11 May 2008

A genuine pain in the ass: proctalgia fugax

I was awakened this morning around 4:30 by a mild case of proctalgia fugax, a type of rectal pain that usually strikes at nite during sleep. Its causes are unknown (if other medical conditions are ruled out) and there is no treatment for it. Luckily, I get them very infrequently, once a year, maybe.

Last nite's episode was, fortunately, a mild one; the pain was of a dull, aching type. However, it was uncomfortable enough to prevent me from going back to sleep and I got up. I walked around the bedroom, went downstairs and came back up, did some stretching and squatting. I figure that if the pain comes when I am in bed, then getting up and moving around should help ease it. The pain did lessen rather quickly. I went back to bed and was able to fall asleep again until about 7:30 when Marissa Cat woke me up. It was way pass her breakfast time.

She will be there again tomorrow morning, but hopefully, proctalgia fugax won't return for a long time.


Deniz Bevan said...

A coccygodynious day, eh?


Let me see you spell that in Scrabulous.

O. B. Sirius said...

Thanks for posting this -- now I have a name for something I've also experienced. The link was very informative and reassuring.

janet said...

I get this pain really bad! Ooouch! Any suggestions for relief!


Sorry, I don't have a "treatment" that works every time. I have tried various stretching positions, walking up & down stairs & sitting on the toilet, but nothing worked consistently. Sometimes passing gas seems to help. Luckily, I get it infrequently.

Anonymous said...

I've been experiencing this for about 10 years and must have an extreme case because the episodes are extremely painful and can last up to an hour. Finally I've found a rather disgusting way to treat it which is inserting a tampon after lubing it with vaseline. It stops it almost immediately - kind of like how standing on a cramping toe stops the cramp. I talked to a gastrointestinal doc about this and he thought it made perfect sense. I thought it was working because of the pressure but he said it was about stretching the muscle. Anyway, for those of us who experience this, almost anything is worth a try.

Al said...

This pain is the worst I've ever experienced. Complicating the extreme discomfort, my blood pressure must also drop because I feel faint during these episodes.
My brother is a family practitioner who sees these case from time to time. In parallel with what anonymous said in the post of 10 July 2008, my brother the doctor says that stretching the anus by sitting on a tennis ball or using some other means to oppose the sensation of pressure and pain in the afflicted area may offer some relief.

Anonymous said...

I have had this condition for some time and only tonight learned it's name. I wanted to post this comment in the hope that it helps someone. I have found relief by tightening the rectal muscle and holding it as long as I can--or until the pain goes away. I usually find this works within minutes. Hope I have helped someone.

Anonymous said...

I've had this condition for over 20 years, it started about 6 months after my daughter was born. Lately I've been under stress and it's been worse, almost happening daily. I read something about taking potassium when it starts hurting, so I started taking a potassium supplement every day for over 2 weeks and I haven't had one episode since, it's wonderful.


That makes sense, because I believe salt, including potassium, deficiency can cause muscle cramps. However, I doubt one could get rid of a rectal cramp right away by ingesting potassium.

Anonymous said...

I've found the most helpful, up-to-date information regarding this condition on Medhelp.org and Wikipedia.com.

Anonymous said...

TREATMENT THAT WORKS FOR ME: I've had these pains for over 10yrs now, most commonly after ejaculation, an erection, or pooping. As soon as I can feel the pain coming on I take 1 or 2 Aleve brand headache meds (For some reason no other pain meds work) and depending on the severity of the pain I either sit on the toilet while trying to relax and not think about it or I start walking around. Usually walking around works best for severe pain. I've heard that a warm bath helps too. Using these methods I usually pull through the pain in a matter of minutes. Good Luck!! 28/M/USA

Anonymous said...

Ive have had this problem for years and had episodes at least 6 times a month until I found how to prevent them from ever happening. everynight before going to bed I make sure to lubricant my anus with Ky jelly. since ive started doing this I have only had 2 episodes all year. this is the theory behind it. the anus is a very dry space, so when you flex it while sleeping or having normal intercouse it moves the muscles of the anus "out of place" causing the cramps. if the anus is lubricated then it always falls back into the natural inline position preventing the cramps from ever happening. not a doc but it has worked great for me.

Anonymous said...

I've had cramps for about 10 years that I describe as being similar to giving birth, only the pain emanated from the rectal area. Recently, I was fortunate in discovering that my episodes always followed having eaten corn. That's corn on the cob, popcorn, corn chips, anything with corn derivatives like cornstarch. It was not obvious at first because it took a couple days or so after eating a corn product for the pain to appear.

Last week, I was out-of-town and happened to discover a very delicious kind of pita chips. I always thought that pita bread was bread, only thinner, so I had the chips every day for 5 days at lunch. I started having pain but not too severe before I came home. I had other symptoms that I found were common with corn intolerance this time, like swollen fingers and very blood shot eyes. I looked up the ingredients for the pita chips and found that it had 4 or 5 types of corn products. I had a handful of chips for so many consecutive days that I still have the rectal cramp attacks few times a day. The last day I ate the chips was a week ago. Furthermore, there were countless ways of having corn or corn derivatives in whatever I ate in restaurants.

I try to avoid any product that is corn based. It is sometimes a difficult task. Corn is in many things. Sometimes, it takes two consecutive days of eating corn chips for the attacks to start. Maybe it depends on the cumulative amount.

As of yet, I have not seen anything on the internet to suggest a cause for this painful condition. As for myself, the only time I have the rectal cramps is after I eat corn. I am not suggesting that corn is the cause for all cases of proctalgia fugax. However, could it be possible that for some people, the cause for proctalgia fugax or levitor ani syndrome is related to an intolerance for something in their diet. A daily journal listing foods that one eats may reveal the culprit for some of you who have this often unbearable pain. Remember that in my case, the pain starts a few days after I eat the offending food.

I hope this can be of help to some of you who suffer from this problem.

Anonymous said...

I also have had this problem. I have had 3 C sections and numerous kidney stones, found the kidney stones to be a breeze compared to this pain. I saw my GI doc and he diagnosed proctalgia and colitis after having a colonoscopy. He prescribed pain medication and Xanax (which helps if I take it all the time). I have been off work for 6 weeks, my symptoms seem to have lasted longer than most of the other stories I have read. The pain is like someone twisting a knife around inside your rectum and then sometimes there is pressure. As I said it has been six weeks and I am just now thinking I can tolerate working again as I sit all day. Placing pressure on the perineal area helps, but you can't sit on your hand using pressure all day. Also sitting on a heating pad helps some, but when it is really bad only pain meds and laying down works. My GI said it is a debilitating disease and I am thoroughly convinced that it is. I have also found that eating beef makes it worse for me, I don't know if this is because of the colitis or the proctalgia. I'm curious as to if anyone else has had this problem that has lasted as long as mine has.

Anonymous said...

I've had it for years but nothing lasting 6 weeks. My episodes of proctalgia fugax last 20-30 minutes tops and come on whether I eat corn or not so for me Corn is not the issue.

Direct pressure seems to help but it still takes about 20 minutes for it subside.

I rarely have mild ones and rarely do they occur during the day.

Anonymous said...

I find that I have an episode after eating dairy and sometimes after eating peanuts. The dairy will always do it, and I have to wonder if there is a connection to that and some noticing benefits from calcium channel blockers. Maybe the additional calcium is worsening a mild potassium deficiency.

