Proctalgia fugax - Revision history

Ostermayer: Prepared the page for translation

2026-01-04T23:54:20Z

Prepared the page for translation

← Older revision		Revision as of 23:54, 4 January 2026
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			<languages/>
			<translate>

	==Background==		==Background==

	[[File:Human anus-en.png\|thumb\|Anatomy of the anus.]]		[[File:Human anus-en.png\|thumb\|Anatomy of the anus.]]
	*Exact pathophysiology unclear, however may include anal sphincter spasm and hypertrophy		*Exact pathophysiology unclear, however may include anal sphincter spasm and hypertrophy
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	*Prevalence 8-18%, does not favor one sex		*Prevalence 8-18%, does not favor one sex
	*Should be considered a diagnosis of exclusion		*Should be considered a diagnosis of exclusion


	==Clinical Features==		==Clinical Features==

	*Spasm-like, sometimes excruciating, pain in the anus, often misinterpreted as a need to defecate		*Spasm-like, sometimes excruciating, pain in the anus, often misinterpreted as a need to defecate
	*Episodic pain (women, patients < 45yo)		*Episodic pain (women, patients < 45yo)
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	*Incontinence		*Incontinence
	*Urgency		*Urgency


	==Differential Diagnosis==		==Differential Diagnosis==

			</translate>
	{{Anorectal DDX}}		{{Anorectal DDX}}
			<translate>


	==Evaluation==		==Evaluation==

	*Diagnosis is largely clinical, and one of exclusion		*Diagnosis is largely clinical, and one of exclusion
	*Digital rectal examination should be performed, with special attention and care noted to assess the external areas for contributing sources of pain		*Digital rectal examination should be performed, with special attention and care noted to assess the external areas for contributing sources of pain
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	**Women should also have pelvic examination to assess for pelvic etiology masking as rectal complaint		**Women should also have pelvic examination to assess for pelvic etiology masking as rectal complaint
	*Laboratory evaluation, including ESR and CRP, may be obtained though are frequently normal		*Laboratory evaluation, including ESR and CRP, may be obtained though are frequently normal
	*If febrile or [[leukocytosis]] present, consider advanced imaging to assess for deeper infections or process not easily evaluated by physical examination		*If febrile or [[Special:MyLanguage/leukocytosis\|leukocytosis]] present, consider advanced imaging to assess for deeper infections or process not easily evaluated by physical examination


	===Rome IV Criteria===		===Rome IV Criteria===

	*The Rome IV criteria are meant to differentiate and assist in the diagnosis of functional gastrointestinal disorders (FGID)<ref name"test"=>Rao SSC, Bharucha AE, Chiarioni G, et al. Anorectal Disorders. Gastroenterology. March 2016:S0016-5085(16)00175-X 10.1053/j.gastro.2016.02.009. doi:10.1053/j.gastro.2016.02.009., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035713/ </ref>		*The Rome IV criteria are meant to differentiate and assist in the diagnosis of functional gastrointestinal disorders (FGID)<ref name"test"=>Rao SSC, Bharucha AE, Chiarioni G, et al. Anorectal Disorders. Gastroenterology. March 2016:S0016-5085(16)00175-X 10.1053/j.gastro.2016.02.009. doi:10.1053/j.gastro.2016.02.009., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035713/ </ref>
	*For the diagnosis of proctalgia fugax, the following should be present		*For the diagnosis of proctalgia fugax, the following should be present
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	#Absence of pain between episodes		#Absence of pain between episodes
	#Exclusion of other causes		#Exclusion of other causes


	==Management==		==Management==

	*In majority of cases, reassurance and explanation of process is sufficient		*In majority of cases, reassurance and explanation of process is sufficient
	**This is due to brief duration of episodes and difficulty in both treating and preventing		**This is due to brief duration of episodes and difficulty in both treating and preventing
	*Referral to gastroenterology if symptoms severe		*Referral to gastroenterology if symptoms severe
	**Some research into inhaled [[beta agonists]] and topical anti-spasmodics, but best provided and managed by GI		**Some research into inhaled [[Special:MyLanguage/beta agonists\|beta agonists]] and topical anti-spasmodics, but best provided and managed by GI


	==Disposition==		==Disposition==

	*Can be safely discharged home when emergent causes excluded		*Can be safely discharged home when emergent causes excluded
	*Provide GI follow up information		*Provide GI follow up information


	==See Also==		==See Also==
	*[[Anorectal Disorders]]
			*[[Special:MyLanguage/Anorectal Disorders\|Anorectal Disorders]]


