Proctalgia fugax

Proctaglia fugax is a disorder characterised by rectal pain that is considered to be functional in aetiology, and thus is a diagnosis of exclusion.

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 defaecation

  • pain lasts for no longer than 30 minutes

  • in between episodes of pain, there is no pain

The underlying aetiology 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.

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.

Management, if required, is often multi-faceted, involving pharmacotherapy (e.g. antispasmodics, salbutamol), psychotherapy, and even invasive therapy (e.g. pudendal nerve blocks) 2,3,5.

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rID: 62384
Tag: cases
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