I also get the instant feeling of passing out, like someone else mentioned. I believe that in addition to the muscle cramping, something is stimulating the autonomic nervous system. This feeling actually bothers me more than the pain.

Anonymous said...

For the person trying potassium supplements- how much are you taking?

Anonymous said...

I've had this pain for about ten years sometimes six months apart and other times three or more times in one week. I have visited my GP who sent me for a colonoscopy to rule out anything else. My doctor gave me an asthma puffer to help but didn't find this did anything. An attack can last up to an hour for me and can happen day or night. I have fainted twice from this. My only relief is to do some deep breathing exercises, or dare I say it have a cigarette relaxes the muscles.

Anonymous said...

Since having a rectal cancer removed three years ago, I get rectal cramps that last for days. Mostly they're achy, rather than sharp pain, but they last so long it's debilitating. And it causes constipation because hardly anything can get out.

My GI doc has given me three different meds that haven't helped (Belladonna Alkyloids, Librax, and Chloridiaz). The only painkiller that works is a couple of Ibuprofin--I've even tried Dilaudid (sp?) and that did nothing.

The GI doc also suggested enemas. I finally tried that after being backed up for two weeks, and it certainly got things moving, but the pain remained.

I'm going to try a food diary. I haven't eaten beef in 8 or 10 years, so I can rule that out right away!

PITB (work it out...)

Anonymous said...

I have been experiencing this for about a year now. An episode seems to come on right after to a couple hours after a bowel movement (no matter what type of movement it is - i.e. loose to firm) It can last with the stabbing pains happening off and on for a couple of hours at a time and in between the stabbing it aches horribly.

I just had a colonoscopy a few months ago and spoke to the doctor about it - She described the pain as an icepick being jammed up you - It described it perfectly. She didn't tell me a name for it - just called it a rectal spasm and that there wasn't anything to be done for it.

I spoke with my personal doctor yesterday - as I had just had an episode the night before - she told me the name proctalgia fugax and perscribed Dicylomine 10 mg caps to take as needed. I haven't tried it yet so can't say how it works or not.

I am keeping my fingers crossed as when it is happening, at work, at home- doesn't matter what time of day or night - it is unbearable.

Anonymous said...

Potassium really works. I'm taking 2 pills each evening, and another anytime that I feel an episode coming on. It works about 95% of the time, which is so much better than getting the episodes more than once a week. I have gotten a couple of bad cramps in the past 6 months, then I just sit on the arm of my sofa to apply pressure, and they don't last long.

Gayle said...

I have had this condtion so long I cannot remember when it started.
It was a blessing that I spoke to my DR about this. He was concerned enough to schedule me a colonoscopy.
They did find polyps and removed them, after the polyps were removed I did not have a spasm for quite awhile. But they are back and this time it seems like they are lasting allot longer and at least 4 or 5 times a week.
The pain and nausea and faintness is horrible.
The pain is allot worse than labor pains.
I do have the generic for Bentyl. It does seem to help. I let one dissolve under my tongue and it seems ro give me the fastest relief yet.
I am going to discuss with my DR on my annual checkup in November.
He is a really good Gyno and will listen to me.
I will keep everyone posted to his comments.

Dante said...

Let me get to the point, I just found a cure- pot.

I too have had this condition; I've had it since my early 20's and I'm now 42 years old (male). I've tried everything short of taking medicine. Usually eating a high fiber diet keeps the symptoms at bay for longer periods of time, but eventually that rectal Charlie horse will hit in the middle of the night (and sometimes more than once in a night) and it's a nightmare. Often I come close to passing out from the pain. Normally walking, and especially walking up and down stairs helps, and sometimes massaging the area helps, but for me these "therapies" shorten the length of the attack only modestly.

I have never used drugs, except recreationally on rare occassion. I can count on two hands the number of times I've tried even a little pot. It just so happened the other day, don't ask me why, that a small quantity of pot was left in my house when I had one of these attacks. After suffering awhile I thought. . . couldn't hurt to try it and I only took one or two puffs, and sure enough, the pain went away in seconds! It happened again a couple of nights ago, and this time I didn't wait as long to try it, I took two small puffs, and sure enough, it again went away in seconds, and I had a good nights sleep. What a relief!

What can I say? I sure don't want to make this a habit, but I'm going to keep some pot around the house for "medicinal purposes," as Granny Clampett used to say. Of course there shouldn't be quotes in my case. It really will be for medicinal purposes.

Good Luck to the rest of you. I know your suffering.

Anonymous said...

I think this is my condition. Read about it in Dr. Gott's column and behold - a name for it!!

I describe to doctors as a burning ass hole - and it burns all the time - unless on the toilet, floating in a pool, lying on my stomach or have had enough wine to dull the burning. The only real thing that has helped me are bee stings - placed very carefully - I'm great for about 5 days after each treatment, but bees are not around like they use to be.

I don't take any meds and while in California I did try pot - it didn't help me at all.

I can't sit for any long periods of time. I can stand and walk but that doesn't relieve the burning.

Some days are much worst but I have bedtime down - stomach only.


In response to the last comment, although I am not qualified to diagnose any medical condition, I suspect what you have is not proctalgia fugax. You may be suffering from hemorroids or a rectal fissure. Go see a proctologist to get proper treatment.

Dante said...

I have to agree with AYDIN ÖRSTAN. An ongoing burning sensation is not a symptom of proctalgia fugax. For your own sake, please, see a doctor for a proper diagnosis.

Anonymous said...

I am 26 yr old black female, I have never had an STD or any other medical problems in my pelvic area. I have been coping with chronic pelvic pain for 7 yrs. I have had paps, and I’ve also had an ultrasound but nothing has ever been found. Here are my symptoms: Throbbing pain in pelvic area (around where uterus and fallopian tubes are) Throbbing pain in lower rectum Pains sometime occur simultaneously Pain occurs before and/or after using bathroom Pain sometimes occurs during sex or after orgasm Pain occurs often during anytime of the day (including the middle of the night which wakes me) Pain is less frequent and not as strong during and immediately after menstrual cycle. Pain is immediate after eating spicy food. Pain occurs during exercise. Pain sometimes occurs when I am stressed. There is also a sharp pain when the wall between vagina and rectum is touched during sex or when I use those muscles down there ( sneeze, got to bathroom, pass gas)

I usually experience relief a couple minutes after using the bathroom. Bowel movements are often small though it feels larger before passing. There has been blood in stool but only 3 times in 7yrs which all can be explained by constipation or diarrhea. I have gas all the time (fortunately there no odor) I feel nauseous from time to time

I believe the issue is in my rectum because that’s where the pain occurs most often especially when I need to go #2. It is also affected by some foods, though I haven’t exactly figured out all of them. If someone could provide me with some possible things to research or get tested for that would be great.I have already had pap smears, xrays, ultra sound, and a colonoscopy which have all come back fine.

Anonymous said...

