Although Proctalgia fugax, also known as Levator syndrome in English, is not a rare disease, almost nothing is known about it. Even sufferers often do not know for decades that they suffer from Proctalgia fugax. Sufferers are affected by sudden, spasmodic, almost attack-like pain in the rectum. Often, these pain passes quickly and is therefore not perceived as a disease. In these cases, patients also do not always see a need for therapy. In others, the quality of life is so severely limited by frequent, long-lasting seizures that tremendous suffering arises.
Proctalgia fugax: causes and diagnosis
The doctors are completely in the dark about the causes of Proctalgia fugax. Spasms of the inner sphincter or the pelvic floor are suspected. Chronic stool constipation and psychosomatic factors are also discussed - often perfectionist and anxious people are affected by Proctalgia fugax. Increasingly, a Proctalgia fugax is also suspected of pelvic floor insufficiency, disorders of the autonomic nervous system and hormonal disorders.
As triggering factors, sufferers sometimes observe stressful situations; Men often report seizures after intercourse (with women getting about twice as likely to develop Proctalgia fugax). Patients often hear from their doctor that no physical causes for Proctalgia fugax are detectable; the diagnosis is made, if at all, mostly on the basis of the description of the symptoms.
If Proctalgia fugax is suspected, the patient should undergo extensive examinations to rule out neurological and hormonal as well as similar symptoms such as anogenital syndrome or anal fissure.
Proctalgia fugax: symptoms and signs
Proctalgia fugax sufferers consistently report almost unbearable anal pain. Especially with a first occurrence of Proctalgia fugax, the patients suffer from a great fear, because they fear that there is a serious emergency. Before puberty, Proctalgia fugax occurs very rarely, usually affecting the age group between 40 and 50.
Basically, two types of Proctalgia fugax are distinguished:
- A day attack occurs from one moment to the next. The pain is getting stronger and can be of changeable localization. Starting from the anus, it can affect the anal canal, pelvic floor and abdomen.
- By contrast, the nighttime attack is constant in its intensity of pain, affecting the entire anal area. Accompanying both forms of Proctalgia fugax are usually nausea to vomiting, dizziness, sweating and even fainting added. The pain sometimes ceases after a short time, most attacks of Proctalgia fugax do not last more than 30 minutes. In particularly severe cases, the pain persists for a few hours.
The seizures occur irregularly; the distances can include days, weeks or months. The general average does not exceed six seizures a year. In old age these are becoming rarer and rarer.
Proctalgia fugax: treatment and therapy
Unfortunately, experts are still relatively baffled by the question of treating Proctalgia fugax. Occasionally, clonidine, nifedipine and salbutamol (when inhaled) are achieved by achieving drug-free conditions by taking the drugs. Haemorrhoidal therapy should also be successful in some cases.
Patients with Proctalgia fugax report varying degrees of success with anticonvulsant and analgesic medications. Some patients can relieve pain with acetaminophen. Above all, the problem is that the effect often only occurs when the pain ceases on its own. Regular preventive use of analgesics (such as ibuprofen or diclofenac), however, is not useful in Proctalgia fugax because it is unknown when the next seizure occurs.
Other people report such severe pain that they are no longer able to take medication or perform enemas. In general, cramps are often associated with magnesium or calcium deficiency. Some Proctalgia fugax patients were able to reduce the frequency of seizures by taking appropriate preparations.
Self-help with Proctalgia fugax
Many sufferers of Proctalgia fugax have themselves found out how they can make the attacks bearable due to the lack of treatment options themselves. These include pressure on the perenium, insertion of a finger into the anus or heat (for example with the shower head on the aching area or a hot sitz bath). Also, certain body positions, such as the knee-elbow position, or stretching (with legs stretched to touch the toes with your fingers), can be effective.
In the long run, in addition to pain therapy, regulation of bowel function, psychotherapy, relaxation techniques and pelvic floor training may be recommended. In general, however, it is important to discuss these possibilities of self-help with a doctor for the individual case.