Proctaglia fugax is a disorder characterized by rectal pain that is considered to be functional in etiology, and thus is a diagnosis of exclusion.
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Clinical presentation
The classic presentation, which form the Rome IV diagnostic criteria if all present for three months, include 1,2:
recurrent episodes of rectal pain that occur independently to defecation
pain lasts for no longer than 30 minutes
in between episodes of pain, there is no pain
Pathology
The underlying etiology of proctalgia fugax is unknown. Popular theories postulate that it may be related to psychiatric disorders, anal sphincter cramps, or pudendal nerve compression or neuralgia 2,3.
Radiographic features
Proctalgia fugax has no radiographic features. Imaging may be performed to exclude other potential clinical differential diagnoses (e.g. pelvic inflammatory disease, inflammatory bowel disease, rectal cancer) 4.
Treatment and prognosis
Management, if required, is often multi-faceted, involving pharmacotherapy (e.g. antispasmodics, albuterol), psychotherapy, and even invasive therapy (e.g. pudendal nerve blocks) 2,3,5.