For everyone who has Pf- I'm so sorry. I've had it since I was a little girl. I was so embarrassed I didn't tell anyone. I thought something was horribly wrong with me. Then in my teens I found out my mom gets them, and several of my sisters.
My mother has Crohns and both of my parents have intestinal issues. For some reason I get the spasms for frequently than my sisters. They are just the worst! I have vomited and feel faint- totally incapacitated. And they can last for more than an hour. I think the record time for me is 1hr. 50min. I also have issues like IBS, anal fissures, etc. But the worst is the proctalgia fugux. I hate that it means "fleeting pain". How about the worst pain ever? Yes, I feel grateful that I am not extremely ill and have a good life but it sure does do its best to ruin things! My partner was so scared the first time he saw me have an attack. I tried to give him things to do (heating pad, water, etc.) so he didn't feel so helpless. It can really effect your loved ones. And I've missed work, concerts, dinners, parties, etc.
And I hate that doctors tell you "oh, well it isn't serious and you just need to de-stress." I'm so glad that some of you have found GI docs that listen and know more than the average Kaiser doc. My mother finally found someone wonderful. I have Kaiser and they spend about 2 minutes in the room with you. I hate going to the doctor- I don't go for my own amusement! I want help people!
I've tried several medications (including inhaler) and they have not worked. I was desperate one time and my sister handed me some pot. I had never used drugs before. I didn't think it would work, but it is sooooooo great! I just don't like using it because of the stigma attached to it.
But there is some scientific data coming out that backs this up. Some research suggests that pot can help with spasms.
I am going to ask my doc to either help me or refer me to a specialist- I haven't tried the nitro cream or the other cream (starts with a d). I am willing to try about anything. I would stick with the pot if it was more excepted, although it hasn't stopped the frequency. Every year I get more than the year before. Doesn't this suggest a condition that is worsening? I just want to be proactive, since this pain sometimes makes me pray to the heavens that I will be taken from this earth. Then it passes and I'm just exhausted, drenched with sweat, and almost delirious. Hope you all find help!

Anonymous said...

I'm a 39 year old male and have experienced these pains for at least 10 years.
My doctor first just told me they were normal and not to worry. Discovering the medical name from my own subsequent research was reassuring.
Having just been woken by an attack, and frustrated by the lack of useful information on the web, I set up a blog http://proctalgiafugax-cures.blogspot.com/ to try and gather first hand experiences together. That prompted me to look for other blogs and I came across this one.
I'll link mine to this - I don't care where the information is, as long as it is out there!

Anonymous said...

I have found something that has helped me. I bought a homeopathic leg cramp pill for my foot cramps, and one time when I had my rectum hurting so bad I figured why not try that pill. I took one pill and felt better in less than a minute. I've used it maybe 3 times since the first time and it still seems to work. I get it at Walmart. At my Walmart it's in the vitamin row on the bottom shelf. It's Hyland's brand and they also have a Nerve Tonic that works. But the Leg Cramp pill has quinine in it, so you wouldn't want to take them very often.

Anonymous said...

I just found this blog, and thought I would comment. I'm a middle-aged male, and get this every 3-4 months - and it's usually in the middle of the night, and painful enough to make me want to throw myself under a bus!

I keep a supply of 500mg methocarbamol on hand just for this. I've heard about some of the other meds mentioned, but have not tried them. I grind up two tablets, and drop them into water and down it on the first sign of the pain. I've also heard medical marijuana works - but have not experienced it (for this, I mean).

Best of luck to everyone! =)

Anonymous said...

Wow, posts on awesome wildlife get zero comments, but posts on arses attract a deluge of posts. What does that say about the internet?

Anonymous said...

Hi, I've just been reading all your comments, and this sounds so familiar, just last night I was woken up in the middle of the night with what first a distant ache, it seems to wake me up even at the first sign, the pain grew and grew and I lay there tossing and turning until it went, I am just scared that this will get more frequent and more painful, I haven't taken any medication yet, but I don't think that will last much longer, it's reassuring to know that I'm not the only one with this.

Anonymous said...

My attacks start out as a dull ache, which gradually builds to a crescendo of agony after about twenty minutes. Then another twenty minutes of incredible pain before it subsides. It usually hurts in my scrotum, penis and belly during the worst phase.

After it's over, I feel like throwing up. Good thing they only clobber me about six times a year.

Anonymous said...

Oh my gosh! I just got a name for this today right before my colonoscope. I am sorry you all have this because it is the worst! If I had this pain all the time I would not want to live, it is that bad. I have about a 3 minute warning and then I just breathe deeply for 45 minutes. Horrible! Wikipedia gives potassium and medical marijuana as the best for relief. I am wondering where I put these things because I want it to take affect quickly.
I have noticed that when wearing 2" heals....sorry guys...It seems to create the situation. So...could it be something in the lower back? A pinched nerve that triggers it? anyone else?

Anonymous said...

I have had this problem for 31 years. That is the mother of all pains. I am no longer afraid of it though. My doctor prescribed Sufrexal P 3 years ago. I take it even to church with me. At the first sign of the pain I apply it to my rectum. It has not failed me once. Try it.

Anonymous said...

Since this thread is still active, I thought I'd add something that might help someone else. I get PF a few times a year, and I have passed out twice during a PF attack. However, at one point I began having rectal twinges on a continual basis, but not full-on attacks. After about a week, they went away. I monitored what I ate, and when it happened again I found that the twinges were correlated with eating "sugar alcohols", such as Maltitol, in diet candy bars. I haven't had any of the twinges since I quit eating them (although I still occasionally get an attack, which probably isn't related). Look up "sugar alcohol" in Wikipedia for more information.

Laura said...

It's a relief to see that there are so many others out there. It first started for me when I was 12, I associated it to the fact that I played the bagpipes, and blew a fuze I guess... For me the spasms occur 2, 3, 4 times a night, or are just constant through out the night. These episodes have lasted over a year and a half and at the age of 28, I'm on round 5.

The last round I was determined to get it resolved, I went to my GP, who didn't know, he referred me to a proctologist, who didn't know, but referred me to a dermatologist, who didn't understand why I was there and sent me to an neurologist. It's a 4-8 month wait between each specialist. I felt like I was going to lose my mind. Eventually It just went away.

But it's back, and I'm with a new GP who doesn't know what it is, and around the cycle I go again. I feel lost and frustrated. I'm terrified of the prospect of another 18 months of sleepless nights.

ON THE BRIGHT SIDE... I do find that putting ice cubes on it works almost instantly. Just a tip.

Anonymous said...

I too have this condition. I've had it for 8 years or so. It's severe in the sense that it wakes me up at 4am and I groan, roll around, pace the hallway, sit on the toilet, lay on the sofa and curl into the fetal position until it goes away - generally 1 to 3 hours later. Terrible pain.

I've noticed 2 things that seem to set it off:
1. Stress
2. Chili powder. No joke. Chili powder in any food will bring this thing on in the night, for me. Took me a while to figure that one out. Keep an eye on your diet and notice if it happens when you eat something unusual.

Vicodin really helps. I have some Vicodin handy and take one immediately when I notice the pain. If you have it as bad as me, you'll be thankful for the pill.

I had an episode this morning at 10am. It lasted for 2 hours. It's 2:36am and I can still feel a dull ache - as if I'm in recovery.

Thanks for all of the tips. Remember, if you have to get some sleep - there's a pill that kills any pain. Don't suffer unnecessarily.

Anonymous said...

I'm reading through and have to say - yes - marijuana does work. I do not enjoy the feeling of being stoned. I've never been a pot smoker. I've noticed that pot does help it.

For night attacks - try some pot. For day attacks - take some Vicodin. Pay attention to your diet and try to keep the stress off with some yoga and meditation.

Take something for the pain at the first sign. 20 minutes in and we all wish we would have taken something before it was too late.

I know what everybody's going through.

