Do you ever experience a sudden, sharp pain in your pelvic area that comes and goes within seconds or minutes? If so, you might be familiar with a condition called proctalgia fugax, commonly known as “lightning pain.” This article will explore what proctalgia fugax is, its causes, and how to manage the discomfort.
Understanding Proctalgia Fugax
Proctalgia fugax is an episodic, fleeting pain that occurs in the anus or lower rectum. It affects approximately one in eight individuals, with women being more prone to experiencing it than men, according to obstetrician and gynaecologist Dr. Tan Toh Lick. The pain is often triggered during menstruation and can last for a few seconds, minutes, or even hours.
Causes and Triggers
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The exact cause of proctalgia fugax remains unclear, but anal muscle spasms are believed to be involved. Dr. Tan explains that chemicals that affect the muscles and blood vessels of the womb during menstruation can also affect the rectum and pelvic floor, leading to cramps. Additionally, the brain may mistakenly send signals to the rectum instead of the uterus during menstruation, resulting in pain. Stress, constipation, bowel movements, and sexual activity can also trigger proctalgia fugax.
Frequency and Severity
The frequency of proctalgia fugax episodes varies from person to person. Some individuals experience recurring episodes, while others may only encounter the pain once or twice in their lifetime, says Professor Francis Seow-Choen, a colorectal surgeon. Although the pain can be intense, with some describing it as worse than childbirth, many individuals do not seek medical attention for proctalgia fugax as they believe it to be a normal part of menstruation.
When to Seek Medical Help
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While proctalgia fugax is generally harmless, it’s advisable to consult a medical professional to rule out other potential underlying conditions. Rectal cramps can sometimes be a symptom of endometriosis, haemorrhoids, anal fissures, rectal prolapse, or malignant disease. A doctor may evaluate a patient’s medical and gastrointestinal history, perform physical examinations, and recommend tests such as pelvic ultrasound scans, hysteroscopy, and laparoscopy to exclude these conditions.
Managing Proctalgia Fugax
In most cases, proctalgia fugax does not require treatment and subsides on its own. However, if the pain becomes significantly severe, painkillers like mefenamic acid and paracetamol can provide relief, as suggested by Dr Tan. Oral contraceptive pills or contraceptive patches may also help alleviate pelvic cramps. Additionally, physiotherapy techniques targeting the puborectalis muscle, which elevates the anus, can be beneficial. Stretching this muscle through gentle movements can induce relaxation and reduce symptoms, according to Professor Seow-Choen.
Breathing Exercises and Physiotherapy
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To further manage proctalgia fugax, a breathing exercise is recommended. By placing one hand on the chest and another on the belly, inhaling slowly through the nose to the count of three and exhaling slowly to the count of five, the pelvic floor muscles can relax. Physiotherapy can also assist individuals with pelvic floor-related proctalgia fugax symptoms. Strengthening and stimulating the pelvic floor through high-intensity electromagnetic therapy and floorwork exercises may help alleviate pelvic pain and tension.
Takeaway
Proctalgia fugax, often described as lightning pain, can be an uncomfortable and unexpected experience for many individuals. Although the exact cause remains unclear, triggers such as menstruation, stress, and constipation have been identified. While the pain usually subsides on its own, it is essential to consult a medical professional if the pain becomes severe or recurrent to rule out other underlying conditions. Through pain management techniques like breathing exercises and physiotherapy, individuals can find relief and improve their quality of life when dealing with proctalgia fugax.
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