal nerves.

Pudendal canal syndrome and proctalgia fugax: A mechanism creating pain

  • J. Bascom
  • Medicine
    Diseases of the colon and rectum
  • 1998
In this subset of patients, the mechanism creating identical pain on sitting and lying seems related to a rise of thelevators rather than to the descent of the levators, which is sometimes investigated as the source of pudendal pain.

Proctalgia fugax – a nightmare drowned in enema

  • B. Olsen
  • Medicine
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
  • 2008
In severe proctitis with ulceration in the distal anterior rectum, noninvasive diagnostic procedures should be performed first (to exclude rectal or recurrent malignancy); in the cases described in the article the three patients developed ‘significant ano-rectal pain and urinary discharge per rectum’ after the biopsy.

Tension myalgia of the pelvic floor.

Retrorectal cyst: a rare tumor frequently misdiagnosed.

The urogenital and rectal pain syndromes

Proctalgia fugax: would you recognize it?

Treatment may be difficult, but if the attacks of pain are numerous and severe, a calcium channel blocker such as nifedipine (Adalat, Procardia) should be tried.