Hang in there!

Anonymous said...

I have had PF for 30 plus years. It happens about 10 or 15 times a year. It usually wakes me from a sound sleep and lasts an average of 25 minutes. Causes are drinking diet drinks, a bowel movement earlier in the evening, erection and having sex. I found walking around makes it worse so I lie on my back, spread my legs a bit and ride it out. Also, strenuous work during the day like heavy lifting can set it off at night when I am asleep. Usually, right before the horrific spasms stop, I pass gas. My suggestion is take something like Metamucil at night so you have an AM bowel movement. Don't have evening or before you go to bed bowel movements. Combine the bowel movement with also having sex in the same night, PF usually occurs with me. Hope this helps. I never knew what I had until blogs like this one developed, thanks..

Anonymous said...

Breaking news (I think there's hope) : I've suffered from this for 10 years or so. The frequency has been increasing over time. In the past few months I've had it fairly regularly (sometimes 3 times per week). I've accepted it but I continually look for treatments. Obviously no such luck. Well, until now. Potassium. Low potassium can trigger it. I've been eating a banana every day. The pain has stopped completely. I'm not kidding. Load up on potassium and see if it helps. My doctor told me about it. He used to have it in college and no longer suffers. Potassium! Good luck!! :)

Anonymous said...

I also have these painful episodes. What works for me is sitting in a tub with about 3 inches of hot water. This will relieve the pain.

I also noticed when I drink Dr. Pepper, it seems to trigger my spasms. I'm now limiting my Dr. Pepper intake.

Anonymous said...

Update on the potassium experiment:

I've been regularly getting potassium, daily, for the past month. I haven't had any pain. I've decided to test it and last week I skipped my potassium for 5 days - sure enough, I woke up with pain 2 nights ago. I tried some remedies which included relaxing and massaging the area. Nothing helped, so I'm glad I took a vicodin right away. I'm back on my potassium kick and have not had trouble since.

No joke. Maybe it's different for everybody, but I suggest loading up on the potassium. It's cured it for me. The pain used to be so bad that it lead me to this blog! They should change the name to "migraine in the ass." Good luck!

Anonymous said...

I am perfectly healthy and started getting this a couple yrs ago. In my case, I have personally narrowed it down to "milk" , even lactose free milk. I find that when I drink it before bed, I wake up in such pain, I can't even move out of bed let alone sit on the toilet without feeling I'm going to pass out with pain. I have cut out the milk and haven't had an episode since. I drink Soy now and no problem, so far. Not sure if there's any relation to milk and this pain but seems to be so in my case. Hope this helps ...

Anonymous said...

I have been a PF sufferer for about 36 years. Mostly the attacks occur between 12PM and 3AM with some happening during the day. The pain is such that I would like to add my observations to other sufferers in the hope of eventually finding a cure. Reading through the blogs it would appear that there are many different ways of obtaining relief. In the end it may boil down to more than one cause of the spasms. As in other male cases, sex or ejaculation seems to be sometimes linked to episodes as in my case. It may well be the similar for females too. It is my experience that diet is not a contributing factor. One of the worst episodes I experienced was prior to a colonoscopy when my bowl was entirely filled with water (and some salty chemicals). In my case the pain is located around the rectum and is felt deep in the buttocks on either side. Last night, after an unsuccessful hot bath I lay on my side with the painful side uppermost. After a few minutes the pain migrated across to the other (lower) side! Explain that! It was like a clogged nostal when the mucus gravitates to the other lower one.
Early on I tried various diets both vegetarian and high fibre. Still the same, getting an attack maybe 6 to 8 times a year and they seem to come in clusters. I noticed that during an episode there was a lot of stomach rumbling accompanied by a release of gas. The pain then disappeared. I tried sitting on the toilet and massaging my lower stomach trying to move the gas in my colon. This was moderately successful but resulted in a tender abdomen from the vigorous digging of the hands. I heard about the hot bath treatment. This produced good results but was very disruptive due to the time taken to prepare the bath. I modified this by using a plastic dish about 400mm square by 100mm deep. It is quick and easy and works most of the time although sometimes the pain returns the moment I go back to bed. I have tried the asthma inhalants both through the nose and into the rectum along with ice cubes - they hurt like hell and none of it worked. I still have a few things to try, I'll keep you posted.

ALI B said...

how interesting this blog is..i started getting PF 20 years ago when i gave up recreational drugs! sounds like i may have to take up marijuana again! sam symptoms as most but stress and tiredness related. i get it 2 nights running quite often this i put down to tiredness. the baths dont work, sitting on the loo relives it a bit. drinking alcohol doesnt work.

Anonymous said...

i have been having these symptoms on and off for about 15 years. Until last night, I just got over it. Last night, I had such a bad one, that I really thought I was having a heart attack or something. I was scared. I woke up in the early hours of the morning and staggered off to the loo, trying not to make too much noise. Sat on the loo hoping to pass a number 2, nothing. Started to feel really dizzy and thought I was going to faint. I started sweating, dripping off me all over. I quickly lay down on the floor as I didn't want to pass out and hit my head or something. I put my legs up on the toilet, but honestly thought that I was going to have a heart attack and die. Couldn't really breathe easily. I am 46, not overweight, not fit but with 3 kids not a couch potato. Don't drink don't smoke but have a really stressful job. I have found that applying pressure to the anus helps, pushing to do a number 2 doesn't help. Am definitely going to try the potassium idea. Fingers crossed, but my god it's painful!

Poor Hiney said...

I just had my quarterly attack earlier today. Im 46 year old Male, they stared about 2 years ago. Mine last for 30 minutes and always during the day. It feels like im giving birth to a basketball out of my butt. Its horrible. Im grateful that I always get these mild warning pains. Ill pop some asprin or something and then endure the pain curled up in the fetal position. I just try to breath and relax, I cant talk to anyone if they are around. I dread that its going to happen when Im in the middle of a photoshoot or wedding. "Sorry, I have to lay down right now, a Mack Truck seems to be coming out of my ass".

Anonymous said...

Last night I had the most painful attack of my life. I was visiting my sister and had the episode late in the evening. She googled and hey presto, found this site! I've mentioned this to numerous doctors and specialists, and none have given me a straight answer. Im going to try potassium supplements and will see how I go. Thanks to everyone for sharing their stories x

Dennis Argall said...

A very interesting discussion! at a very interesting blog

My first experience of proctalgia fugax was in the office in 1975 - I am now 69 - when slain by a pain so severe and bizarre that I was glad I had an office with a door I could lock. I eventually recovered curled on the carpet under the desk.

I began to know how to avoid it in the late 1990s. It has returned more recently, I have to think harder to avoid these days.

It is associated with irritable bowel syndrome, in the case of pf the cramp is at the end (also very unpleasantly at times at both ends, the other being the ileocecal valve http://en.wikipedia.org/wiki/Ileocecal_valve ). The normal peristaltic action of the gut goes wrong, contractions haywire. There is a deprivation of energy to the nerves of the gut. Useful to look at Ray Peat's web site http://raypeat.com/ and use the search engine for 'cramps' and 'energy'. There are lots of ways of dealing with energy deficits, including sufficient but not excessive exercise (myself constrained by chronic fatigue) to avoid lactic states. I also use up to 10 micrograms of the active thyroid hormone T3 http://www.rxlist.com/cytomel-drug.htm to stimulate cellular respiration 3 or 4 times a day, on prescription... this for broader chronic issues but I know if I drop off dose pf is likely to be a first sign of problems, as absence of pf is a good marker that my system is going well.