	==References==		==References==

	<references />		<references />

	[[Category:GI]]		[[Category:GI]]
			</translate>

Rossdonaldson1: /* Background */

2025-04-16T22:24:08Z

Background

← Older revision		Revision as of 22:24, 16 April 2025
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	==Background==		==Background==
			[[File:Human anus-en.png\|thumb\|Anatomy of the anus.]]
	*Exact pathophysiology unclear, however may include anal sphincter spasm and hypertrophy		*Exact pathophysiology unclear, however may include anal sphincter spasm and hypertrophy
	*Frequently brought on by stress		*Frequently brought on by stress

Rossdonaldson1: /* Evaluation */

2025-04-16T21:21:37Z

Evaluation

← Older revision		Revision as of 21:21, 16 April 2025
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	*If febrile or [[leukocytosis]] present, consider advanced imaging to assess for deeper infections or process not easily evaluated by physical examination		*If febrile or [[leukocytosis]] present, consider advanced imaging to assess for deeper infections or process not easily evaluated by physical examination

	~~'''~~Rome IV Criteria~~'''~~<ref name"test"=>Rao SSC, Bharucha AE, Chiarioni G, et al. Anorectal Disorders. Gastroenterology. March 2016:S0016-5085(16)00175-X 10.1053/j.gastro.2016.02.009. doi:10.1053/j.gastro.2016.02.009., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035713/ </ref>		===Rome IV Criteria===
	*The Rome IV criteria are meant to differentiate and assist in the diagnosis of functional gastrointestinal disorders (FGID)		*The Rome IV criteria are meant to differentiate and assist in the diagnosis of functional gastrointestinal disorders (FGID)<ref name"test"=>Rao SSC, Bharucha AE, Chiarioni G, et al. Anorectal Disorders. Gastroenterology. March 2016:S0016-5085(16)00175-X 10.1053/j.gastro.2016.02.009. doi:10.1053/j.gastro.2016.02.009., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035713/ </ref>
	*For the diagnosis of proctalgia fugax, the following should be present		*For the diagnosis of proctalgia fugax, the following should be present
	#Recurrent episodes of pain unrelated to defecation		#Recurrent episodes of pain unrelated to defecation

Rossdonaldson1: /* Background */

2025-04-16T21:18:43Z

Background

← Older revision		Revision as of 21:18, 16 April 2025
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	*Prevalence 8-18%, does not favor one sex		*Prevalence 8-18%, does not favor one sex
	*Should be considered a diagnosis of exclusion		*Should be considered a diagnosis of exclusion


	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Differential Diagnosis */

2025-04-16T21:16:33Z

Differential Diagnosis

← Older revision		Revision as of 21:16, 16 April 2025
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Levator ani
	*Coccydynia

	{{Anorectal DDX}}		{{Anorectal DDX}}

Rossdonaldson1: /* Differential Diagnosis */

2025-04-16T21:15:26Z

Differential Diagnosis

← Older revision		Revision as of 21:15, 16 April 2025
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Levator ani		*Levator ani
	*[[Constipation]]
	*[[Fecal impaction]]
	*Coccydynia		*Coccydynia

Rossdonaldson1: /* Differential Diagnosis */

2025-04-16T21:14:04Z

Differential Diagnosis

← Older revision		Revision as of 21:14, 16 April 2025
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	*[[Constipation]]		*[[Constipation]]
	*[[Fecal impaction]]		*[[Fecal impaction]]
	*[[Prostatitis]]
	*Coccydynia		*Coccydynia

Rossdonaldson1: /* Differential Diagnosis */

2025-04-16T21:13:45Z

Differential Diagnosis

← Older revision		Revision as of 21:13, 16 April 2025
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	*[[Fecal impaction]]		*[[Fecal impaction]]
	*[[Prostatitis]]		*[[Prostatitis]]
	*[[Proctitis]]
	*[[Anorectal abscess]]
	*Coccydynia		*Coccydynia

Rossdonaldson1: /* Differential Diagnosis */

2025-04-16T21:12:43Z

Differential Diagnosis

← Older revision		Revision as of 21:12, 16 April 2025
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Levator ani		*Levator ani
	*[[Rectal prolapse]]
	*[[Constipation]]		*[[Constipation]]
	*[[Fecal impaction]]		*[[Fecal impaction]]
	*[[Prostatitis]]		*[[Prostatitis]]
	*[[Proctitis]]		*[[Proctitis]]
	*Prolapsed [[internal hemorrhoid]]
	*[[Anorectal abscess]]		*[[Anorectal abscess]]
	*Coccydynia		*Coccydynia

Rossdonaldson1: /* Differential Diagnosis */

2025-04-16T21:12:11Z

Differential Diagnosis

← Older revision		Revision as of 21:12, 16 April 2025
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Levator ani		*Levator ani
	*[[External hemorrhoid]]
	*[[Anal fissure]]
	*[[Rectal prolapse]]		*[[Rectal prolapse]]
	*[[Constipation]]		*[[Constipation]]