Why at night? Several considerations. If we have a day of huge expenditure of resources and can't get the resources back in sleep (imbalance between http://en.wikipedia.org/wiki/Catabolism and http://en.wikipedia.org/wiki/Anabolism ); if we eat big meals late, or alcohol late, the gut is going to be exhausted in the night. Medications can contribute. Sex? Pf is the ultimate punishment dreamt up by a cabal of gods and ayatollahs for having a nice time.

BUT, ALSO DO CONSIDER: I recently had an apnea [ http://en.wikipedia.org/wiki/Apnea ] diagnosis, demonstrated in a sleep test where I jerked awake from complex dream to adrenal alertness, not returning to sleep... the record showed I had not breathed for 50 seconds. This produces hypoxia, depriving brain and muscle everywhere of life and energy. We return to breathing and life with massive release of adrenalin which I am sure can trigger pf (adrenalin says 'go', muscles say 'where?'). What causes the apnea? Lots of things, but a sleep mask, though annoying, has given me sleep as not for a long time.

hope these thoughts help! :-)

Think about stress and pain in context of thinking of energy, disruption and friction, physiological and psychological (my cells carry no textbook to tell the difference).

Anonymous said...

Thanks for your comments and the discussion - this is very useful. I'm 48 now, and have suffered for around 20 years, not often, maybe 5 to 6 times a year, but nasty! Start relatively slow, then grow to real pain where I can't stay still, I go shivery, teeth chatter, extremely sensitive feet and penis (yes, I am male). Mine come on often after sex, and I am pretty sure it is compression of the nerves in the sacral area that set off some form of spasm in the anal sphincter. They once got set off by doing stomach curls. I have applied the rule that if you have muscle spasms, press hard on the muscle area for around 10 seconds (so a physio friend told me). When I get these now, I lubricate my anus, stick my finger up there, find the spasming bit on the sphincter and press quite hard to break the muscle spasm. Not nice, hurts, but stops the spasm for me. Hope that's of some use.

Anonymous said...

I have had this for about 2 years now, I never knew what it was called until tonight, I have never been to my doc (cause to be honest I don't want anyone near there) but I'm so glad I found this blog, I am only 24/f, and I can't believe the pain and discomfort this causes it makes me feel like plummeting my head through a wall, I do find relief through applying pressure but not for long, I haven't ever found a remedy that makes it completely dissappear, I'm just thankful that I don't get it as often as some people I have read here, its also a relief to know that its more common than i thought, I do hope that eventually something will be found to cure it, cause I don't think I could have these the rest of my life :(

Anonymous said...

Hey, anonymous Jan 12, do look at this
and consider a little calcium - apart from tablets, a not-too-long bath with a handful of Epsom Salts (magnesium sulphate) and several spoons full of sodium bicarbonate (baking soda) may be very helpful, can't hurt (unless you get the Epsom Salts in the eye, a bit stinging) or if very tired and you stay in the bath a long time and get more tired. It's sort of a (good) form of exercise in itself if you are not fit.

Anonymous said...

I've been experienced this kind of pain since I was a child, now I'm 46, always at night and most of the times around 3.30 AM. recently I've found that taking a few homeopathic globes of phytolacca decandra works for me, the pain is gone in a few minutes and I can go back to sleep. hot bidet or applying a hot water bottle to the area soothes the pain, too.

Anonymous said...

Have had it for years. Two Aleve gel caps as quick as possible....best remedy yet for me. My mom had it....i have it and now my grown son has it. Why would it be hereditary? I hate it.

Anonymous said...

I'm a 41 yr old woman. My first clear memory of this was age 12 approximately while sitting on a tennis court. I think the pain has gotten worse with age. I never had a name for it (even though I tried online research before) until today when I went for colonoscopy screening. After googling it now I am seeing conflicting and inconsistent descriptions, however this blog so far fits my experience best. (most of the health publications indicate the pain is only for a few minutes.... left sided.... mostly men... or mostly women.... or mostly age 45...). There is not much of a pattern for me although a couple times after or while exercising it began (the dull pain quickly leading to the severe pain). So I have thought that being dehydrated had someting to do with it. The pain has happened while sleeping. The pain has happened after sex. The pain has happened after bowel movement. I have fainted several times from this. I went to a dr years ago and explained this and was not given any diagnosis. (he probably thought it was a woman's issue brought on by stress). When the pain hits I HAVE to lie on my stomach (quickly or else I will faint). In the short time before I have to do that, I try to grab an ice pack (even a popsicle!) and some ibuprofen or pain pill (vicodin). I find the pain so severe that I have to moan out loud and that helps me deal with the pain. I am going to try the KY lube daily as someone posted here to see how that works. And I may also try the potassium tablets. It would be great to never experience the pain again.

Jessica said...

I'm typing this after an attack. In fact, my butt still hurts a bit. I've suffered for this for a few years and was scared it was cancer at first, making me afraid to say anything. After searching it online I found it wasn't so deadly, but still very painful. Then I found this blog and thread.

For me the pain is not stabbing but an intense ache that has me curling in fetal position for relief. I can feek my rectum spasming as well, but the pain is located farther up. The first few attacks I found myself on the toilet thinking it was a bad bowl movement. The spasms are tricky like that. I never managed to pass anything. The pain made my breathing laboured and brought tears to my eyes. I always kept quiet, though, as to not wake anyone.

My attacks generally last about 30 minutes to 1 hour. This one lasted about an hour. I can feel them coming on for a few minutes beforehand, unless it's one of the instances when the pain wakes me up, and feel them ease off. Aferward I am drained and tired.

The attacks were more frequent before. I have had them during the day but the seem to come mostly at night. I have woken up from the pain. I seem to get the attacks moatly as I am just laying down to sleep. There seems to be no foods or activities that trigger attacks. They just come a few times a year. I do have a history of constipation, though.

I have found pacing to help as well as a hot water bottle. Applying pressure just where the buttcrack ends helps immediately, but as soon as I let go the pain returns. What I always end up doing is pacing and then laying on the couch so my butt faces the back. This allows me to smash the hot water bottle between myself and the couch. I have tried sitting on hot water bottles, but it exploded once giving me burns on my butt. Not at all better.

I plan to try potassium. Marijuanna is my second choice, but I have hward potassium helps with muscle cramos and spasms, which is thought to be the cause of PF. I do not want to go to a doctor as there is no cure.

Anonymous said...

I think that it may be the whole banana (and other fruit) rather than just potassium that's of value. Irritable bowel, as with that constipation, needs help by increased moisture and healthy fibre. As well as pain management we need to reduce risk of cramp by reducing exhaustion. I have had chronic fatigue for a long time and an attack of pfg is a clear sign my system is exhausted. Probably most industrially produced food is lacking enough magnesium so the Epsom Salts bath, a handful of that plus a bit less baking soda, after exercise, should reduce risk...if you can rest after that exercise. That works for me and is system correcting not just pain opposing.

Anonymous said...

Hello all fellow sufferers! I am a 32 year old male and I've been suffering from this from the age of 17. It's relieving to hear that other people are going through it and that it's nothing sinister developing, although I sort of knew this after about 10 years due to the longevity of it. During that time I saw my GP who said he didn't know what it was which also I found strangely comforting.
I just wanted to share my experiences of it with people who understand what I am going through.
Like a lot of people have said it mainly comes at night and wakes me up from a deep sleep. I have tried working out why and when it will happen, I have looked at diet but nothing stands out. I can go 2/3 months without getting any attacks at all then have up to 7 or 8 of them within the next few months. Sporadic is not the word!!
Some are mild in pain and others have had me rolling around, curled up, rocking back and forth, clammy and sweaty, feeling I'm going to pass out and swearing out loudly to myself. It really can be excruciating.
Also like others I have noticed that it can come on after erections or ejaculation but that is not the only time. Other times I know I am going to get it soon because of how my bowels act/feel. I can sometimes get very foul smelling gas (sorry, I know it's gross!) and know it will come on at some point. This is confusing to me because I have always felt it was muscular. Having said that I have stopped trying to work out what causes it now and just do this every time it comes on;
Straight away I get up out of bed and take ibuprofen and drink a lot of water with them. I then sit on my couch, not in any particular position and actively take my mind away from the pain. By this I mean do a crossword or play an app on my smart phone, read......anything that requires concentration and takes focus away from it. Passing gas seems to help but obviously not something you can force.....much!
The banana/potassium is something I will definitely try as a prevention. Also the apnea comment was interesting to me as this is something I am sure I get too.
Like someone else said I am not afraid of it anymore and when it comes I brace myself, go through my little routine and wait for it to pass.
Good luck!

Susan Cathro said...

I have Irritable Bowel and this lovely PF thing. I started taking "Align" probiotic several months ago because someone recommended it for IBS. Since then I've noticed that it's decreased the frequency and severity of FP episodes! Helped some with other IBS symptoms, too. Anyhoo.. just wanted to pass the info along! :)

Anonymous said...

Hubby has this problem. Very interested in the issue of low potassium. You may want to consider low magnesium as well?
This site (ods.od.nih.gov) has some good info including the following:
Symptomatic magnesium deficiency due to low dietary intake in otherwise-healthy people is uncommon because the kidneys limit urinary excretion of this mineral [3]. However, habitually low intakes or excessive losses of magnesium due to certain health conditions, chronic alcoholism, and/or the use of certain medications can lead to magnesium deficiency.

Early signs of magnesium deficiency include loss of appetite, nausea, vomiting, fatigue, and weakness. As magnesium deficiency worsens, numbness, tingling, muscle contractions and cramps, seizures, personality changes, abnormal heart rhythms, and coronary spasms can occur [1,2]. Severe magnesium deficiency can result in hypocalcemia or hypokalemia (low serum calcium or potassium levels, respectively) because mineral homeostasis is disrupted [2].

For those who cannot see a particular link to diet or things you may have done to trigger an attack, don't forget simple things like not having access to fresh fruit or vegetables in a particular season (do you have bananas in summer but not in winter). Also when your body is under a particular stress (work, heavy labour, excess excercise, other medical issues) It may be using more vitamins and minerals than your consuming, so consider taking extra vitamins or having extra healthy food. Don't forget to come back and let others know if you have tried something different and it is working!!

Anonymous said...

Glad I just found this blog. I'm 61, male, and have had this about 15 years, about 4 or 5 times a year; the first time I thought I was dying of something nasty and it felt like I was trying to pass a brick. I figured out its name a while ago and asked my GP about it who had not heard of it. I do use the inhaler as soon as I feel one starting (usually randomly in the middle of the night, a few times after sex or bowel movement but mostly random). I find the inhaler decreases the pain over what it was before I started using it but can't be sure that's really what's working. Last night I had an episode and took 3 hits of the inhaler and it didn't seem to work as well so I took a klonopin which I use sometimes for sleep and I did fall asleep. I will try the potassium and maybe the pot (haven't done that in years!). Good luck to everyone with PF.

Anonymous said...

I think it's useful to keep focus on cramp as a local energy deficit. Analgesia (how funny a word in this context!) may offer relief but not reduce the problem. Diet with fibre, with less alcohol, more fluid, can help but no amount of fluid or fibre can suffice if the muscles responsible for peristalsis are exhausted. Magnesium most valuable, in Epsom Salts bath with bicarb is good. But in general connect thinking on this with whether at night your system gets the recovery from exhaustion of the day (catabolic-anabolic cycle).

In the last year I have learned I have sleep apnea and though I hate the CPAP machine I not only wake more refreshed but my digestive tract works.

That may not be your situation but indicative of my preference for systemic rather than masking. Klonopin can muddle and habituate. Take care!

Shuzzbot said...

Yep a Mack truck out the arse is the best description. I've fainted twice from this however believe this is associated with a drop in blood pressure as opposed to just pain. Occurrence every couple of months associated with constipation or harder bowel movement in the evening. So see the merit in the fruit and potassium recommendations. I've found insertion of finger and pressure inside the anus works, sounds drastic but nothing compared to the pain. Also, as the episodes last about an hour take oxycodone - obviously not a solution for regular sufferers but thankfully my doctor has a thorough understanding of the condition

Khan said...

Stopped drinking coffee regularly and it almost stopped PF except when occasionally I drank coffee it happened again within 1-2 day. It also has some relation with IBS and sex as mentioned in the blog. When it is mild i tried diverting mind by reading and it went away within 3 minutes. When severe I tried a pinch of salt and it went away in a minute. It didn't work next time so I tried munching/licking few things having strong taste (cardamom whole, orange, etc.) that worked within 2-3 minutes. This last thing works with me perfectly with a precaution of avoiding coffee. Also I don't drink alcohol and smoke cigarette. I don't want to take medicine.

Anonymous said...

Guess what I experienced just before finding this blog post!

It woke me up. I sat on the toilet and, of course, nothing. Over the next 30-60 minutes the pain just subsided on its own.

Male, 39, fit & active, healthy vegan diet with lots of whole foods. No drugs, no meds, no alcohol. I normally have a large/huge poop once a day when I wake up, and I'm in and out of the bathroom in 3-5 minutes - including paperwork ;)

For me, this PF thing is like suddenly having a potato shoved up my ass. I've experienced it a few times a year over the last few years, but this is the first time it's happened in 6+ months.

For the last few weeks I've been eating 10-30 bananas a day (as part of a detox diet) so potassium/fibre isn't lacking.

The only thing that's really different is that it's been 2-3 weeks since I've done my regular yoga workout, which includes inversions (headstands and such). I've been doing the yoga for years, but only doing the inversions regularly for 6-12 months, except for the last few weeks. I wonder if a few minutes a day of being upside-down has been preventing this pain in the ass...?

Time to work on my Sirsasana and Mūla Bandha :)

Anonymous said...

HI all I get PF and have done since I stopped taking the pill in 2007. For me it has got slightly more bearable over time initially it was 45-60 minutes of sheer agony, on bathroom floor doubled up just waiting for it to go. It quite honestly for me was like someone was jamming a red hot poker up my rear end. Pain in rectum and shooting into stomach it was horrible. No other way to describe it. Mine is cycle related as I started writing down when it happened and turned out to always be on the night of cycle day 12, so can only assume it is ovulation related for me. Have learned one trick to help the pain and that is sit in a basin of hot water (as hot as you can stand) that seems to relax the muscles enough to stop the pain. I also read somewhere that a man used to use a syringe type thing and inject hot water up his rear end that stops the pain. Apparently it is a severe muscle cramp internally. HOpe this helps someone although there seems to be many various reasons why people get this.

Dennis said...

Very interesting. That would be coinciding with a spike in estrogen, which triggers ovulation. The corpus luteum product of ovulation releases progesterone which is the source of comfort and relief.

I guess you have something of a 'rhythm method' http://en.wikipedia.org/wiki/Calendar-based_contraceptive_methods#Rhythm_method_.28Knaus.E2.80.93Ogino_method.29 possible, but it's an unpleasant way to be given the timetsble. Mind you PF is generally post exercise, thus for men notably post-orgasmic experience, which is no great pleasure!

You may want to plan to reduce heavy exercise around that time you might expect PF.

This is perhaps the best advice on progesterone v estrogen

Also use Ray's search box, left of that page.

In discussion of use and dosage, Ray is referring to the product he developed but does not promote, detesting commercial advice on the web... search for Progest-E.

Anonymous said...

I have severe proctalgia fugax & it feels like being ass raped by a jagged machete!!

Ive been using cannabis for 2 years now & i find it has completely stopped it, however if i dont medicate then i start getting mild pains within a day, severe pains after 18+ hours if i dont smoke a j. It also helps with other conditions i have, so for me its great as it is 1 non nauseating medicine rather than lots of pills n potions!

Anonymous said...

What I gather from all of these comments is:

stay hydrated
low stress
being sedentary makes it worse
eat an early dinner
increase uptake of magnesium, potassium, and fiber
consider eliminating corn, coffee, beef, spicy things, dairy
lubricate anus with ky jelly before bed
"Align" probiotic

TREATMENTS during an attack:
hot water bath/sitz bath
drink lots of water
ice cubes!
applying pressure by sitting on tennis ball, chair, pulling butt up, massage, etc
albuterol inhaler
tucking legs to chest
using a tampon or hemorrhoid cream applicator to apply internal pressure
smoking pot
homeopathic leg cramp pills
homeopathich phytolacca decandra
smoke a cigarette
nerve tonic/leg cramp med with quinine
warm water enema
other analgesic drugs

too bad I'm allergic to bananas!

I personally find it to be a problem when I am really sedentary, after sex/masturbation, and when I am not well hydrated. I'm only 28.

Anonymous said...

prev comment 04092014 - nearly a year since hubby had this issue. He has been keeping magnesium levels up. Had not taken magnesium for 4 days (although having said that there were are periods in the past year where he had not been having his magnesium regularly). Thinks he sat down more than usual during the day. Cannot pin the problem to anything in particular. Will try and make sure he has his magnesium more regularly and will post within a year.

Anonymous said...

I've dealt with this pain on and off again for about 25 years. I never knew what it was until I did some research online. Even then it took me years to pinpoint it and put a name with it. I always attributed these early morning attacks to possibly food poisoning. December 2013 was by far THE WORST attack yet. It woke me up at about 4:30 a.m. I had a dull pain in my rectum. I thought," here I go again." As I got out of bed the pain got intense x 10. By the time I got to the bathroom it was unbearable. I sat on the toilet and began sweating profusely. My t-shirt was soaking wet. Then I got tunnel vision and a feeling of nausea with diarrhea. The pain was so intense, I just knew I was going to die that morning. I couldn't get comfortable. I stood up and that was it. BAM! I hit the floor. All 6'6" 235 lbs. of me. Passed out. I woke up trying to figure out where I was. I got up again and, BAM! Passed out again. This time I cracked my forehead on something. I made it back to my bed somehow and went to sleep. BTW I've never passed out in my life until that morning. When I got up a few hours later to survey the damage, I looked in the mirror and there was a scab down the middle of my forehead, a hole in the drywall, the bathroom door almost off the hinges and my left hand swollen. If someone had told me that by sticking an icepick through my arm or putting my hand in an aquarium with an eastern diamondback rattlesnake would have stopped that pain, I would have done it. I hope I never have an attack with that level of pain again. My middle finger and ring finger still hurt 7 months later. Maybe ligament damage. I think for me running has something to do with it. Because not long after I began running I started having PF. All I know is I ate a salad late that afternoon and then went running. I'm almost scared to run anymore after that. Maybe I'll try the potassium pills that someone mentioned in a previous post.

Anonymous said...

Well, I'm glad you didn't have the rattlesnake on hand, or on any other part of anatomy!

I had another round of this thing early this year. In combination with other stuff, mad headaches, tinnitus, vertigo, and gut madness on a weekly cycle.

Solved it, hopefully properly now.

Firstly the focus - on what's gone wrong rather than which pill.

It's clearly associated with a breakdown of sense in the peristaltic contractions that should send stuff through the gut smoothly. Exhaustion plays a role and it's evident that if you then try to get some muscles to work (the other writer's male ejaculation, or straining to empty the bowel) you set off hell, or I've too often set off my hell.

So there's need for the gut not to be exhausted. And the autonomic nervous system wired up too crazily.

I found out with a blood test that I had very low vitamin D, and it seems most of the world has that problem these days, especially those working indoors or obeying the cancer squads' advice to stay out of the sun. So since March I've been taking 4000iu of vitamin D a day. Search the web, the best advice seems to be that 10,000iu a day for three months may get levels too high. Like vitamin A and vitamin E, it's oil soluble, so not lost like other vitamins in urine. Anyway, read up on that. Taking vitamin D has reduced my sensitivity to heat and cold and pain and made the whole system run a bit better.
A rheumatologist recommended, since I thought I was eating too much of it, that I get bread and other wheat items out of my diet. This has, literally, reduced the crap in my system, and my gut runs better... lost about ten pounds (4kg) in a month. Not so much to try to find its way through the gut.

I also read up on Buscopan (hyoscine, scopalomine) sold in Australia for irritable bowel, spastic colon etc... but I think struck off by the FDA in the US for the wondrous reason that the drug companies don't want to make it any more, not profitable. Buscopan opposes the neurotransmitter acetylcholine, which has a lot of autonomic nervous system responsibilities. Yes it causes cramp, but also reduces blood pressure so be careful about what follows if you have a high blood pressure history. What interested me was that in reporting to doctor stressed out with all that mess of symptoms earlier in the year, my 70 year old heart was chugging out blood pressure like a teenager, 115/78. Aha, I thought, the acetylcholine working overtime here. So I took minimal doses of Buscopan, 10mg a day, and have more or less continued that since March. It's worked, no more alternation of constipation and violent clearance, no more proctalgiafugax.

Then, reading on, I discover some new research about acetylcholine, stress and the immune system.... http://www.jleukbio.org/content/88/2/263.abstract

Now I have a history in recent years of catching every virus and converting it into a secondary bacterial infection... and I'm wondering if this is connected to the gut problem, the cramp problem the absolutely crap problem. So I'm continuing with not everyday doses of the Buscopan to see whether I'm breaking out of the pattern of constant infection. Time will tell.

A Chinese doctor once said to me "you must save half your chi (energy) for yourself, for your own system"... good advice, and I'd suggest this pf problem is a very big signal of failure to do that.

Anonymous said...

Hi, I have been experiencing pf for around 12 years now. I am female and 45 years of age. I first started with it when I came off the pill, in order to have a baby. At first I thought it was some sort of symptom of constipation, although I have never been constipated in my life! Strangely, I never got it whilst pregnant or breast feeding that I can remember. Went back on the mini pill and it started again, but more intermitent. Then got diagnosed with a genetic disorder that means my cholesterol is sky high, nothing to do with lifestyle. Now on heart attack strength statins! Pf has got 10x worse! Now much more frequent and more painful. Attacks happen at any time, but mostly at night. Wake up with a start as soon as it revs up, and its 'here we go again' get up, take fast acting painkillers and then sit on the loo, bent double, bearing down and just wait until it's over. Can't do much else, like run a bath etc as don't want to wake small child. Last night it lasted almost an hour. I'm now sat at my desk feeling very sore indeed and feeling as though I may have another episode before I leave. Shall I chance it or not?! If it happens in a public place it is soooo embarassing, apparently I go very white and look as though I am going to pass out. I sometimes feel I am going to pass out! At work I have to take myself off to a 'quiet' loo and sit there for 1/2 hour hoping no one knocks or notices I am missing! Took potassium and iron tonic for around a month and didn't get any symptoms, but hen again I can go a couple of months without an attack. The advice re exhausted muscles is interesting as my posture is pretty poor and my core muscles none existent! I have noticed certain things can bring it on eg after a No 2, or after sex, but mostly I can't tie it down to anything specific. I believe it may be genetic as my father gets it on and off, but that being the case it can't be down to women's 'problems'. As with other's experiences, my doctor had no idea what it was and sent me for a scan of my women's bits, which of course proved to be a waste of time. I then came across this blog and then did some more research on line and took him the details. He'd never come across it before, but he knows now! Feel comforted by the fact that I am not going to die from it, although the pain of it, I sometimes think I am!!! Now resigned to the fact that I probably will have it on and off for the rest of my life. Hey ho there are much, much worse things that can happen....

Dennis Argall said...

We are all or mostly anonymous.... I'm a frequent anonymous, the one talking about energy.

I want to make nor particular recommendation to the young mother who just wrote. Please avoid trying to flex that sphincter muscle when cramped! Simplest recommendation: have a flat heat pad nearby that can be heated in microwave for a couple of minutes, then sit relaxed as possible or lie in foetal position with it for as long as necessary. Be careful with breathing. Ensure god steady breaths, in meditative way, for the brain to calm and to ensure you don't hyperventilate. When you can, have warm bath for short time, or bottom bath in toddler pond if no bath, with Epsom Salts (handful) and Baking Soda (half as much) both for the warmth comfort and because the magnesium and the bicarbonate both restore energy via clear biochemical processes. Also look at Ray Peats writing, perhaps start here:

I have no commercial interest, just practical results for myself. I don't think it's necessarily genetic if shared with parent. We pick up energy habits, we have had same diets, same stressors, etc... Stay with thinking about life experience and bodily inputs and outputs rather than a package planted like a bomb.

Regarding breathing, read about


But note that where the article is negative no drug company is going to support research into something that can't be sold in a pill, so it will always be lacking in the support that conventional medicine demands.

So read this too.


Also use Rays search box there for the word pregnancy for lots of valuable reading.

and make own decisions, shape own lifestyle. No doctor has ever understood or dealt with PF for me, it can't be fixed with a tablet while sitting down.

Jim said...

I've been getting several attacks of Proctalgia Fugax per year, almost always at night.
I stumbled on a way of making the attack stop every time. It's really simple.
I make a fist, reach around and sort of punch my anus with my knuckles. Not too hard but just hard enough to send a shock wave up the colon. I punch at different intervals in order to interrupt the spasms.
I normally punch about 20 -25 times. And that's it. It just stops.

I began using this method several years ago and I've been able to stop every attack since.
I sure hope it works for you too.

"Sue" said...

I'm a fairly healthy, albeit somewhat overweight, 44yo female. I had my first episode of PF about 10 years ago. It happens maybe 5-8 times a year, usually at night. I mentioned it to my doctor during an appointment about something else. He printed out some information I already knew.
I usually just sit on the toilet and bear down as if trying to pass a bowel movement. That, and/or kneeling on the floor and bending down with my face almost on the floor. This helps stretch that area. Just relaxing with some deep breaths helps me and it's over in about 20 minutes.
Episodes after sex or masturbation don't happen just to males though. I've experienced it after self-pleasure so I don't do that anymore. And I had an erotic dream the other morning and woke up to first to an orgasm followed immediately by an episode of PF. :(
I've tried an inhaler but maybe it was the wrong medication.
I'm not willing to try marijuana as I don't want to get high...and the stuff stinks anyway. Maybe if they ever come up with an odor-free medical variety that won't make me high, I'd be willing to try.
When I was pregnant, I would get horrible charlie horses in the middle of the night. A daily banana helped stop that so I'm gonna go that route again in hopes that it's all I need to prevent episodes of PF.

Anonymous said...

So reasuring to know that there are lots of people out there who are in the same positiin as me.
I can't remember the first time I suffered an at attack probably early teens, some mild lasting a few mins, some excruciatingly painful.
Picked up a few ideas to try, thanks:)

Anonymous said...

I have this problem sometimes several times a week. Sometimes out in public where none of the remedies mentioned would be feasible remedies. What works within minutes for me is to sit on a hard chair, slightly rotated back to where I can feel the pressure on the correct spot, grab the bootom of the chair seat and pull my body into the chair seat for 10 second intervals. Rease and do it again. I get relief within minutes!! If it is too bad, I sit on the tennis ball on a softer cushioned chair. Never ever sit on the toilet! It makes it so much worse. You want pressure for relief. Try it!

Anonymous said...

Question for my fellow sufferers -
Does anyone else get pain in one or both of their feet during an attack? I get pain in my left foot slightly prior to and during an attack. I can usually tell by my foot rather than my bottom when it is starting to subside.

Anonymous said...

Glad i am not the only human with such a weird problem on the earth.
I just came to know today the name of my problem.
I had a mild episode today's afternoon. It begins after i masturbate lying on the bed straight.
I tried to keep myself calm and sit cross legs. It help in subsiding the pain in less then 15-20 min much faster than my previous episodes.
Previously it took up to an hour.
What i felt is that it happens whenever i masturbate intentionally or unintentionally(night fall)
It happens more whenever i masturbate in the bed. Masturbating in standing position helps a bit.
I tried the drinking water trick myself without any net suggestion and it subsides the pain in less than 30 mins
Also i suggest to masturbate very calmly. Do not let it go over your head.
Make it very slow.
I will try to eat banana and drink a lot of water .
Hope the next episode comes after infinite time.
Note: I also have a problem of hemorrhoids. I am just 22 years male.
Hope this problem will not ruin my marriage life in the future.
If anybody has any suggestion , please reply as my doctor is not finding it as a problem. He says, there is nothing like that.
Sometimes i get relief after passing gas which passes automatically . I do not force it.
Last suggestion: Never try to sit on the toilet and excrete during episode
I tried once and my toilet bowl was full of blood from my ass and it was fucking painful.
I think this happens due to high blood pressure in the anal canal which creating pressure in the ass and which burst some hemorrhoid in urge to loo.

Anonymous said...

Heating pads and hot baths Tylenol does not work for me and as I have ulcerative colitis I can't take any nsaids I've found that rolling around in a hot bath will release gas the only prob is with the colitis it can get a bit messy my Dr prescribed hyocyamine and it helps a little take some of the edge out and I wish my episodes only lasted 30 min I've had a 2 hr episode and right now I'm goin on an hour and a half